Inderal Tablets / Film-coated
Propranolol Hydrochloride
40mg
AstraZeneca UK Limited
| Pack size | 50's Plastic Bottle |
|---|---|
| Dispensing mode | POM |
| Source | UK |
| Agent | Modern Pharmaceutical Co. |
| Retail Price | 15.50 AED |
Indications
Inderal Tablets / Film-coated is used for:
HTN, Cardiac arrhythmias, Myocardial infarction, Angina pectoris, Portal hypertension, Migraine prophylaxis, Phaeochromocytoma, Hyperthyroidism, Essential tremor
Adult Dose
Oral
Hypertension
As conventional tab or oral soln: Initially, 40-80 mg bid. Usual range: 160-320 mg/day. Max: 640 mg/day.
As extended release cap: Initially, 80 mg once daily. Usual range: 120-160 mg once daily. Max: 640 mg/day.
Phaeochromocytoma
As conventional tab or oral soln: 60 mg/day in divided doses given 3 days pre-op w/ alpha-blocker. If tumour is inoperable, 30 mg/day in divided doses may be given.
Myocardial infarction
As conventional tab or oral soln: 40 mg 4 times daily for 2-3 days followed by 80 mg bid. Alternatively, 180-240 mg/day in divided doses. Doses are given w/in 5-21 days of MI.
Cardiac arrhythmias
Adult: As conventional tab or oral soln: 30-160 mg/day in divided doses.
Prophylaxis of migraine
As conventional tab or oral soln: Initially, 40 mg bid or tid. Usual range: 120-240 mg/day.
As extended release cap: 80 mg once daily, may be increased to 160 mg once daily. Max: 240 mg/day.
Portal hypertension
As conventional tab or oral soln: Initially, 40 mg bid increased at wkly intervals up to 160 mg bid. As extended release cap: 80 mg once daily, may be increased to 160 mg once daily. Max: 320 mg once daily.
Angina pectoris
As conventional tab or oral soln: Initially, 40 mg bid or tid. Usual range: 120-240 mg/day. Max: 320 mg/day.
As extended release cap: 80 mg once daily, may be increased to 160 mg once daily. Max: 240 mg/day.
Hypertrophic cardiomyopathy
Adult: As conventional tab or oral soln: 10-40 mg, 3-4 times daily.
Hyperthyroidism
As conventional tab or oral soln: 10-40 mg, 3-4 times daily.
As extended release cap: 80 mg once daily, may be increased to 160 mg once daily. Max: 240 mg/day.
Anxiety
As conventional tab or oral soln: 10-40 mg bid or tid.
As extended release cap: 80 mg once daily. Max: 160 mg once daily.
Essential tremor
As conventional tab or oral soln: Initially, 40 mg bid or tid. Usual range: 120-240 mg/day.
As extended release cap: 80 mg once daily, may be increased to 160 mg once daily. Max: 240 mg/day.
Hepatic impairment: Severe: 20 mg tid. As extended release cap: 80 mg once daily or 160 mg every other day.
Child Dose
Oral
Hypertension
Child: As conventional tab: Initially, 1 mg/kg/day in 2 divided doses. Usual range: 2-4 mg/kg/day in 2 divided doses. Max: 4 mg/kg/day in 2 or 3 divided doses.
Phaeochromocytoma
Child: As conventional tab or oral soln: 0.25-0.5 mg/kg 3-4 times daily.
Cardiac arrhythmias
Child: As conventional tab or oral soln: 0.25-0.5 mg/kg 3-4 times daily.
Prophylaxis of migraine
Child: As conventional tab or oral soln: ?12 yr 10-20 mg bid or tid. >12 yr Initially, 40 mg bid or tid increased to wkly intervals up to 160 mg/day. Max: 240 mg/day.
Hyperthyroidism
Child: As conventional tab or oral soln: 0.25-0.5 mg/kg 3-4 times daily.
Renal Dose
Administration
Tab: Should be taken on an empty stomach. Take before meals.
Cap: May be taken with or without food. Take consistently either always w/ or always w/o meals.
