Propranolol is only part of a complete program of treatment for hypertension that may also include diet, exercise, and weight control. Follow your diet, medication, and exercise routines very closely if you are being treated for hypertension. Store at room temperature away from moisture and heat. Do not allow liquid medicine to freeze. Throw away any unused Hemangeol 2 months after you first opened the bottle. Dosage Information in more detail What happens if I miss a dose? For regular short-acting propranolol: Take the missed dose as soon as you remember.
Skip the missed dose if your next dose is less than 4 hours away. Skip the missed dose if your next dose is less than 8 hours away. Do not take extra medicine to make up the missed dose. What happens if I overdose? Seek emergency medical attention or call the Poison Help line at Overdose symptoms may include slow or uneven heartbeats, dizziness, weakness, or fainting.
What should I avoid while taking propranolol? It may increase your blood levels of propranolol. Avoid getting up too fast from a sitting or lying position, or you may feel dizzy.
Get up slowly and steady yourself to prevent a fall. Non-cardioselective beta-blockers oppose the bronchodilator effects of beta-agonist bronchodilators, propranolol is contraindicated in patients with asthma see section 4.
Calcium channel blockers Verapamil,diltiazem or bepridil: Calcium channel blockers and beta-blockers have additive effects on AV conduction and sinus node function and can cause bradycardia and hypotension. The combination with propranolol should be avoided, especially in patients with cardiac decompensation see section 4.
Potentiation of bradycardia effects with possible fatal outcomes. Treatment with Fingolimod should not be initiated in patients receiving beta blockers. In case of combination, appropriate monitoring for treatment initiation, at least overnight monitoring is recommended.
The plasma levels and the effects of beta-blockers are reduced by the barbiturates. Barbiturates are potent liver enzyme inducers which may increase the metabolism of propranolol. This probably was because propranolol is partially metabolized by the same enzyme like propafenone CYP2D6. This combination is also not advisable because propafenone has negative inotropic effects. Concomitant use of MAO inhibitors except MAO-B inhibitors with antihypertensive agents may diminish the antihypertensive effect and lead to hypertensive reactions.
Combination to be used with caution, dose adjustment may be required Amiodarone: A few case reports suggest that patients treated with amiodarone can have severe sinus bradycardia when treated concomitantly with propranolol.
Amiodarone has an extremely long half-life about 50 days , which means that interactions may occur long after discontinuation of therapy. Class I antiarrhythmic drugs disopyramide, quinidine: Class I antiarrhythmic drugs and beta-blockers have additive negative inotropic effects which may result in hypotension and severe hemodynamic side effects in patients with impaired left ventricular function.
Quinidine appears to increase propranolol plasma levels by inhibiting the CYP2D6, thereby reducing its clearance. Therefore dose of propranolol should be reduced at the initiation of treatment with quinidine.
It has been studied mainly in indomethacin. In a study on diclofenac no such interaction could be detected. Data for COX-2 inhibitors are missing. Cimetidine increases levels of propranolol in plasma, probably by inhibiting its first pass metabolism. There may be a risk of eg bradycardia with oral dosing. Concomitant use of beta-adrenergic antagonists and anaesthetics may attenuate reflex tachycardia and increase the risk of hypotension see section 4.
As a general rule, avoid sudden withdrawal of beta-blocker treatment. The anaesthesiologist should be informed when the patient is receiving beta-adrenergic antagonists. A number of reports are available for severe hypertension and bradycardia in patients treated with propranolol and epinephrine. These clinical observations have been confirmed by studies in healthy volunteers.
It has also been suggested that the intravascular administration of epinephrine may trigger these reactions. It is sold in the United States under the brand name Inderal.
When combined with the diuretic, hydrochlorothiazide, it is sold under the brand name Inderide. Propranolol also is produced as a generic product by a number of generic manufacturers.
Purpose Propranolol is approved by the Food and Drug Administration FDA for the treatment of hypertension high blood pressure , angina, certain types of cardiac arrhythmias, certain types of cardiac output diseases, a sympathetic nervous system disorder known as pheochromocytoma, hyperthyroid conditions, migraine, heart attack, and tremors of a variety of origins. It is also used on occasion for the treatment of medication-induced movement disorders caused by antipsychotic drugs and certain anxiety states in people suffering from a specific form of social phobia.
Beta blockers , such as propanolol, are not useful for people with general social phobia who are anxious in most social situations; instead, propanolol may be useful for people who are anxious about specific performance situations, such as presenting a speech before an audience. Description Propranolol falls into the broad pharmacologic category known as beta blockers. Beta blockers block specific sites in the central nervous system known as beta-adrenergic receptor sites.
When these sites are blocked, heart rate and blood pressure are reduced and patients become less anxious.
© Copyright 2017 Propranolol 49mg *** Propranolol is a nonselective beta-adrenergic receptor blocker which is used in the treatment of a variety of diseases like hypertension, angina, migraine, heart attack, tremors etc. It is a prescription drug which should only be used as per the doctor’s advice..