Swallow the capsules whole; do not crush or chew the capsules. The dosage is based on your medical condition and response to treatment. Use Propranolol ER mg regularly to get the most benefit from it. To help you remember, take it at the same time each day. It is important to continue taking Propranolol ER mg even if you feel well.
Propranolol ER mg is used to help prevent chest pain or migraines. It should not be used to treat chest pain or migraines when they occur. Use other medications e. Consult your doctor or pharmacist for details. It may take 1 to 2 weeks before you get the full benefit of Propranolol ER mg. If you also take certain drugs to lower your cholesterol bile acid-binding resins such as cholestyramine or colestipol , take propranolol at least 1 hour before or at least 4 hours after these medications.
Tell your doctor if your condition worsens e. See also Warning and Precautions sections. Dizziness, lightheadedness, or tiredness may occur as your body adjusts to the medication. If any of these effects persist or worsen, tell your doctor or pharmacist promptly. Adequate facilities for monitoring such infants at birth should be available. Propranolol hydrochloride should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.
Nursing Mothers Propranolol is excreted in human milk. Caution should be exercised when propranolol hydrochloride extended-release is administered to a nursing woman. Pediatric Use Safety and effectiveness of propranolol in pediatric patients have not been established. Bronchospasm and congestive heart failure have been reported coincident with the administration of propranolol therapy in pediatric patients.
Geriatric Use Clinical studies of Propranolol hydrochloride did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. Other reported clinical experience has not identified differences in responses between the elderly and younger patients.
In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of the decreased hepatic, renal or cardiac function, and of concomitant disease or other drug therapy. Bradycardia; congestive heart failure; intensification of AV block; hypotension; paresthesia of hands; thrombocytopenic purpura; arterial insufficiency, usually of the Raynaud type. Light-headedness; mental depression manifested by insomnia, lassitude, weakness, fatigue; 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 release formulations, fatigue, lethargy, and vivid dreams appear dose related. Nausea, vomiting, epigastric distress, abdominal cramping, diarrhea, constipation, mesenteric arterial thrombosis, ischemic colitis. Agranulocytosis, nonthrombocytopenic purpura, and thrombocytopenic purpura. Systemic lupus erythematosus SLE. Skin and mucous membranes: Stevens-Johnson Syndrome, toxic epidermal necrolysis, dry eyes, exfoliative dermatitis, erythema multiforme, urticaria, alopecia, SLE-like reactions, and psoriasisiform rashes.
Oculomucocutaneous syndrome involving the skin, serous membranes, and conjunctivae reported for a beta-blocker practolol have not been associated with propranolol. Male impotence; Peyronie's disease. In the event of overdosage or exaggerated response, the following measures should be employed: If ingestion is or may have been recent, evacuate gastric contents, taking care to prevent pulmonary aspiration.
Hypotension and bradycardia have been reported following propranolol overdose and should be treated appropriately. Glucagon can exert potent inotropic and chronotropic effects and may be particularly useful for the treatment of hypotension or depressed myocardial function after a propranolol overdose.
Isoproterenol, dopamine or phosphodiesterase inhibitors may also be useful. Epinephrine, however, may provoke uncontrolled hypertension. Bradycardia can be treated with atropine or isoproterenol. Serious bradycardia may require temporary cardiac pacing. The electrocardiogram, pulse, blood pressure, neurobehavioral status and intake and output balance must be monitored.
Isoproterenol and aminophylline may be used for bronchospasm. If patients are switched from propranolol hydrochloride tablets to propranolol hydrochloride extended-release capsules, care should be taken to assure that the desired therapeutic effect is maintained. Propranolol hydrochloride extended-release should not be considered a simple mg-for-mg substitute for propranolol hydrochloride.
Propranolol hydrochloride extended-release has different kinetics and produces lower blood levels. Retitration may be necessary, especially to maintain effectiveness at the end of the hour dosing interval.
Hypertension The usual initial dosage is 80 mg propranolol hydrochloride extended-release once daily, whether used alone or added to a diuretic. The dosage may be increased to mg once daily or higher until adequate blood pressure control is achieved.
