$Unique_ID{BRK02116}
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$Title{PROPRANOLOL}
$Subject{Inderal (Wyeth-Ayerst)
Inderal LA (Wyeth-Ayerst)
propranolol (various manufacturers)}
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$Log{
Inderal 10*0211601.scf
Inderal 20*0211602.scf
Inderal 40*0211603.scf
Inderal 80*0211604.scf
Inderal LA 80*0211605.scf
Inderal LA 120*0211606.scf}

Copyright (C) 1991 Publications International, Ltd.


PROPRANOLOL
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BRAND NAMES (Manufacturers):
     Inderal (Wyeth-Ayerst)
     Inderal LA (Wyeth-Ayerst)
     propranolol (various manufacturers)
TYPE OF DRUG:
     Beta-adrenergic blocking agent
INGREDIENT:
     propranolol
DOSAGE FORMS:
     Tablets (10 mg, 20 mg, 40 mg, 60 mg, 80 mg, and 90 mg)
     Extended-release capsules (80 mg, 120 mg, and 160 mg)
     Oral solution (4 mg and 8 mg per ml)
     Oral concentrated solution (80 mg per ml)
STORAGE:
     Store at room temperature in a tightly closed, light-resistant container.
       The solutions should never be frozen.

USES

     Propranolol is used to treat high blood pressure, angina pectoris (chest
pain), and irregular heartbeats.  It is also useful in preventing migraine
headaches and preventing additional heart attacks in heart attack patients.
Propranolol belongs to a group of medicines known as beta-adrenergic blocking
agents or, more commonly, beta blockers.  These drugs work by controlling
nerve impulses along certain nerve pathways.

TREATMENT

     Propranolol can be taken with a glass of water, with meals, immediately
following meals, or on an empty stomach (depending on your doctor's
instructions).  Try to take the medication at the same time(s) each day.
     The extended-release capsules should be swallowed whole.  Do not chew or
crush them.  Breaking the capsule releases the medication all at
once-defeating the purpose of extended-release capsules.
     The oral solution should be measured with a specially designed 5-ml
measuring spoon.  An ordinary kitchen teaspoon is not accurate enough.
     The oral concentrated solution must be mixed in four ounces ( cup) of
water, juice, or soda before drinking.  The cup should be refilled with more
of the liquid, which must be drunk to ensure that the entire dose is taken.
This form may also be mixed with applesauce or pudding.
     It is important to remember that propranolol does not cure high blood
pressure, but it will help to control the condition as long as you continue to
take it.
     Try not to miss any doses of this medicine.  If you do miss a dose, take
the missed dose as soon as possible, unless it is within eight hours (if you
are taking this medicine only once a day) or within four hours (if you are
taking this medicine more than once a day) of your next scheduled dose.  In
that case, do not take the missed dose at all; just return to your regular
dosing schedule.  Do not double the next dose of the medication.

SIDE EFFECTS

     Minor.

     Anxiety; constipation; decreased sexual ability; diarrhea; difficulty in
sleeping; drowsiness; dryness of the eyes, mouth, and skin; headache; nausea;
nervousness; stomach discomfort; tiredness; or weakness.  These side effects
should disappear during treatment, as your body adjusts to the medicine.
     To relieve constipation, increase the amount of fiber in your diet (fresh
fruits and vegetables, salads, bran, and whole-grain breads) and drink more
water (unless your doctor directs you to do otherwise).
     If you are extra-sensitive to the cold, be sure to dress warmly during
cold weather.
     Plain, nonmedicated eye drops (artificial tears) may help to relieve eye
dryness.
     Sucking on ice chips or chewing sugarless gum helps to relieve mouth and
throat dryness.

     Major.

     Tell your doctor about any side effects that are persistent or
particularly bothersome.  IT IS ESPECIALLY IMPORTANT TO TELL YOUR DOCTOR about
breathing difficulty or wheezing, cold hands or feet (due to decreased blood
circulation to skin, fingers, and toes), confusion, depression, dizziness,
hair loss, hallucinations, light-headedness, nightmares, numbness or tingling
of the fingers or toes, rapid weight gain (three to five pounds within a
week), reduced alertness, swelling, sore throat and fever, skin rash, or
unusual bleeding or bruising.

