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Risk Factors:

Pregnancy: Risk cannot be ruled out. Lactation: Caution advised or effect undetermined. Contraindications: 2nd or 3rd degree AV block (without pacemaker) severe bradycardia sick sinus syndrome uncontrolled heart failure cardiogenic shock severe peripheral arterial disease hypotension meTabletolic acidosis untreated pheochromocytoma severe asthma or COPD.

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Indications:

Indications
Angina. Hypertension.

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Adverse Effects:

Cardiovascular effects including bradycardia postural hypotension. Rarely heart failure increased AV block cardiac arrhythmias. Raynaud's phenomenon cold
extremities sexual dysfunction. GI sleep and CNS disturbances. Dyspnoea rarely bronchospasm. Skin reactions withdraw if unexplained dry e1 or rash. Fatigue
paraesthesia peripheral neuropathy arthralgia myopathy altered blood sugar haematology and lipid levels.

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Don’t Use:

Precautions: 1st degree AV block. Heart failure (avoid if uncontrolled). Peripheral arterial circulatory disorders (avoid if severe) Prinzmetal's angina Myasthaenia
gravis. Ischaemic heart disease withdraw gradually. History of bronchospasm. Diabetes hyperthyroidism renal or hepatic impairment psoriasis. Elderly. Consider
withdrawal before elective surgery. Anaphylaxis risk due to increased sensitivity to allergens. Always withdraw gradually over period of 1-2 weeks.