Central Nervous System
Cardiovascular System-Migraine; Vasoconstrictors
Central Nervous System-Neurodegenerative Diseases
= Additional active ingredients
PRESENTATION AND DOSSAGE
TABS: 50 X 10 mg
TABS: 50 X 40 mg
TAKE WITH FOOD
Management of angina pectoris, control of essential and renal hypertension, control of essential tremor, control of most forms of cardiac dysrhythmias, adjunct in the management of tachycardias and arrhythmias due to thyrotoxicosis and thyrotoxic crises, management of hypertrophic obstructive cardiomyopathy, management of pheochromocytoma (with an alpha blocker). Prolol is also indicated for the long term prophylaxis after recovery from acute myocardial infarction (treatment to be initiated by a hospital physician), migrane prophylaxis.
hypersensitivity to propranolol or to any of the medicine’s ingredients, if patient or anyone in his family are suffering or have suffered in the past from asthma and/or wheezing, if patient have suffered in the past from: uncontrolled heart failure, very slow or irregular pulse, very low blood pressure, severe blood circulation disturbances, second or third degree heart block, Prinzmetal’s angina. Do not use in the following cases: untreated phaeochromocytoma, metabolic acidosis, strict diet regimen or after fasting. Do not use in patients prone to develop hypoglycemia.
Poor cardiac reserve should be controlled with digitalis and diuretics. History of bronchospasm (cardioselective β blockers e.g. acebutolol, atenolol, betaxolol, bisoprolol, celiprolol, metoprolol, nebivolol, and the β blocker, labetalol, usually have a lesser effect on airways resistance than the non-selective type but their use should also be avoided in patients with wheezing or obstructive airway disease unless there are compelling clinical reasons). Diabetes. Asthenic symptoms. Cerebrovascular insufficiency. Atopy. Renal or hepatic impairment, thyrotoxic crisis. General anaesthesia; consider withdrawal before elective surgery. Pregnancy, lactation. Withdraw gradually.
Cold extremities, CNS and sleep disturbances (particularly with the more lipophilic drugs), bradycardia (less with carvedilol, pindolol), exertional tiredness, bronchospasm, heart failure, hypotension, GI upset, alopecia, thrombocytopenia. Withdraw gradually in unexplained dry eyes or skin rash.
Verapamil, diltiazem, class I antiarrhythmics, amiodarone, cardiac depressant anesthetics, cardiac glycosides. Oral hypoglycemics, insulin, reserpine, ergot alkaloids. Cimetidin (with labetalol and propranolol only), indomethacin (possibly other NSAID), clonidine. Thyroxine, liver enzyme inducers (e.g. rifampicin, barbiturates), direct and indirect sympathomimetic amines, fluvoxamine, phenothiazines, propafenone.
Angina Pectoris, Essential Tremor, Migraine Prophylaxis Adults: The recommended initial dosage is 40 mg, 2-3 times daily. This may be increased by the same amount, at weekly intervals, according to patients response. An adequate response in the management of migraine and essential tremor is usually seen in the range of 80-160 mg/day, and in the treatment of angina in the range of 120-240 mg/day.
Children: The dosage for migraine prophylaxis in children is as follows: Under the age of 12 years: 20 mg 2 or 3 times daily. Over the age of 12 years: The adult dosage.
Hypertension: The recommended initial dosage is 80 mg, twice a day. This may be increased at weekly intervals, according to patient response. The usual dosage range is 160-320 mg/day. With concurrent diuretic or other antihypertensive drugs, a further reduction of blood pressure is obtained.
Arrhythmias, Hypertrophic Obstructive Cardiomyopathy, Thyrotoxicosis, Thyrotoxic Crises: Adults: A dosage range of 10-40 mg, 3-4 times daily, usually achieves the desired response.
Children: For these indications as well as for pheochromcytoma, dosage should be individually determined, and the following is only a guide: A dosage of 0.25-0.5 mg per kg body weight 3-4 times daily, as required.
Pheochromocytoma: Use only with an alpha-receptor blocking drug. Preoperatively, a dosage of 60 mg/day, for 3 days, is recommended. In non-operable malignant cases, administer 30 mg/day.
Post-Myocardial Infarction: Treatment should start between days 5 and 21 after myocardial infarction, with an initial dose of 40 mg four times a day for 2 or 3 days. In order to improve compliance, the total daily dosage may thereafter be given as 80 mg twice a day.
Use in the Elderly: Evidence concerning the relation between blood level and age is conflicting. Propanolol should be used to treat the elderly with caution. It is suggested that treatment should start with the lowest dose. With regard to the elderly, the optimum dose should be individually determined according to clinical response.
MANUFACTURER & DISTRIBUTER:
Manufacturer: Dexcel Ltd.
License Holder: Dexcel Ltd.