The usual maintenance dosage is to mg once daily. In some instances a dosage of mg may be required. The time needed for full hypertensive response to a given dosage is variable and may range from a few days to several weeks. Angina Pectoris Starting with 80 mg propranolol hydrochloride extended-release once daily, dosage should be gradually increased at three- to seven- day intervals until optimal response is obtained.
Although individual patients may respond at any dosage level, the average optimal dosage appears to be mg once daily. In angina pectoris, the value and safety of dosage exceeding mg per day have not been established. Your doctor may gradually increase your dosage until the dosage that initiates optimal improvement is established.
In most cases the daily maintenance Inderal LA dosage for high blood pressure is mg. The recommended starting dosage for angina pectoris is Inderal LA 80mg once a day. The usual maintenance dosage is Inderal LA mg once a day. The recommended starting dosage for migraine is Inderal LA 80mg once a day. Depending on your response to the treatment, your doctor may gradually increase your dosage. Adequate facilities for monitoring these infants at birth should be available.
Propranolol hydrochloride should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Caution should be exercised when propranolol hydrochloride is administered to a nursing woman. Sympathetic stimulation may be a vital component supporting circulatory function in patients with congestive heart failure, and its inhibition by beta blockade may precipitate more severe failure.
Although beta blockers should be avoided in overt congestive heart failure, if necessary, they can be used with close follow-up in patients with a history of failure who are well compensated and are receiving digitalis and diuretics. Beta-adrenergic blocking agents do not abolish the inotropic action of digitalis on heart muscle.
In Patients without a History of Heart Failure, continued use of beta blockers can, in some cases, lead to cardiac failure. Propranolol hydrochloride should be administered with caution since it may block bronchodilation produced by endogenous and exogenous catecholamine stimulation of beta receptors. The necessity or desirability of withdrawal of beta-blocking therapy prior to major surgery is controversial. It should be noted, however, that the impaired ability of the heart to respond to reflex adrenergic stimuli may augment the risks of general anesthesia and surgical procedures.
Propranolol hydrochloride, like other beta blockers, is a competitive inhibitor of beta-receptor agonists and its effects can be reversed by administration of such agents, e. However, such patients may be subject to protracted severe hypotension.
Difficulty in starting and maintaining the heartbeat has also been reported with beta blockers. Beta-adrenergic blockade may prevent the appearance of certain premonitory signs and symptoms pulse rate and pressure changes of acute hypoglycemia in labile insulin-dependent diabetes. In these patients, it may be more difficult to adjust the dosage of insulin. Hypoglycemic attacks may be accompanied by a precipitous elevation of blood pressure in patients on propranolol.
Propranolol therapy, particularly in infants and children, diabetic or not, has been associated with hypoglycemia especially during fasting as in preparation for surgery. Hypoglycemia also has been found after this type of drug therapy and prolonged physical exertion and has occurred in renal insufficiency, both during dialysis and sporadically, in patients on propranolol. Acute increases in blood pressure have occurred after insulin-induced hypoglycemia in patients on propranolol.
Beta blockade may mask certain clinical signs of hyperthyroidism. Therefore, abrupt withdrawal of propranolol may be followed by an exacerbation of symptoms of hyperthyroidism, including thyroid storm. Propranolol may change thyroid-function tests, increasing T4 and reverse T3, and decreasing T3.
In Patients with Wolff-Parkinson-White Syndrome, several cases have been reported in which, after propranolol, the tachycardia was replaced by a severe bradycardia requiring a demand pacemaker. In one case this resulted after an initial dose of 5 mg propranolol. Propranolol hydrochloride is not indicated for the treatment of hypertensive emergencies.
Beta-adrenoreceptor blockade can cause reduction of intraocular pressure. Patients should be told that propranolol hydrochloride may interfere with the glaucoma screening test. Withdrawal may lead to a return of increased intraocular pressure.
Risk of anaphylactic reaction. While taking beta blockers, patients with a history of severe anaphylactic reaction to a variety of allergens may be more reactive to repeated challenge, either accidental, diagnostic, or therapeutic. Such patients may be unresponsive to the usual doses of epinephrine used to treat allergic reaction. Diabetes and Hypoglycemia Beta-adrenergic blockade may prevent the appearance of certain premonitory signs and symptoms pulse rate and pressure changes of acute hypoglycemia, especially in labile insulin-dependent diabetics.
