Celiprolol: Uses, Dosage, Side Effects & Warnings | DrugsAtlas
Authoritative Clinical Reference
DRUG NAME: Celiprolol
Therapeutic Class: Antihypertensive
Subclass: β1-selective Beta-blocker with Partial β2 Agonist Activity
Specialty: Cardiology
Schedule (India): Schedule H
Route(s): Oral
Formulations Available in India:
• Tablets: 200 mg, 400 mg
• Tablets: 200 mg, 400 mg
INDICATIONS + DOSING — FOR CLINICIAN USE ONLY
Primary Indications (Approved / Standard in India)
| Indication | Starting Dose | Titration | Maintenance Dose | Maximum Dose | Clinical Notes |
| Essential Hypertension | 200 mg once daily | Increase to 400 mg once daily after 2–4 weeks if inadequate response | 200–400 mg once daily | 400 mg once daily | Administer on empty stomach (≥30 min before meals); taper gradually before discontinuation, particularly in ischaemic heart disease |
| Stable Angina Pectoris (mild to moderate) | 200 mg once daily | Increase to 400 mg once daily if clinically indicated | 200–400 mg once daily | 400 mg once daily | Not first-line for angina; consider in patients with concurrent bronchospastic airway disease requiring beta-blocker therapy |
Secondary Indications — Adults (Off-label, if any)
| Indication | Dose | Duration | Notes | Evidence |
| Vascular Ehlers-Danlos Syndrome (vEDS) — OFF-LABEL | 400 mg once daily | Long-term | Specialist only; requires confirmed genetic diagnosis and multidisciplinary management (cardiology/genetics) | French RCT (Boutouyrie et al.) demonstrated reduction in arterial events; limited data; not standard practice in India |
PAEDIATRIC DOSING (Specialist Only)
Primary Indications:
• NOT APPROVED for any indication in children in India
• No paediatric formulations available
• NOT APPROVED for any indication in children in India
• No paediatric formulations available
Secondary Indications — Paediatrics (Off-label, if any):
• NOT RECOMMENDED in children
• Insufficient safety and efficacy data
• No established Indian practice consensus
• Use only under specialist supervision in exceptional circumstances
• NOT RECOMMENDED in children
• Insufficient safety and efficacy data
• No established Indian practice consensus
• Use only under specialist supervision in exceptional circumstances
RENAL ADJUSTMENT
| Renal Function | Recommendation |
| Mild impairment (eGFR 60–89 mL/min) | No dose adjustment required |
| Moderate impairment (eGFR 30–59 mL/min) | No dose adjustment required |
| Severe impairment (eGFR <30 mL/min) | Initiate at 200 mg once daily; monitor blood pressure and heart rate closely |
| Haemodialysis | Not significantly dialysable; no supplemental dose required |
HEPATIC ADJUSTMENT
| Child-Pugh Class | Recommendation |
| Class A (Mild) | No dose adjustment required |
| Class B (Moderate) | Initiate at 200 mg once daily; monitor for hypotension and bradycardia |
| Class C (Severe) | Avoid use — impaired hepatic metabolism leads to unpredictable drug effects |
CONTRAINDICATIONS
• Sinus bradycardia (<50 beats per minute)
• Second-degree or third-degree atrioventricular block (without pacemaker)
• Acute decompensated heart failure
• Cardiogenic shock
• Severe peripheral arterial occlusive disease
• Active bronchospasm or recent status asthmaticus
• Hypersensitivity to celiprolol or any beta-blocker
• Second-degree or third-degree atrioventricular block (without pacemaker)
• Acute decompensated heart failure
• Cardiogenic shock
• Severe peripheral arterial occlusive disease
• Active bronchospasm or recent status asthmaticus
• Hypersensitivity to celiprolol or any beta-blocker
CAUTIONS
• Controlled bronchospastic airway disease — use only when benefit exceeds risk; partial β2 agonism offers relative safety
• Diabetes mellitus — may mask autonomic signs of hypoglycaemia
• First-degree AV block — monitor for progression
• Psoriasis — potential exacerbation with beta-blockers
• Pheochromocytoma — use only after adequate alpha-blockade
• Myasthenia gravis — may worsen muscle weakness
• Abrupt discontinuation — taper over 1–2 weeks to prevent rebound tachycardia, hypertension, or angina exacerbation
• Diabetes mellitus — may mask autonomic signs of hypoglycaemia
• First-degree AV block — monitor for progression
• Psoriasis — potential exacerbation with beta-blockers
• Pheochromocytoma — use only after adequate alpha-blockade
• Myasthenia gravis — may worsen muscle weakness
• Abrupt discontinuation — taper over 1–2 weeks to prevent rebound tachycardia, hypertension, or angina exacerbation
PREGNANCY
| Parameter | Details |
| Risk summary | Limited human data; animal studies suggest relatively low risk |
| Preferred alternatives | Labetalol, methyldopa |
| When may be used | Only if benefit outweighs risk; under obstetric cardiology supervision |
| Monitoring | Maternal blood pressure; fetal growth (beta-blockers associated with IUGR); neonatal bradycardia and hypoglycaemia |
LACTATION
| Parameter | Details |
| Compatibility | Likely compatible — minimal excretion into breast milk |
| Preferred alternatives | Labetalol if beta-blocker required |
| Drug level in milk | Low |
| Infant monitoring | Bradycardia, poor feeding, inadequate weight gain |
ELDERLY
• Starting dose: 200 mg once daily
• Titration: Slower increments over 3–4 week intervals preferred
• Special considerations:
• Titration: Slower increments over 3–4 week intervals preferred
• Special considerations:
