Acebutolol: what it treats, how to take it, side effects
Last updated September 6, 2026.
**Acebutolol is a prescription beta blocker used to treat high blood pressure and certain irregular heartbeats.** It reduces the effects of adrenaline on your heart, slowing your heartbeat and lowering blood pressure. Do not stop it suddenly: abrupt withdrawal can worsen chest pain or trigger a heart attack.
What does it treat?
You may receive acebutolol for high blood pressure or ventricular premature beats, which are extra beats starting in your heart's lower chambers. These can feel like skipped beats or pounding, but an ECG or heart monitor is needed to identify the rhythm. For blood pressure, your doctor may combine it with another medicine, such as a thiazide diuretic.
How do you take it?
Acebutolol comes in 200 mg and 400 mg capsules taken by mouth, with or without food. For high blood pressure, the labeled starting dose is 400 mg daily, taken once daily or divided into two doses; the usual effective total is 400 to 800 mg daily. For ventricular premature beats, treatment usually starts at 200 mg twice daily, with gradual adjustment to 600 to 1200 mg daily. The labeled daily ceiling is 1200 mg; older adults should avoid doses above 800 mg daily, and kidney impairment requires lower doses. Take it at consistent times. If you miss a dose, take it when remembered unless the next dose is nearly due; skip rather than double. For a suspected severe allergic reaction, stop taking it and get emergency help. Otherwise, call your doctor about concerning symptoms before stopping; planned withdrawal usually takes about two weeks.
Side effects to know
- Common: You may notice tiredness, dizziness, headache, nausea, diarrhea, constipation, or trouble sleeping.
- Serious: Stop taking acebutolol and get emergency help for throat swelling or trouble breathing suggesting a severe allergic reaction. A very slow pulse with dizziness, new wheezing, swelling, or unexplained weight gain needs immediate medical advice before your next dose because it can signal excessive heart slowing or worsening heart failure.
Who should not take it?
Do not take acebutolol if you have a persistently very slow heartbeat, second-degree or third-degree heart block, uncontrolled heart failure, cardiogenic shock, or an allergy to its ingredients. Discuss asthma, circulation problems, kidney or liver disease, diabetes, an overactive thyroid, and previous severe allergic reactions before treatment. Review all medicines, especially digoxin, other medicines that slow your pulse, reserpine, cold remedies, and NSAIDs such as ibuprofen. Acebutolol can hide a fast heartbeat from low blood sugar. During pregnancy, the label allows use only when the potential benefit justifies fetal risk; breastfeeding is not recommended. Ask your clinician before drinking alcohol, and avoid it if you feel dizzy or lightheaded.
When is it an emergency?
An overdose can cause a very slow heartbeat, severe weakness, fainting, breathing difficulty, or seizures. Call Poison Control at 1-800-222-1222 immediately after a suspected overdose, even without symptoms. Call 911 for collapse, breathing trouble, a seizure, or inability to wake up. Also call 911 for throat or tongue swelling or new, severe, or persistent chest pain, including after suddenly stopping acebutolol.
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Common questions
What is the maximum daily dose?
The labeled maximum is 1200 mg daily. For high blood pressure, that total is divided into two doses. Older adults should avoid more than 800 mg daily, and kidney impairment requires a lower dose. Do not raise your dose yourself.
Can I drink alcohol?
Ask your clinician before drinking while taking acebutolol. Avoid alcohol if you have dizziness or lightheadedness. Do not skip your medicine to drink.
Can I take acebutolol during pregnancy or breastfeeding?
Contact your prescriber if you are pregnant or planning pregnancy. The label recommends pregnancy use only when the expected benefit justifies the risk to your baby. Exposure has been associated with lower birth weight, low blood pressure, and slow heartbeat in newborns. Breastfeeding is not recommended because acebutolol and its active metabolite enter breast milk. Do not stop suddenly while arranging a treatment review.
Should I take it with food?
You can take acebutolol with or without food. Keep the same scheduled times each day. Follow any separate diet instructions your clinician gives you for blood pressure.
What if I accidentally take an extra dose?
Call Poison Control at 1-800-222-1222 for advice immediately. Do not wait for symptoms. Overdose signs include marked slowing of your pulse, weakness, fainting, and breathing difficulty. Call 911 for collapse, trouble breathing, seizures, or inability to wake up.
Which medicines should I check before combining them?
Ask before using cold remedies containing pseudoephedrine, phenylephrine, or oxymetazoline because blood pressure can rise sharply. NSAIDs such as ibuprofen can reduce blood pressure control. Digoxin and other medicines that slow your heart need review because your pulse can become too slow. Share your complete medication list before starting or changing treatment.