"Official medicines" is the best online drugstore.

World’s leading meds delivered to your door – and you don’t even need a prescription! Only certified, first class drugs on offer! Buy more and spend less with our great discount system.

The meds you need, reliable and hassle free! Top products of top brands.

The only pharmacy shop you will ever need! Approved drugs available without prescription. Best deals, unmatched service and shipping. 100% safe!


(pro-PRAN-oh-lahl HIGH-droe-KLOR-ide)
Betachron E-R, Inderal, Inderal LA, Propranolol Intensol,  APO-Propranolol, Detensol, Detensol, Dom-Propranolol, Novo-Pranol, Nu-Propranolol, PMS-Propranolol
Class: Beta-adrenergic blocker

 Action Blocks beta receptors, primarily affecting the cardiovascular system (decreased heartrate, decreased cardiac contractility and decreased BP) and lungs (promotes bronchospasm).

 Indications Treatment of hypertension; angina pectoris; hypertrophic subaortic stenosis; MI; pheochromocytoma; migraine prophylaxis; essential tremor; some ventricular and supraventricular arrhythmias. Unlabeled use(s): Treatment of alcohol withdrawal syndrome; esophageal varices rebleeding; anxiety; thyrotoxicosis symptoms.

 Contraindications Hypersensitivity to beta-blockers; greater than first-degree heart block; CHF unless secondary to tachyarrhythmia or untreated hypertension treatable with beta-blockers; overt cardiac failure; sinus bradycardia; cardiogenic shock; untreated bronchial asthma or bronchospasm, including severe COPD.

 Route/Dosage

Hypertension

ADULTS: PO Initial dose: 40 mg bid initially or 80 mg sustained-release medication/day; titrate to response. Maintenance: 120 to 240 mg/day in 2 to 3 divided doses or 120 to 160 mg/day sustained-release medication. Do not exceed 640 mg/day. CHILDREN: PO 0.5 mg/kg bid; titrate q 3 to 5 days to maximum dose of 1 mg/kg bid.

Angina

ADULTS: PO 80 to 320 mg/day in 2 to 4 divided doses or 160 mg/day of sustained-release medication.

Arrhythmias

ADULTS: PO 10 to 30 mg 3 to 4 times/day before meals and at bedtime.

Hypertrophic Aortic Stenosis

ADULTS: PO 20 to 40 mg 3 to 4 times/day before meals and at bedtime or 80 to 160 mg sustained-release medication 1 time/day.

MI

ADULTS: PO 180 to 240 mg/day in 3 to 4 divided doses up to 240 mg/day.

Pheochromocytoma

ADULTS: PO 60 mg/day for 3 days prior to surgery, given with alpha-blocker.

Migraine

ADULTS: PO 80 mg in divided doses daily or once daily (sustained release); titrate to response (maximum dose: 240 mg/day); discontinue after 6 wk if no response.

Arrhythmias (Life Threatening)

ADULTS: IV 1 to 3 mg at rate of 1 mg/min; may repeat after 2 min; give subsequent doses q 4 hr.

Essential Tremor

ADULTS: PO 40 mg bid initially; titrate to response. Maintenance: 120–320 mg/day in 2 to 3 divided doses.

 Interactions

Barbiturates: Decreased bioavailability of propranolol. Cimetidine: Increased propranolol levels. Clonidine: Attenuation or reversal of antihypertensive effect; potentially life-threatening increases in BP, especially on withdrawal. Epinephrine: Initial hypertensive episode followed by bradycardia. Ergot alkaloids: Peripheral ischemia, manifested by cold extremities and possible gangrene. Hydralazine: Increased serum levels of both drugs. Insulin: Prolonged hypoglycemia with masking of symptoms. Lidocaine: Increased lidocaine levels, leading to toxicity. NSAIDs: Some agents may impair antihypertensive effect. Phenothiazines: Increased effects of either drug. Prazosin: Increased orthostatic hypotension. Propafenone, quinidine, thioamines: Increased effects of propranolol. Rifampin: Decreased effects of propranolol. Theophylline: Reduces elimination of theophylline; pharmacologic antagonism. Verapamil: Increased effects of both drugs.

 Lab Test Interferences May interfere with glaucoma screening tests; may increase BUN, serum transaminases, alkaline phosphatase or LDH.

