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High Blood Pressure - Merck Supported

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43 Daily Frequency Comments 1 Nebivolol induces nitric oxide-induced vasodilation. Avoid abrupt cessation. 1 Avoid use in patients with reactive airways disease. Avoid abrupt cessation. 2 1 2 Generally avoid, especially in patients with CHD or HF. Avoid abrupt cessation. 1 2 2 Use of carvedilol is preferred in patients with HFrEF. Avoid abrupt cessation. 1 2 1 Do not use in combination with ACEi or ARB. Aliskiren is very long acting. ere is an increased risk of hyperkalemia in CKD or in those on K+ supplements or K+-sparing drugs. Aliskiren may cause acute renal failure in patients with severe bilateral renal artery stenosis. Avoid use in pregnancy. 1 ese are associated with orthostatic hypotension, especially in older adults with a greater BP drop with first dose effect. ese may be considered a second-line agent in patients with symptomatic benign prostatic hypertrophy. 2 or 3 1 or 2 2 ese are generally reserved as last-line choices because of significant CNS adverse effects, especially in older adults. Avoid abrupt discontinuation of clonidine, which may induce hypertensive crisis. Clonidine must be tapered to avoid rebound hypertension. 1 weekly 2 1

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