INTERACTIONS

     Propranolol interacts with a number of other types of medications:
     1. Indomethacin, aspirin, or other salicylates may decrease the
blood-pressure-lowering effects of beta blockers.
     2. Concurrent use of beta blockers and calcium channel blockers
(diltiazem, nifedipine, verapamil) or disopyramide can lead to heart failure
or very low blood pressure.
     3. Cimetidine and oral contraceptives (birth control pills) can increase
the blood concentrations of propranolol, which can result in greater side
effects.
     4. Side effects may also be increased when beta blockers are taken with
clonidine, digoxin, epinephrine, phenylephrine, phenylpropanolamine,
phenothiazine tranquilizers, prazosin, reserpine, or monoamine oxidase (MAO)
inhibitors.  At least 14 days should separate the use of a beta blocker and an
MAO inhibitor.
     5. Barbiturates, alcohol, and rifampin can increase the breakdown of
propranolol in the body, which can lead to a decrease in its effectiveness.
     6. Beta blockers may antagonize (work against) the effects of
theophylline, aminophylline, albuterol, isoproterenol, metaproterenol, and
terbutaline.
     7. Beta blockers can also interact with insulin or oral antidiabetic
agents, raising or lowering blood sugar levels or masking the symptoms of low
blood sugar.
     8. The action of beta blockers may be excessively increased if they are
used with chlorpromazine, furosemide, or hydralazine.
     BE SURE TO TELL YOUR DOCTOR about any medications you are currently
taking, especially any of those listed above.

WARNINGS

     * Before starting to take this medication, it is important to tell your
doctor if you have ever had unusual or allergic reactions to any beta blocker
(acebutolol, atenolol, betaxolol, carteolol, esmolol, labetalol, metoprolol,
nadolol, penbutolol, pindolol, propranolol, timolol).
     * Tell your doctor if you now have or if you have ever had allergies,
asthma, hay fever, eczema, slow heartbeat, bronchitis, diabetes mellitus,
emphysema, heart or blood vessel disease, kidney disease, liver disease,
thyroid disease, or poor circulation in the fingers or toes.
     * You may want to check your pulse while taking this medication.  If your
pulse is much slower than your usual rate (or if it is less than 50 beats per
minute), check with your doctor.  A pulse rate that is too slow may cause
circulation problems.
     * This medicine may affect your body's response to exercise.  Make sure
you ask your doctor what an appropriate amount of exercise would be for you,
taking into account your medical condition.
     * It is important that you do not stop taking this medicine without first
checking with your doctor.  Some conditions may become worse when the medicine
is stopped suddenly, and the danger of a heart attack is increased in some
patients.  Your doctor may want you to gradually reduce the amount of medicine
you take before stopping completely.  Make sure that you have enough medicine
on hand to last through vacations, holidays, and weekends.
     * Before having surgery or any other medical or dental treatment, tell
your physician or dentist that you are taking this medicine.  Often, this
medication will be discontinued 48 hours prior to any major surgery.
     * Propranolol can cause dizziness, drowsiness, light-headedness, and
decreased alertness.  Use caution while driving a car or operating dangerous
machinery.
     * While taking this medicine, do not use any over-the-counter
(nonprescription) allergy, asthma, cough, cold, sinus, or diet preparations
without first checking with your pharmacist or doctor.  The combination of
these medicines with a beta blocker can result in high blood pressure.
     * Be sure to tell your doctor if you are pregnant.  Animal studies have
shown that some beta blockers can cause problems in pregnancy when used at
very high doses.  Adequate studies have not been done in humans, but there has
been some association between use of beta blockers during pregnancy and low
birth weight, as well as breathing problems and slow heart rate in newborn
infants.  However, other reports have shown no effects in newborn infants.
Also, tell your doctor if you are breast-feeding an infant.  Although this
medicine has not been shown to cause problems in breast-fed infants, some of
the medicine may pass into breast milk, so caution is warranted.

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The material contained here is "FOR INFORMATION ONLY" and should not replace 
the counsel and advice of your personal physician.  Promptly consulting your 
doctor is the best path to a quick and successful resolution of any medical 
problem.
