PROPRANOLOL

Product: 
PROPRANOLOL
Formulary: 
Generic Formulary
Category: 
Pain & Fever
Sub Group: 
ANTIMIGRAINE DRUGS
International Brand Name: 
Apo-Propranolol, pms Propranolol
Dosages: 
40 MG/80 mg/60 mg
Unit of Packing: 
Tablets
In treatment of: 
Propphylaxis of Migrane
Adverse Effects: 
1.Congestive heart failure is precipitated or aggravated 2.Decreases coronary blood flow 3.Forgetfulness 4.Nightmares 5.Decreases exercise capacity 6.Decreases carbohydrate tolerance 7.Decrease insulin release 8.Increases free fatty acid levels and increase LDL to HDL ratio 9.Worsens chronic obstructive lung diseases 10.Gastrointestinal problems 11.Nausea 12.Sexual dysfunction 13.Cold extremities 14.Tiredness 15.Exacerbates prinzmetal`s angina 16.Bradycardia 17.Depression 18.Fever 19.Rash
Contraiindication: 
1.Hypersensitivity to the drug 2.Second or third degree heart block 3.Congestive heart failure 4.Cardiogenic shock 5.Bradycardia 6.Chronic obstructive pulmonary diseases 7.Hypoglycemia 8.Haemorrhage .
Special Precaution: 
1.Peripheral arterial diseases 2.Ischaemic heart disease 3.Congestive heart failure 4.Renal impairment 5.Hepatic impairment 6. Diabetes mellitus 7. The drug should be gradually withdraw with caution 8. Non allergic bronchospastic diseases 9. Thyrotoxicosis 10. Along with other antihypertensive drugs
Interaction: 
Quinidine: Orthostatic hypotension. Rifampicin, Phenobarbital, NSAIDs, Thyroid hormones, Smoking: Decrease antihypertensive action of propranolol. Corticosteroids: Antagonism of hypotensive effect. Sympathomimetics: Marked hypertension and bradycardia. Insulin: Hypoglycemic effects prolonged by propranalol and masking of symptoms of hypoglycemia in diabetes. Lidocaine: Increased levels of lidocaine may occur resulting in toxicity. Calcium channel blockers: Severe bradycardia especially in those with impaired LV function. Phenothiazines: Chlorpromazine increases plasma levels of propranolol. Reserpine: Additive effect resulting in vertigo, syncope or postural hypotension. Clonidine: May increase the postural hypotension. Severity of rebound hypertension caused by abrupt withdrawal of clonidine enhanced. Haloperidol: Severe hypotension. Prazosin: May increase first dose response (acute postural hypotension) of prazosin. Theophylline: Propranolol antagonises effect of theophylline. Alcohol: Enhanced hypotensive effect. ACE inhibitors: Enhanced hypotensive effect. Lab tests: May interfere with Glaucoma screening test due to reduction in intraocular pressure.
Servings: 
40 to 240mg/day Hypertension: Starts with 80mg once daily or in 2 divided doses and gradually increases up to 320mg/day based on patient`s response in divided doses 12th hourly or 8th hourly. Maximum daily dose: 640mg. Sustained release formulations: 120 to 160mg/day. Once daily. Children: 1mg/kg/day gradually increases to 4mg/kg/day based on patient`s response in 4 divided doses Maximum dose: 5mg/kg/day. Arrhythmias & Anxiety: 30mg to 150mg/day in 3 to 5 divided doses. Children: 0.5 to 4mg/kg/day in 3 to 4 divided doses.

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