Tilisolol: Uses, Dosage, Side Effects & Warnings | DrugsAtlas
Authoritative Clinical Reference
DRUG NAME: Tilisolol
Therapeutic Class: Beta-Adrenergic Blocker (Beta-blocker)
Subclass: Cardioselective Beta-1 Blocker
Speciality: Cardiology
Schedule (India): Schedule H
Route(s): Oral
Formulations Available in India:
• Tablet: 5 mg, 10 mg (film-coated)
• Tablet: 5 mg, 10 mg (film-coated)
INDICATIONS + DOSING — FOR CLINICIAN USE ONLY
Primary Indications (Approved / Standard in India)
Hypertension
| Parameter | Recommendation |
| Starting dose | 5 mg once daily |
| Titration | Increase to 10 mg once daily after 1–2 weeks based on BP response |
| Usual maintenance dose | 5–10 mg once daily |
| Maximum dose | 10 mg once daily |
Clinical Notes:
- Generally well tolerated in mild-to-moderate hypertension
- Beta-1 selectivity may permit cautious use in patients with mild-moderate pulmonary disease under close monitoring
Angina Pectoris (Stable)
| Parameter | Recommendation |
| Starting dose | 5 mg once daily |
| Titration | Increase to 10 mg once daily based on symptom control |
| Usual maintenance dose | 5–10 mg once daily |
| Maximum dose | 10 mg once daily |
Secondary Indications — Adults (Off-label, if any)
• Supraventricular Tachycardia (SVT) — OFF-LABEL
- Dose: 5–10 mg once daily
- Duration: As per arrhythmia control plan
- Specialist only
- Evidence: Limited specialist experience; not first-line in India
PAEDIATRIC DOSING (Specialist Only)
Primary Indications (Approved / Standard in India):
NOT RECOMMENDED — Safety and efficacy not established in children below 18 years.
Secondary Indications — Paediatrics (Off-label, if any):
Not applicable — No paediatric off-label use recommended due to lack of Indian data. Not recommended below 18 years of age even under specialist supervision.
RENAL ADJUSTMENT
| eGFR (mL/min/1.73 m²) | Recommendation |
| ≥30 | No dose adjustment required |
| <30 | Use with caution; consider starting at 2.5 mg under specialist guidance |
| Haemodialysis | Insufficient data; specialist supervision required |
HEPATIC ADJUSTMENT
| Severity | Recommendation |
| Mild impairment (Child-Pugh A) | No dose adjustment required |
| Moderate impairment (Child-Pugh B) | Start with 2.5–5 mg once daily; titrate cautiously |
| Severe impairment (Child-Pugh C) | Avoid use; insufficient safety data |
CONTRAINDICATIONS
• Sinus bradycardia (<50 bpm)
• Second- or third-degree AV block (without pacemaker)
• Overt cardiac failure or cardiogenic shock
• Severe bronchial asthma or active bronchospasm
• Hypersensitivity to tilisolol or other beta-blockers
• Sick sinus syndrome (without pacemaker)
• Second- or third-degree AV block (without pacemaker)
• Overt cardiac failure or cardiogenic shock
• Severe bronchial asthma or active bronchospasm
• Hypersensitivity to tilisolol or other beta-blockers
• Sick sinus syndrome (without pacemaker)
CAUTIONS
• Bronchial asthma / COPD — risk of bronchospasm despite beta-1 selectivity
• Diabetes mellitus — may mask hypoglycaemia symptoms (tachycardia, tremor)
• Peripheral vascular disease — may worsen claudication symptoms
• Thyrotoxicosis — may mask tachycardia signs
• First-degree AV block — monitor closely
• Prinzmetal angina — risk of coronary vasospasm
• Avoid abrupt withdrawal — risk of rebound angina, hypertension or arrhythmia; taper over 1–2 weeks
• Diabetes mellitus — may mask hypoglycaemia symptoms (tachycardia, tremor)
• Peripheral vascular disease — may worsen claudication symptoms
• Thyrotoxicosis — may mask tachycardia signs
• First-degree AV block — monitor closely
• Prinzmetal angina — risk of coronary vasospasm
• Avoid abrupt withdrawal — risk of rebound angina, hypertension or arrhythmia; taper over 1–2 weeks
PREGNANCY
| Parameter | Recommendation |
| Risk | Not well studied; theoretically safer due to beta-1 selectivity |
| When to use | Only if benefit clearly outweighs risk |
| Preferred alternatives | Labetalol or methyldopa (as per Indian obstetric practice) |
| Monitoring | Fetal growth restriction, fetal bradycardia, neonatal hypoglycaemia |
LACTATION
| Parameter | Recommendation |
| Compatibility | Limited data; likely minimal transfer into breast milk |
| Expected drug levels in milk | Low (estimated) |
| Preferred alternatives | Labetalol, metoprolol (better studied) |
| Infant monitoring | Bradycardia, poor feeding, lethargy |
ELDERLY
• Recommended starting dose: 2.5–5 mg once daily
• Slower titration required due to increased sensitivity and reduced drug clearance
