What is this medication?
Antianginal Agent; Class II Antiarrhythmic; Nonselective Beta-Blocker
Propranolol/Inderal is officially indicated for chronic stable angina, cardiac arrythmias, essential tremor, hypertension, migraine prophylaxis, myocardial infarction early treatment and secondary prevention, obstructive hypertrophic cardiomyopathy, pheochromocytoma, or proliferating infantile hemangioma. It is also prescribed off-label for use in antipsychotic induced akathisia, performance anxiety disorder, thyroid storm, thyrotoxicosis, lithium induced tremor, and variceal hemorrhage prophylaxis.
“ALERT: US Boxed Warning
Cardiac ischemia after abrupt discontinuation (Inderal LA, Inderal XL, Innopran XL):
Following abrupt discontinuation of therapy with beta-blockers, exacerbations of angina pectoris and myocardial infarction (MI) have occurred.
When discontinuing long-term administration of propranolol, particularly in patients with ischemic heart disease, gradually reduce the dose over a period of 1 to 2 weeks and monitor the patient. If angina markedly worsens or acute coronary insufficiency develops, promptly resume therapy, at least temporarily, and take other measures appropriate for the management of unstable angina. Warn patients against interruption or discontinuation of therapy without health care provider’s advice.
Because coronary artery disease is common and may be unrecognized, avoid abrupt discontinuation of propranolol therapy, even in patients treated only for hypertension.”
How does this medication work?
Propranolol/Inderal competitively blocks beta1 and beta2 adrenergic receptors resulting in decreased heart rate, myocardial contractility, blood pressure, and myocardial oxygen demand. Reduces portal vein (major blood vessel that feeds into liver) pressure via beta2 effects on splanchnic vasoconstriction which in turn lowers portal blood flow.
How should I take this medication?
Instant release: 10-160 mg divided in up to four daily dosages
Extended release: 60-320 mg once daily
How to Take: Follow instructions provided by physician/pharmacy label, swallow whole (extended release), take consistently at same times each day unless otherwise directed, take instant release tablets on an empty stomach, extended can be with or without but be consistent, store at room temperature
You Need to Avoid: Careful standing up too quickly as you may get dizzy. Do not stop this medication abruptly to avoid rebound tachycardia, hypertension and in severe cases angina, heart attack, or arrythmia. Consume alcohol with caution as it may affect blood levels of propranolol. If consumed, then monitor blood pressure and heart rate.
What should I watch for while using this medication?
Before starting Propranolol/Inderal make sure your physician is aware of any allergies, medications you currently take, if you have a low resting heart rate, asthma or other bronchospastic disease, cardiac conduction abnormalities, diabetes, liver disease, myasthenia gravis, peripheral vascular disease, hyperthyroidism, kidney disease, psoriasis, or if pregnant/breastfeeding
What if I miss a dose?
If you miss a dose of medication, try to take it as soon as possible. However, if it is almost time for your next dose, take only that scheduled dose. Do not take double or extra doses.
How should I store this medication?
Keep out of the reach of children at all times. Store at room temperature, 59 to 86° F (15 to 30° C). Protect from light. Keep the container tightly closed. Properly dispose of any unused medication after the expiration date.
What are the possible side effects of using this medication?
Hypotension, dizziness, fatigue, bradycardia (low heart rate), depression, insomnia, weakness, disorientation, nausea, purpura (red/purple spots on skin), alopecia, impotence
Note this is not a complete list of side effects, only common ones.
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