Begin with an initial bolus of 10-20 mg intravenously over 1-2 minutes. Monitor blood pressure closely.
Following the bolus, initiate a continuous infusion at 0.5-2 mg/min. Adjust the infusion rate based on the patient’s response. Target a decrease in systolic blood pressure of approximately 20-25% from baseline, while maintaining perfusion.
Blood pressure should be assessed every 2-5 minutes during titration. Maintain close attention to heart rate and rhythm; bradycardia is a potential side effect.
Increase the infusion rate by 0.5-1 mg/min increments at intervals guided by blood pressure response, not exceeding a maximum rate of 4mg/min. Smaller incremental adjustments are preferable for better control.
Once the desired blood pressure is achieved, maintain the infusion at a stable rate. Gradually wean the patient off the infusion once stable, reducing the rate by 0.5 mg/min every 15-30 minutes to minimize rebound hypertension.
Note: This is a general guideline. Specific titration rates should be adjusted based on the individual patient’s clinical status, comorbidities, and response to treatment. Continuous monitoring by qualified medical personnel is mandatory. Always consult institutional protocols and guidelines.
Adverse effects like bradycardia, hypotension, and heart block should be managed promptly with appropriate interventions. Discontinue the infusion if severe adverse effects occur.