• Extra risks: bradycardia, orthostatic hypotension, dizziness, falls, worsening renal function
• Monitor heart rate and blood pressure frequently during titration
• Slower titration required due to increased sensitivity and reduced drug clearance
• Extra risks: bradycardia, orthostatic hypotension, dizziness, falls, worsening renal function
• Monitor heart rate and blood pressure frequently during titration
MAJOR DRUG INTERACTIONS
| Interacting Drug | Effect / Recommendation |
| Verapamil / Diltiazem | Avoid combination — risk of severe bradycardia, AV block, and asystole |
| Class I antiarrhythmics (quinidine, disopyramide) | Additive negative inotropy — avoid or use under specialist supervision |
| Clonidine | Risk of rebound hypertension if clonidine stopped before beta-blocker; discontinue beta-blocker several days before stopping clonidine |
| Insulin / Oral hypoglycaemics | May mask hypoglycaemia symptoms; increased vigilance required |
| MAO inhibitors | Potential for severe hypertension; avoid combination |
MODERATE DRUG INTERACTIONS
| Interacting Drug | Effect / Recommendation |
| NSAIDs | May attenuate antihypertensive effect; monitor BP |
| Digoxin | Additive bradycardia; monitor heart rate |
| Rifampicin | May reduce beta-blocker levels via CYP enzyme induction; monitor efficacy |
| SSRIs (fluoxetine, paroxetine) | Minor CYP2D6 inhibition — possible increased beta-blocker levels; monitor for bradycardia |
| Antihypertensives (other) | Additive hypotension; adjust doses accordingly |
COMMON ADVERSE EFFECTS
• Fatigue
• Dizziness
• Bradycardia
• Cold extremities
• Gastrointestinal discomfort (nausea, constipation)
• Headache
• Dizziness
• Bradycardia
• Cold extremities
• Gastrointestinal discomfort (nausea, constipation)
• Headache
SERIOUS ADVERSE EFFECTS
• Severe bradycardia or heart block — may require temporary pacing or hospitalisation
• Bronchospasm — discontinue immediately if occurs
• Severe hypotension with syncope
• Worsening of heart failure
• Depression (rare)
• Agranulocytosis (extremely rare — isolated case reports; requires immediate discontinuation)
• Bronchospasm — discontinue immediately if occurs
• Severe hypotension with syncope
• Worsening of heart failure
• Depression (rare)
• Agranulocytosis (extremely rare — isolated case reports; requires immediate discontinuation)
MONITORING REQUIREMENTS
| Timing | Parameters |
| Baseline | Heart rate, blood pressure, ECG (if indicated), renal function, hepatic function |
| After initiation/dose change | HR and BP at 1–2 weeks |
| Long-term | HR, BP every 3–6 months; consider ECG if symptomatic; periodic renal and hepatic function in at-risk patients |
BRANDS AVAILABLE IN INDIA
• Selecap-T (Sun Pharma)
• Beta-Til (Intas)
• Tilotens (Macleods)
• Tilocard (Zydus)
• Beta-Til (Intas)
• Tilotens (Macleods)
• Tilocard (Zydus)
PRICE RANGE (INR)
| Formulation | Price per tablet |
| Tablet 5 mg | ₹3–7 |
| Tablet 10 mg | ₹5–10 |
• Not currently under NPPA price control
CLINICAL PEARLS
• Beta-1 selective alternative for patients intolerant to non-selective beta-blockers
• Lower CNS penetration than propranolol — may reduce sleep disturbance and mood-related side effects
• Once-daily dosing improves compliance
• Avoid concomitant use with verapamil or diltiazem — significant risk of AV block
• Never stop abruptly — taper dose over 1–2 weeks when discontinuing
• In diabetic patients, counsel regarding altered hypoglycaemia awareness
• Lower CNS penetration than propranolol — may reduce sleep disturbance and mood-related side effects
• Once-daily dosing improves compliance
• Avoid concomitant use with verapamil or diltiazem — significant risk of AV block
• Never stop abruptly — taper dose over 1–2 weeks when discontinuing
• In diabetic patients, counsel regarding altered hypoglycaemia awareness
TAGS
tilisolol; hypertension; beta-blocker; cardioselective; angina; bradycardia risk; renal-safe; not for asthma; oral antihypertensive
VERSION
RxIndia v0.9 — 28 Feb 2026
REFERENCES
• CDSCO
• IP 2018
• NLEM 2022
• API Textbook of Medicine, 11th Ed
• Manufacturer drug inserts (Tilotens, Selecap-T)
• AIIMS Drug Formulary
• IP 2018
• NLEM 2022
• API Textbook of Medicine, 11th Ed
• Manufacturer drug inserts (Tilotens, Selecap-T)
• AIIMS Drug Formulary
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Clinical Responsibility
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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