In these patients, it may be more difficult to adjust the dosage of insulin. Propranolol therapy, particularly when given to infants and children, diabetic or not, has been associated with hypoglycemia especially during fasting as in preparation for surgery.
Hypoglycemia has been reported in patients taking Propranolol after prolonged physical exertion and in patients with renal insufficiency. Thyrotoxicosis Beta-adrenergic blockade may mask certain clinical signs of hyperthyroidism. Therefore, abrupt withdrawal of Propranolol may be followed by an exacerbation of symptoms of hyperthyroidism, including thyroid storm. Propranolol may change thyroid-function tests, increasing T4 and reverse T3, and decreasing T3. Wolff-Parkinson-White Syndrome Beta-adrenergic blockade in patients with Wolff-Parkinson-White syndrome and tachycardia has been associated with severe bradycardia requiring treatment with a pacemaker.
In one case, this result was reported after an initial dose of 5 mg Propranolol. Precautions General Propranolol should be used with caution in patients with impaired hepatic or renal function. Beta-adrenergic receptor blockade can cause reduction of intraocular pressure. Withdrawal may lead to a return of increased intraocular pressure. While taking beta-blockers, patients with a history of severe anaphylactic reaction to a variety of allergens may be more reactive to repeated challenge, either accidental, diagnostic, or therapeutic.
Such patients may be unresponsive to the usual doses of epinephrine used to treat allergic reaction. Clinical Laboratory Tests In patients with hypertension, use of Propranolol has been associated with elevated levels of serum potassium, serum transaminases, and alkaline phosphatase. In severe heart failure, the use of Propranolol has been associated with increases in Blood Urea Nitrogen.
Alcohol when used concomitantly with Propranolol, may increase plasma levels of Propranolol. Cardiovascular Drugs Antiarrhythmics Propafenone has negative inotropic and beta-blocking properties that can be additive to those of Propranolol.
Quinidine increases the concentration of Propranolol and produces greater degrees of clinical beta-blockade and may cause postural hypotension. The clearance of lidocaine is reduced with administration of Propranolol. Lidocaine toxicity has been reported following co-administration with Propranolol. Digitalis Glycosides Both digitalis glycosides and beta-blockers slow atrioventricular conduction and decrease heart rate. Concomitant use can increase the risk of bradycardia.
Both agents may depress myocardial contractility or atrioventricular conduction. There have been reports of significant bradycardia, heart failure, and cardiovascular collapse with concurrent use of verapamil and beta-blockers.
Co-administration of Propranolol and diltiazem in patients with cardiac disease has been associated with bradycardia, hypotension, high degree heart block, and heart failure. ACE Inhibitors When combined with beta-blockers, ACE inhibitors can cause hypotension, particularly in the setting of acute myocardial infarction.
The antihypertensive effects of clonidine may be antagonized by beta-blockers. Alpha Blockers Prazosin has been associated with prolongation of first dose hypotension in the presence of beta-blockers. Postural hypotension has been reported in patients taking both beta-blockers and terazosin or doxazosin. Reserpine Patients receiving catecholamine-depleting drugs, such as reserpine should be closely observed for excessive reduction of resting sympathetic nervous activity, which may result in hypotension, marked bradycardia, vertigo, syncopal attacks, or orthostatic hypotension.
Inotropic Agents Patients on long-term therapy with Propranolol may experience uncontrolled hypertension if administered epinephrine as a consequence of unopposed alpha-receptor stimulation.
Isoproterenol and Dobutamine Propranolol is a competitive inhibitor of beta-receptor agonists, and its effects can be reversed by administration of such agents, e.
Also, Propranolol may reduce sensitivity to dobutamine stress echocardiography in patients undergoing evaluation for myocardial ischemia.
Administration of indomethacin with Propranolol may reduce the efficacy of Propranolol in reducing blood pressure and heart rate. Antidepressants The hypotensive effects of MAO inhibitors or tricyclic antidepressants may be exacerbated when administered with beta-blockers by interfering with the beta blocking activity of Propranolol.
Anesthetic Agents Methoxyflurane and trichloroethylene may depress myocardial contractility when administered with Propranolol. Warfarin Propranolol when administered with warfarin increases the concentration of warfarin. Prothrombin time, therefore, should be monitored.
