It is a short acting agent and was the first to be introduced in this category. Initial dose is one mg bid and may be titrated up to 10 mg bid. It is longer acting drug and can be given once a day. First dose hypotension is very common with this drug. Patient should be instructed to take this medicine at bed time and he has to be careful for the 2nd dose.
Third dose is tolerated well.
Be careful in the elderly patients treated with diuretics. Tachyphylaxis is common if used as a single rug. Dizziness, vertigo, palpitation, fluid retention, headache and priapism. The initial dose is 0.1 mg once or twice a day to 1.2 mg in two divided doses. It is available in patch form which can be applied to the skin preferably to chest wall once a week.