Inderal

Propranolol HCl

Control of HTN; cardiac arrhythmias; anxiety & anxiety tachycardia. Management of angina pectoris; essential tremor; hypertrophic obstructive cardiomyopathy; phaeochromocytoma. Long-term prophylaxis after recovery from acute MI. Prophylaxis of migraine. Adjunctive management of thyrotoxicosis.

Adult HTN 80 mg bd, increased at wkly intervals according to response. Usual dose range: 160-320 mg daily, max: 640 mg daily. Angina, anxiety, migraine & essential tremor 40 mg bd or tds, increased by same amount at wkly intervals according to response. Usual dose range for anxiety, migraine & essential tremor: 80-160 mg daily & for angina: 120-240 mg daily. Max daily dose for migraine: 240 mg & for angina: 480 mg. Arrhythmias, anxiety tachycardia, hypertrophic obstructive cardiomyopathy & thyrotoxicosis 10-40 mg tds or qds. Max daily dose for arrhythmias: 240 mg. Post MI Start treatment between days 5 & 21 after MI, w/ initial dose of 40 mg qds for 2 or 3 days. Total daily dosage may be given as 80 mg bd thereafter. Phaeochromocytoma Used only in presence of effective α-blockade: Pre-op: 60 mg daily for 3 days. Non-operable malignant cases: 30 mg daily. Childn Individualized dosage. Arrhythmias, phaeochromocytoma, thyrotoxicosis 0.25-0.5 mg/kg tds or qds. Migraine >12 yr Adult dose, <12 yr 20 mg bd or tds. Elderly Individualized dosage.

May be taken with or without food.

Hypersensitivity. History of bronchial asthma or bronchospasm; bradycardia; cardiogenic shock; hypotension; metabolic acidosis; after prolonged fasting; severe peripheral arterial circulatory disturbances; 2nd- or 3rd-degree heart block; sick sinus syndrome; untreated phaeochromocytoma; uncontrolled heart failure; Prinzmetal's angina. Not to be used in patients prone to hypoglycaemia.

History of anaphylactic reaction to variety of allergens. Poor cardiac reserve, severe peripheral arterial circulatory disorders, 1st degree heart block. Hypoglycaemia. Portal HTN. Reduced heart rate. Increased risk of hepatic encephalopathy development. May mask signs of thyrotoxicosis. Not to be discontinued abruptly in patients w/ ischemic heart disease. Decompensated cirrhosis, hepatic or renal impairment. May affect ability to drive or operate machinery. Not to be given during pregnancy. Not recommended during lactation.

Fatigue &/or lassitude (often transient); bradycardia, cold extremities, Raynaud's phenomenon; sleep disturbances, nightmares.

Prolonged hypoglycaemic response to insulin. Increased rizatriptan exposure. Potentiated atrial conduction time effect w/ class I antiarrhythmics eg, disopyramide. Increased AV conduction time w/ digitalis glycosides. Negative inotropic effects w/ Ca-channel blockers eg, verapamil, diltiazem. Increased risk of hypotension & cardiac failure w/ dihydropyridine Ca-channel blockers eg, nifedipine. Counteracted β-blocker effects by sympathomimetics eg, adrenalin. Increased plasma conc of lignocaine. Increased plasma levels by cimetidine, hydralazine, chlorpromazine & alcohol. Exacerbated rebound HTN followed by w/drawal of clonidine. Vasospastic reactions w/ ergotamine, dihydroergotamine or related compds. Decreased hypotensive effects by prostaglandin synthetase inhibiting drugs eg, ibuprofen, indomethacin. Attenuated reflex tachycardia & increased risk of hypotension w/ anaesth. Quinidine, propafenone, rifampicin, theophylline, warfarin, thioridazine, nisoldipine, nicardipine, isradipine, lacidipine.

Beta-Blockers

C07AA05 - propranolol ; Belongs to the class of non-selective beta-blocking agents. Used in the treatment of cardiovascular diseases.

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