The time needed for full hypertensive response propranolol a given dosage is variable and may range precio cytotec honduras a few days to several weeks, propranolol er 160mg. For more information, call or go to www. Copyright c First Databank, Inc, propranolol er 160mg. Warfarin Propranolol when administered with warfarin increases the concentration of warfarin. Consult your doctor or pharmacist for details. During pregnancythis medication should be 160mg only when clearly needed. Propranolol should be administered with caution in this setting since it may provoke a bronchial asthmatic attack by blocking bronchodilation produced by endogenous and exogenous catecholamine stimulation of beta-receptors. The apparent plasma half-life is about 10 hours. In some instances a dosage of mg may be required. The dosage may be increased to mg once daily or higher until adequate blood pressure control is achieved. In dosages greater than required for beta blockade, Propranolol also exerts a quinidine-like or anesthetic-like membrane action which affects the cardiac action potential. Other symptoms of low blood sugarsuch as dizziness and sweatingare unaffected by this drug. Caution is advised if you have alcohol dependence or liver disease. Diabetes and Hypoglycemia Beta-adrenergic blockade may prevent the appearance of certain premonitory signs and symptoms pulse rate and pressure changes of acute hypoglycemia, especially in labile insulin-dependent diabetics. If you have any further questions on the use of this medicine, ask your doctor or pharmacist.
Both agents may depress myocardial contractility or propranolol conduction. Talk to propranolol pharmacist for more details. Cardiac Failure Sympathetic stimulation may be a vital 160mg supporting circulatory function in patients with congestive heart failure, propranolol er 160mg, and its inhibition by beta blockade may precipitate more severe failure. The generic name of Inderal LA is Propranolol. The antihypertensive effects of clonidine may be antagonized by beta-blockers. When access to beta-receptor sites is blocked by propranolol, the chronotropic, inotropicand vasodilator 160mg to beta-adrenergic stimulation are decreased proportionately. Fast heart rate atrial 160mg Form: Average shipping time is 2 to 3 weeks. Reported increased plasma concentrations, propranolol er 160mg, and increased and decreased clearance of propranolol. Ask your doctor or pharmacist about using this product safely. You may report side effects 160mg Health Canada at Propranolol hydrochloride extended-release is available as 60 mg, 80 mg, mg, and mg capsules. Drug Interactions Increased risk of hypotension, especially in patients with acute MI; bronchial hyperreactivity may be increased. Nitroglycerine tablets were allowed during the study, propranolol er 160mg. Beta-adrenergic receptors have propranolol demonstrated in the pial vessels of the brain. Benzodiazepines Propranolol can inhibit propranolol metabolism of diazepam, resulting in increased concentrations of diazepam and its metabolites.
Glucagon can exert potent inotropic and chronotropic effects and may be particularly useful for the treatment of hypotension or depressed myocardial function after a Propranolol overdose. Propranolol hydrochloride ER should not be considered a simple mg-for-mg substitute for propranolol hydrochloride. Renal Insufficiency The pharmacokinetics of Propranolol hydrochloride have not been investigated in patients with renal insufficiency. Adequate facilities for monitoring such infants at birth should be available. Properly discard this product when it is expired or no longer 160mg. Glucagon can exert potent inotropic and chronotropic effects and may be particularly useful for the treatment of hypotension or depressed myocardial function after a propranolol overdose. ECG's were recorded while patients propranolol until angina developed. The usual maintenance dosage is to mg once daily. Sugar intolerance Propranolol you have 160mg told that you have an intolerance to some sugars, contact your doctor before taking this medicine, 160mg it contains lactose, propranolol er 160mg. In dosages greater than required for beta blockade, propranolol propranolol also exerts a quinidine-like or anesthetic-like membrane action which affects the cardiac action potential. Studies suggest 160mg that propranolol is not dose-limiting for intestinal absorption of propranolol in the usual therapeutic dose range. Angina Pectoris In a double-blind, placebo-controlled study of 32 patients of both sexes, aged 32 to 69 years, with stable angina, propranolol mg t. The significance of the membrane action in the treatment of arrhythmias is uncertain. There have been reports of significant bradycardia, propranolol er 160mg, heart failure, propranolol er 160mg, and propranolol collapse with concurrent use of 160mg and beta-blockers.
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