 Adverse Reactions

CV: Bradycardia; hypotension; CHF; atrioventricular (AV) block; worsening angina; torsades de pointes; edema; peripheral ischemia. CNS: Depression; tiredness; fatigue; lethargy; sleep disturbances;. bizarre dreams; short-term memory loss; dizziness. DERM: Rash; pruritus. EENT: Dry eyes; visual disturbances. GI: Dyspepsia; nausea; vomiting; diarrhea; dry mouth. GU: Impotence; urinary retention; difficulty with urination. HEMA: Agranulocytosis. HEPA: Elevated liver enzymes. META: Hyperglycemia; hypoglycemia. RESP: Wheezing; dyspnea; bronchospasm; difficulty breathing. OTHER: Increased sensitivity to cold (Raynaud’s phenomenon); psoriasis-like eruptions; skin necrosis; systemic lupus erythematosus; decreased exercise tolerance.

 Precautions

Pregnancy: Category C. Lactation: Excreted in breast milk. Children: Safety and efficacy not established. IV use is not recommended, but oral propranolol has been used. Abrupt withdrawal: A beta-blocker withdrawal syndrome (eg, hypertension, tachycardia, anxiety, angina, MI) may occur 1 to 2 weeks after sudden discontinuation of systemic beta blockers. If possible, gradually withdraw therapy over 1 to 2 weeks. Anaphylaxis: Deaths have occurred; aggressive therapy may be required. CHF: Should be administered cautiously in patients whose CHF is controlled by digitalis and diuretics. Diabetes mellitus: May mask symptoms of hypoglycemia (eg, tachycardia, BP changes). May potentiate insulin-induced hypoglycemia. Nonallergic bronchospastic diseases: Give drug with caution in patients with bronchospastic diseases. Peripheral vascular disease: May precipitate or aggravate symptoms of arterial insufficiency. Renal/Hepatic impairment: Dose should be reduced. Thyrotoxicosis: May mask clinical signs (eg, tachycardia) of developing or continuing hyperthyroidism. Abrupt withdrawal may exacerbate symptoms of hyperthyroidism, including thyroid storm. Wolff-Parkinson-White syndrome: In several cases, tachycardia was replaced by severe bradycardia requiring a demand pacemaker.

PATIENT CARE CONSIDERATIONS

 Administration/Storage

  • Administer consistently either with or without food.
  • Patients who are taking sustained-released capsules should swallow them whole; instruct patient not to bite, open or chew capsules.
  • Administer via IV route only in cases of life-threatening arrhythmias or those occurring under anesthesia and only under careful monitoring (eg, central venous pressure, ECG).
  • Store tablets/capsules/oral solution at room temperature in tight, light-resistant containers.
  • Protect injectable solution from light.
  • Administer IV form undiluted or diluted with 10 ml D5W for Injection. Give 1 mg or less/min; may be diluted in 50 ml sodium chloride and 1 mg given over 10 to 15 min.

 Assessment/Interventions

  • Obtain patient history, including drug history and any known allergies. Note diabetes; respiratory, liver or cardiac disease or sensitivity to other beta blockers.
  • Review baseline ECG.
  • Assess pulse and BP before and during administration. If pulse rate is below 60 bpm or if patient hypotensive, withhold medication and notify physician.
  • If renal damage is present, obtain creatinine clearance.
  • Obtain hepatic enzyme levels before and during administration.
  • Monitor I&O and daily weight during therapy for signs of fluid retention.
  • Monitor for headache, light-headedness and decreased BP, which may indicate need for reduced dosage.
  • If sudden severe dyspnea or edema of hands and feet develops, withhold medication and notify physician.
  • If chest pain occurs, assess for location, intensity, duration and radiation, and notify physician.
OVERDOSAGE: SIGNS & SYMPTOMS
  Bradycardia, hypotension, CHF, AV block, intraventricular conduction defects, asystole, coma

 Patient/Family Education

  • Explain that dosage will be tapered slowly before stopping. Warn that sudden discontinuation can cause chest pain or heart attack.
  • Instruct patient to take medication at same time each day.
  • Teach patient how to take pulse and instruct to check before taking drug. Warn patient not to take drug if pulse is less than usual rate (or < 60 bpm) and to call physician.
  • Educate patient or family to take BP and advise to take on regular basis.
  • Inform diabetic patient to monitor blood glucose level carefully.
  • Instruct patient to report the following symptoms to physician: Difficulty breathing, night cough, slowed pulse rate, dizziness, rash, fever, sore throat, confusion, depression, drowsiness, unusual bruising, or bleeding.
  • Caution patient to avoid sudden position changes to prevent orthostatic hypotension.
  • Advise patient that drug may cause drowsiness and to use caution while driving or performing other tasks requiring mental alertness.
  • Instruct patient not to take otc medications (including nasal decongestants, diet aids, or cold preparations) without consulting physician.

Popularity: 3% [?]


If you're still unable to find appropriate information in the article, please use search form below