Table 11

Initiating dose, target dose, and titration scheme of β blocking agents in placebo controlled large trials3-150

β Blocker First dose (mg) Titration scheme daily dose (mg)3-151 Target total daily dose (mg)
Metoprolol (MERIT trial)253-152 Wk 1
25
Wk 2
25
Wk 3
50
Wk 4
50
Wk 5
100
Wk 6
100
Wk 7
200
200
Bisoprolol (CIBIS II)1.25Wk 1
1.25
Wk 2
2.5
Wk 3
3.75
Wk 4–7
5.0
Wk 8–11
7.5
Wk 12–15
10
10
Carvedilol3-153 (US trials)3.125Wk 1
3.125
Wk 2
3.125
Wk 3
6.25
Wk 4
6.25
Wk 5
12.5
Wk 6
12.5
Wk 7
25
Wk 8
25
503-154
  • 3-150 Forced titration in all studies, assuming preceding dose tolerated.

  • 3-151 Dose once daily for metoprolol and bisoprolol and twice daily for carvedilol.

  • 3-152 Slow release (metoprolol CR/XL) formulation 12.5 mg recommended in NYHA class III–IV patients.

  • 3-153 Recommended titration schedule in UK; in USCP dosing schedule differed in different component trials.

  • 3-154 In two doses: 25 mg bid except for patients > 85 kg where the dose may be increased to 50 mg bid.