Table 1:

Medical management of varices

Medication	Starting dose	Maximum dose	Treatment target
Nadolol	20–40 mg qhs Increase every 3 days until at goal	160 mg/day without ascites 80 mg/day with ascites	Resting heart rate of 55–65/min SBP >90
Propranolol	20–160 mg twice daily Increase every 3 days until at goal	320 mg/day without ascites 160 mg/day with ascites	Resting heart rate of 55–65/min SBP >90
Carvedilol	6.25 mg daily	6.25 mg twice daily Avoid in refractory ascites	SBP >90

Note: Consider reduction/temporary discontinuation of agent in patients with refractory ascites if (a) SBP <90, (b) serum creatinine >1.5 mg/dL (>132 mmol/L), or (c) sodium <130 mmol/L.

SBP = Systolic blood pressure; qhs = every night at bedtime