Inderal Special Precautions





Zuellig Pharma
Full Prescribing Info
Special Precautions
Inderal As With Other Beta-Blockers: although contraindicated in uncontrolled heart failure (see Contraindications), may be used in patients whose signs of heart failure have been controlled. Caution must be exercised in patients whose cardiac reserve is poor.
although contraindicated in severe peripheral arterial circulatory disturbances (see Contraindications), may also aggravate less severe peripheral arterial circulatory disturbances.
due to its negative effect on conduction time, caution must be exercised if it is given to patients with first degree heart block.
may block/modify the signs and symptoms of the hypoglycaemia (especially tachycardia). Inderal occasionally causes hypoglycaemia, even in non-diabetic patients, e.g., neonates, infants, children, elderly patients, patients on haemodialysis or patients suffering from chronic liver disease and patient suffering from overdose. Severe hypoglycemia associated with Inderal has rarely presented with seizures and/or coma in isolated patients. Caution must be exercised in the concurrent use of Inderal and hypoglycaemic therapy in diabetic patients. Inderal may prolong the hypoglycaemic response to insulin.
may mask the signs of thyrotoxicosis.
will reduce heart rate, as a result of its pharmacological action. In the rare instances when a treated patient develops symptoms which may be attributable to a slow heart rate, the dose may be reduced.
should not be discontinued abruptly in patients suffering from ischaemic heart disease.
Either the equivalent dosage of another beta-blocker may be substituted or the withdrawal of Inderal should be gradual.
may cause a more severe reaction to a variety of allergens, when given to patients with a history of anaphylactic reaction to such allergens. Such patients may be unresponsive to the usual doses of adrenalin used to treat the allergic reactions.
Inderal must be used with caution in patients with decompensated cirrhosis.
In patients with significant hepatic or renal impairment care should be taken when starting treatment and selecting the initial dose.
In patients with portal hypertension, liver function may deteriorate and hepatic encephalopathy may develop.
There have been reports suggesting that treatment with propranolol may increase the risk of developing hepatic encephalopathy.
Effect on Ability to Drive or Operate Machinery: Use is unlikely to result in any impairment of the ability of patients to drive or operate machinery. However it should be taken into account that occasionally dizziness or fatigue may occur.
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