Contra Indications
Sinus bradycardia, cardiogenic shock, sick sinus syndrome, Raynaud's syndrome, 2nd and 3rd degree heart block, overt CHF, bronchial asthma, COPD, untreated phaeochromocytoma, Prinzmetal's angina; severe peripheral arterial disease, metabolic acidosis. Concomitant use w/ thioridazine.
Precautions
Sinus node dysfunction, DM, history of nonallergic bronchospasm (e.g. chronic bronchitis, emphysema), myasthenia gravis, 1st degree heart block. May mask signs of hyperthyroidism and hypoglycaemia. Renal or hepatic impairment. Abrupt withdrawal may exacerbate angina symptoms or precipitate MI in patients w/ coronary artery disease. Elderly. Pregnancy and lactation. Patient Counselling Avoid cigarette smoking. Monitoring Parameters Monitor ECG, heart rate and BP.
Pregnancy-Lactation
Pregnancy category: C; intrauterine growth retardation, small placentas, and congenital abnormalities reported, but no adequate and well-controlled studies conducted
Lactation: Use is controversial; an insignificant amount is excreted in breast milk
Interactions
May cause additive negative chronotropic and/or inotropic effect w/ amiodarone, disopyramide, quinidine, flecainide and Ca channel blockers. May cause additive hypotensive effect w/ phenothiazines. β-adrenergic stimulating effects of sympathomimetic agents are antagonised. Concomitant admin w/ catecholamine-depleting drugs (e.g. reserpine) may cause additive effects and potentiate depression. Reduced antihypertensive effect w/ aluminium and NSAIDs. Coadministration w/ warfarin increases its bioavailability and prothrombin time. Altered antidiabetic response when used w/ antidiabetic agents and insulin. Increased risk of hypotension and attenuation of the reflex tachycardia w/ anaesth drugs.
Potentially Fatal: Increased risk of QT interval prolongation and torsades de pointes w/ thioridazine.
Adverse Effects
Side effects of Propranolol Hydrochloride :
Most adverse effects have been mild and transient and have rarely required the withdrawal of therapy.
Cardiovascular: Bradycardia; congestive heart failure; intensification of AV block; hypotension; paresthesia of hands; thrombocytopenic purpura; arterial insufficiency, usually of the Raynaud type.
Central Nervous System: Lightheadedness; mental depression manifested by insomnia, lassitude, weakness, fatigue; reversible mental depression progressing to catatonia; visual disturbances; hallucinations; vivid dreams; an acute reversible syndrome characterized by disorientation for time and place, short-term memory loss, emotional lability, slightly clouded sensorium, and decreased performance on neuropsychometrics. For immediate formulations, fatigue, lethargy, and vivid dreams appear dose related.
Gastrointestinal: Nausea, vomiting, epigastric distress, abdominal cramping, diarrhea, constipation, mesenteric arterial thrombosis, and ischemic colitis.
Allergic: Hypersensitivity reactions, including anaphylactic/anaphylactoid reactions, pharyngitis and agranulocytosis, erythematous rash, fever combined with aching and sore throat, laryngospasm, and respiratory distress.
Respiratory: Bronchospasm.
Hematologic: Agranulocytosis, nonthrombocytopenic purpura, and thrombocytopenic purpura.
Skin: Stevens-Johnson Syndrome, toxic epidermal necrolysis, exfoliative dermatitis, erythema multiforme, and urticaria.
Mechanism of Action
Propranolol is a non-cardioselective beta-blocker that competitively blocks beta1- and beta2-receptors resulting in decreased heart rate, myocardial contractility, BP and myocardial oxygen demand. It has membrane-stabilising properties.
Note
Inderal 40mg Tablets / Film-coated manufactured by AstraZeneca UK Limited. Its generic name is Propranolol Hydrochloride. Inderal is availble in United Arab Emirates.
Farmaco UAE drug index information on Inderal Tablets / Film-coated is not intended for diagnosis, medical advice or treatment; neither intended to be a substitute for the exercise of professional judgment.