Propranolol

Propranolol is commonly prescribed to help treat heart conditions including abnormal heart rhythm or heart disease.

Propranolol is used to treat heart conditions including blood pressure, abnormal heart rhythm, pheocromocytoma or chest pain. In some cases this medication is used to treat migraines or tremors in the body or to increase the chance of survival after a heart attack. Propranolol is a beta blocker that relaxes the blood vessels to help improve blood flow throughout the body to help decrease your blood pressure.

Indications and Usage

Propranolol is sold under the brand names Inderal LA, Inderal, InnoPran XL, InnoPran and Pronol. In many cases these medications is taken once a day, but some conditions will require you to take your medications in divided doses. Talk with your doctor regarding any specific instructions that may apply to your condition. Any doses you take should be taken around the same time every day. Do not crush or chew any tablet forms of your medication. If you are taking a liquid form of the medication, dilute it with juice, water, a soft drink, applesauce or pudding. Do not mix this dose before you intend to take it.

Propranolol Dosage

Those using propranolol after a heart attack will be given 180-240 mg per day in divided doses. If you are using the oral formula you will be given 40 mg initially which will be increased as necessary to alleviate your symptoms.

When treating an adrenal gland tumor, patients will be given 60 mg per day for the three days prior to their surgery. Those not having surgery will be given 30 mg per day in divided doses.

When treating chest pain patients will be given 80 mg per day, which may be increased up to 320 mg per day if needed.

When treating blood pressure, patients will be given 80 mg once a day just before bed. This may be increased if your doctor determines it is necessary. Those using an oral prescription will have their doses divided into two 40 mg doses.

If you are treating hypertrophic subaortic stenosis, you will be given 80-160 mg per day. If you are using the oral dosing for this condition you will be given three to four 20-40 mg doses, at least one of which must be taken just before bed. These doses should also be taken with meals.

Alternative treatments include migraines and tremors. Those treating migraines will be given 80 mg per day while those treating tremors will be given 40 mg per day.

Propranolol is not intended to be used in children unless extreme circumstances are present. Similarly, this drug has been rated in pregnancy category C so there is some risk to taking this medication while you are pregnant. Talk to your doctor about the potential risks if you are pregnant or breastfeeding to help ensure that the potential benefits of taking this medication outweighs the risk.

Table 1: Propranolol Dosage

Indications

Usual Dosage

Special Dosage

Acute heart attack

180-240 mg per day in divided doses

Oral dosage- 40 mg per day in three doses

Adrenal gland tumor

60 mg per day

30 mg per day for those who cannot have surgery

Chest pain

80 mg per day

Doses may be increased up to 320 mg as necessary

Blood pressure

80 mg per day just before bed

Oral dosage- 40 mg twice a day as necessary

Hypertrophic subaortic stenosis

80-160 mg once a day

Oral dosage- 20-40 mg three to four times a day

Migraine headaches

80 mg per day which is increased as needed

N/A

Tremors

40 mg per day

N/A

Propranolol Side Effects

Side effects of propranolol are not common, but should be monitored carefully when they occur. Some side effects of Propranolol include short-term memory loss, nausea, fatigue, low blood sugar, diarrhea, vomiting, asthma, constipation, hair loss, lupus, Peyronie's disease and impotence. Let your doctor know if any of these side effects occur as you may need to adjust your medication to help avoid them getting worse.

If you begin to suffer from unexplained blisters, unexplained rash, itching, peeling of the skin, difficulty breathing, wheezing, unexplained swelling, difficulty swallowing, chest pain, sudden dizziness, weight gain, cold, fainting spells, confusion or irregular heartbeat and tingling or numb hands and feet you may be suffering from a negative reaction to your medication. Talk to your doctor about whether or not it is safe to continue using propranolol at the level that you are currently taking it. Do not stop taking your medication suddenly without medical advice to do so.

If you suddenly begin to suffer from sore throat, difficulty breathing, swelling of the feet or hands, unusual weight gain, chest pain, unusual bleeding or slow, irregular heartbeat you may be suffering from an overdose of propranolol. Contact emergency medical services immediately to get assistance. If you have any information regarding how much propranolol you have taken and when you have taken your most recent doses, have this ready when you make this phone call.

Table 2: Propranolol Side Effects

Types of Side Effects

Symptoms

Uncommon Side Effects

Short-term memory loss, nausea, fatigue, low blood sugar, diarrhea, vomiting, asthma, constipation, hair loss, lupus, Peyronie's disease and impotence.

Serious Side Effects

Unexplained blisters, unexplained rash, itching, peeling of the skin, difficulty breathing, wheezing, unexplained swelling, difficulty swallowing, chest pain, sudden dizziness, weight gain, cold, fainting spells, confusion or irregular heartbeat and tingling or numb hands and feet

Overdose

Sore throat, difficulty breathing, swelling of the feet or hands, unusual weight gain, chest pain, unusual bleeding or slow, irregular heartbeat

Interactions

Medications that have been reported to negatively interact with propranolol include clonidine, digitalis, dobutamine, haloperidol, isoproterenol, blood thinners, antidepressants, MAO inhibitors, aspirin, NSAIDs, doxazosin, heart medication, blood pressure medication, amiodarone, and ACE inhibitors. Let your doctor know if you are taking these or any other medications, both prescribed and over the counter to help avoid a potentially dangerous reaction to your prescription.

You should not drink alcohol while using propranolol as this can increase the levels of the drug in your body to an unsafe level.

Propranolol may make you dizzy, so take care when getting up from a lying position. Take your time when getting up and steady yourself so you do not fall and cause yourself injury.

Recommended:

Diovan

Diovan is used to manage high blood pressure. This medication is often prescribed in addition to other medications to manage your condition.


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