Celiprolol tablets will no longer be available in New Zealand once current supplies are exhausted. See the notification from PHARMAC here.
Celiprolol is a beta-blocker approved to treat hypertension and angina. For patients currently taking celiprolol, either:
1. Replace with an alternative beta-blocker:
- In most cases, we suggest the prescriber chooses the beta-blocker they are most familiar with, if it is appropriate for the individual patient.
- A direct switch to the new beta-blocker is reasonable, using the recommended dose for the patient’s indication. Titrate the dose if necessary according to heart rate, disease symptoms or any adverse effects.
- Theoretically celiprolol has intrinsic sympathomimetic activity (ISA), but any clinical value of this is theoretical and not well-substantiated. Pindolol is the only other funded beta-blocker with ISA, but there is no advantage in using this over the other options.
2. Stop the beta blocker:
- Taper celiprolol slowly as sudden withdrawal can cause rebound tachycardia, hypertension and angina.
- A general guide is to halve the dose for a week or a month, then halve again for another week or month, then stop.
- Introduce an alternative antihypertensive or antianginal from a different class if necessary, depending on the individual patient.
BPAC has published an article on beta-blockers, which includes the different pharmacological properties of those subsidised in New Zealand.
Health professionals are welcome to contact our service for more specific advice on individual patients.