Generic Inderal

1. Denomination

Inderal

2. Active Substance

Propranolol

3. Indications for Use.

The drug should be administered strictly on personality measures.
Arterial hypertension, stenocardia, sinus tachycardia (including while there is hyperthyroidism), supraventricular tachycardia, tachy-systolic form of atrial fibrillation, supraventricular and ventricular beats, hypertrophic cardiomyopathy, myocardial infarction, bulging of mitral valve, subaortic stenosis, sympathoadrenal crisis in diencephalic syndrome patients, neurocirculatory asthenia, portal hypertension, essential tremor, panic attacks, aggressive behavior, migraine (prevention measures), ancillary treatment in pheochromocytoma, thyrotoxicosis (including presurgery preparation), thyrotoxic crisis, primary uterine inertia, menopausal vasomotor syndrome, abstinence syndrome; treatment of the akathisia provoked with neuroleptics.

4. Action

Arterial tension under the influence of Propranolol drops. Tonicity of bronchi elevates. The drug enhances spontaneous uterus involutions and generated ones. The drug decreases bleeding in childbirth and in postsurgical period.

5. Posology and Administration

The drug is administered stream intravenously, in adults for the stopping of arrhythmia, thyrotoxic crisis, acute ischemia -  1 mg during one minute, if needed, repeatedly with an interval of 2 minutes (ECG and AT being controlled). The maximal dose is 10 mg. Propranolol should be taken orally, rinsing it with liquid or semi-liquid food (water, juice, apple sauce, pudding), for adults: in arterial hypertension the starting dose is 80 mg each 2 times a day, a supporting dose is 160–320 mg. Prolonged forms: 80 mg once daily, if needed, up to 120–160 mg single-shot, AT being controlled. When there are arrhythmias it is taken 10–30 mg each 3–4 times a day, when there is subaortal stenosis it is taken 20–40 mg each 3–4 times a day. When there are portal hypertension, stenocardia, migraine, excitement, tremor the starting dose is 40 mg each 2–3 times a day, a supporting one is 160, 120–240, 80–160, 80–120, 80–160 mg/daily, respectively. When there is pheochromocytoma it should be taken 30–60 mg/daily during 3 days (before surgery). When there is myocardial infarction – in the period from the 5-th to the 21-th day after infarction it should be taken 40 mg each 4 times daily during 2–3 days, further on it should be taken 80 mg 2 times daily. For induction of labor it is used 20 mg each every 30 minutes 4–6 times (80–120 mg/daily), for prevention of postpartum hemorrhages 20 mg each 3 times daily during 3–5 days. When there is glaucoma the drug should be introduced intra-conjunctivally into an impaired eye.

In children: orally the starting dose is 0,5–1 mg/kg/daily, a supporting one is 2–4 mg/kg/daily in 2 intakes.

6. Counterindications

Chronic bronchitis, emphysema, diabetes, hypoglycemia, acidosis, compromised function of liver and kidneys, psoriasis, irritable bowel syndrome, myasthenia, pregnancy, breastfeeding, old age.

7. Should Be Taken with Precautions, if…

Regular medicinal control is needed during the treatment.
Elderly patients are at risk of central nervous system side effects. When there is compromised liver function it is recommended reduction of doses and monitoring in the first 4 days of the therapy. Caution and strict care are needed while treatment of diabetes patients.
During the treatment it is recommended to avoid alcohol consummation.
The treatment should be withdrawn little by little, during, around 2 weeks.

8. Interface with Other Medications

It is counterindicated to use different drugs simultaneously, without a doctor’s order.

9. Overdosing

Symptoms: dizziness, bradycardia, arrhythmia, heart failure, significant drop of arterial tension, coma, respiratory affection, bluish discoloration of feet and hands, convulsions.

10. Side Effects

On the part of nervous system: undue fatigability, weakness, dizziness, headache, drowsiness or insomnia, “nightmare” dreams, depression, unrest, conscious fog or short-term loss of memory, hallucinations, numbness of limbs and their unintentional rhythmic motions. On the part of sense organs: disorders of vision acuteness, reduction of secretion of tear, dry and painful eyes. On the part of cardio-vascular system: disorder of heart-beat rhythm, low arterial tension, lower extremities coldness. On the part of intestinal system: dry mucus coating, nausea, vomiting, pains in the zone of the stomach, elevated gas production, constipations or diarrhea, compromised liver function, change of taste. Allergic reactions: itching, skin rash, hives.
Others: enhancement of perspiration, hypothyroidism, pain in the back, weakening of libido, decrease of potency, “withdrawal” syndrome (enhancement of stenocardia attacks, high arterial tension).

11. Pregnancy and Lactation

Counterindicated in pregnancy. During the treatment breastfeeding should be avoided.

12. Driving

Drivers of vehicles and people whose activity is connected with alertness should use the drug with caution.

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