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Indications

Propranolol is indicated in:

  • Essential hypertension
  • Angina pectoris
  • Cardiac arrhythmia
  • Thyrotoxicosis
  • Anxiety
  • Prophylaxis of migraine, etc.

Pharmacology

Propranolol Hydrochloride is a B-adrenergic receptor blocking drug which is widely used in hypertension and angina pectoris. Propranolol antagonizes catecholamines at B-adrenergic receptors, thus prevents excess rate and force of contraction of the heart and decreases the excess consumption of oxygen by the heart.

Propranolol is almost completely absorbed from the gastrointestinal tract, but a portion is immediately metabolized by the liver when passing through the portal circulation. Peak plasma concentration occurs in 1 to 1.5 hours after oral administration. The plasma half-life of propranolol is from 3 to 6 hours. The metabolites of propranolol are excreted through the urine.

Dosage And Administration

Adult (above 18 years):

  • Hypertension: Initially 80 mg twice daily, may be increased at weekly intervals and then maintenance dose of 160-320 mg daily is recommended.
  • Angina pectoris: Initially 40 mg 2-3 times daily and then maintenance dose of 120-240 mg daily is given.
  • Thyrotoxicosis: 10-40 mg, 3-4 times daily is given.
  • Anxiety: 40 mg once daily, may be increased to three times daily.
  • Prophylaxis of migraine: Initially 40 mg 2-3 times daily; then maintenance dose of 80-160 mg daily is recommended.

Child (From day 1 to 18 years): Hypertension:

  • Neonate: 0.25-0.5 mg/kg 3 times daily, adjusted according to response.
  • Child 1 month: 12 years: 0.25-1 mg/kg 3 times daily, maximum dose 5 mg/kg daily in divided dose.
  • Child 12-18 years: initially 80 mg twice daily, maintain 160-320 mg daily.

Interaction

Patients receiving verapamil, salbutamol, Levosalbutamol, ergot alkaloids, lidocain, phenobarbital drugs should be closely observed during therapy.

Contraindications

Bronchospasm, cardiogenic shock, second or third degree heart block, diabetes mellitus etc.

Side Effects

Cold extremities, lassitude, nausea, dizziness, insomnia, paresthesia etc.

Pregnancy And Lactation

Pregnancy category C, should not be used in pregnant women. Propranolol is excreted in human milk. Caution should be taken when propranolol is administered to a nursing mother.

Precautions And Warnings

It should be taken with caution in hepatic and renal impairment, pregnancy and lactating mother.

Therapeutic Class

Beta-adrenoceptor blocking drugs, Beta-blockers.

Storage Conditions

Store in a cool and dry place, protected from light.