- Increased susceptibility to orthostatic hypotension
- Greater risk of bradycardia and conduction disturbances
- Reduced hepatic and renal reserve may prolong drug effects
- Fall risk assessment advised
MAJOR DRUG INTERACTIONS
| Interacting Drug | Effect | Recommendation |
| Verapamil, Diltiazem | Severe bradycardia, AV block, myocardial depression | Avoid combination |
| Class I antiarrhythmics (disopyramide, quinidine) | Additive negative inotropy and conduction delay | Avoid combination |
| Clonidine | Rebound hypertensive crisis on clonidine withdrawal | Discontinue celiprolol first; then taper clonidine |
| MAO inhibitors | Potential hypertensive crisis | Avoid concurrent use |
MODERATE DRUG INTERACTIONS
| Interacting Drug | Effect | Recommendation |
| ACE inhibitors, ARBs, diuretics | Additive hypotensive effect | Monitor blood pressure |
| NSAIDs | Attenuation of antihypertensive efficacy | Monitor blood pressure; consider alternatives |
| CYP2D6 inhibitors (fluoxetine, paroxetine) | Potential increase in celiprolol levels | Monitor clinical response |
| Insulin, sulfonylureas | Masking of hypoglycaemic symptoms (tachycardia, tremor) | Counsel diabetic patients; monitor glucose closely |
| Digoxin | Additive bradycardia | Monitor heart rate |
COMMON ADVERSE EFFECTS
• Headache
• Fatigue
• Dizziness
• Gastrointestinal disturbances (nausea, dyspepsia)
• Palpitations (related to partial β2 agonist activity)
• Cold extremities
• Fatigue
• Dizziness
• Gastrointestinal disturbances (nausea, dyspepsia)
• Palpitations (related to partial β2 agonist activity)
• Cold extremities
SERIOUS ADVERSE EFFECTS
• Symptomatic bradycardia requiring intervention
• Bronchospasm (particularly in susceptible patients)
• Worsening or precipitation of heart failure
• Severe hypotension
• High-grade AV block
• Skin reactions (rare)
• Peripheral vasospasm (Raynaud’s phenomenon) — rare
• Bronchospasm (particularly in susceptible patients)
• Worsening or precipitation of heart failure
• Severe hypotension
• High-grade AV block
• Skin reactions (rare)
• Peripheral vasospasm (Raynaud’s phenomenon) — rare
MONITORING REQUIREMENTS
| Phase | Parameters |
| Baseline | Blood pressure, heart rate, ECG (if cardiac history present), renal and hepatic function |
| After initiation/dose change | Blood pressure and heart rate weekly for 2–4 weeks |
| Long-term | Blood pressure, heart rate, clinical assessment for heart failure signs; periodic renal and hepatic function in elderly or at-risk patients |
BRANDS AVAILABLE IN INDIA
• Cardiatens (400 mg)
• Celol (200 mg, 400 mg)
• Celipro (200 mg, 400 mg)
• Celol (200 mg, 400 mg)
• Celipro (200 mg, 400 mg)
PRICE RANGE (INR)
| Formulation | Approximate Price |
| Tablet 200 mg | ₹10–15 per tablet |
| Tablet 400 mg | ₹18–25 per tablet |
• Not included in NLEM; not under NPPA price control
• Limited availability in government supply chains
• Limited availability in government supply chains
CLINICAL PEARLS
• Partial β2 agonist activity distinguishes celiprolol from other beta-blockers; may offer relative bronchospasm protection in selected patients with airway disease
• Less bradycardic than atenolol or metoprolol — useful in patients with borderline low heart rate
• Bioavailability reduced by food — counsel patients to take on empty stomach, at least 30 minutes before breakfast
• Long elimination half-life supports once-daily administration
• Not routinely preferred for post-myocardial infarction or heart failure — lacks strong outcome evidence in these settings
• Consider alternatives in significant hepatic impairment due to unpredictable metabolism
• Less bradycardic than atenolol or metoprolol — useful in patients with borderline low heart rate
• Bioavailability reduced by food — counsel patients to take on empty stomach, at least 30 minutes before breakfast
• Long elimination half-life supports once-daily administration
• Not routinely preferred for post-myocardial infarction or heart failure — lacks strong outcome evidence in these settings
• Consider alternatives in significant hepatic impairment due to unpredictable metabolism
TAGS
celiprolol; hypertension; beta-blocker; vasodilating beta-blocker; partial β2 agonist; bronchospasm-caution; elderly-suitable; off-label vEDS; non-NLEM
VERSION
RxIndia v1.0 — 28 Feb 2026
REFERENCES
• CDSCO product listings
• Indian Pharmacopoeia / National Formulary of India
• API Textbook of Medicine
• AIIMS Essential Drug List
• ICMR Hypertension Guidelines
• Goodman & Gilman’s The Pharmacological Basis of Therapeutics
• Boutouyrie P et al. — Randomized trial of celiprolol in vascular Ehlers-Danlos syndrome (for off-label indication)
• Indian Pharmacopoeia / National Formulary of India
• API Textbook of Medicine
• AIIMS Essential Drug List
• ICMR Hypertension Guidelines
• Goodman & Gilman’s The Pharmacological Basis of Therapeutics
• Boutouyrie P et al. — Randomized trial of celiprolol in vascular Ehlers-Danlos syndrome (for off-label indication)
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This platform is designed strictly for healthcare professionals. Data provided is synthesized from authoritative pharmacological sources and clinical registries. Do not use for consumer medical decisions. Always verify critical dosing and contraindications with official institutional protocols and peer-reviewed journals.
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