Generic
Propranolol Hydrochloride
12 brands available in the market
At a glance
Propranolol Hydrochloride is a non-cardioselective beta-blocker used for essential hypertension, angina pectoris, cardiac arrhythmia, thyrotoxicosis, anxiety, and prophylaxis of migraine.
Description
Propranolol is a beta-adrenergic receptor blocking drug that competitively blocks beta1- and beta2-receptors, decreasing heart rate, myocardial contractility, blood pressure, and myocardial oxygen demand. It has membrane-stabilizing properties and antagonizes the beta-adrenergic stimulating effects of sympathomimetic agents.
Indications
- Essential hypertension
- Angina pectoris
- Cardiac arrhythmia
- Thyrotoxicosis
- Anxiety
- Prophylaxis of migraine
Therapeutic class
Beta-adrenoceptor blocking drugs, Beta-blockers
Pharmacological class
Non-selective Beta-blocker
Pharmacology
Propranolol is a non-cardioselective beta-blocker that competitively blocks beta1- and beta2-receptors, decreasing heart rate, myocardial contractility, blood pressure, and myocardial oxygen demand. It has membrane-stabilizing properties and antagonizes the beta-adrenergic stimulating effects of sympathomimetic agents.
Mechanism of action
Reduces heart rate and blood pressure by blocking beta-adrenergic receptors.
Dosage
Adult Dose (Oral):
- Hypertension: 80 mg twice daily initially; 160-320 mg/day maintenance; max 640 mg/day
- Angina pectoris: 40 mg 2-3 times daily initially; 120-240 mg/day maintenance; max 320 mg/day
- Arrhythmia: 30-160 mg/day in divided doses
- Migraine prophylaxis: 40 mg 2-3 times daily initially; 120-240 mg/day maintenance
- Anxiety: 10-40 mg 2-3 times daily
- Hyperthyroidism: 10-40 mg 3-4 times daily
- Severe hepatic impairment: 20 mg three times daily
Pediatric Dose (Oral):
- Hypertension: 1 mg/kg/day in 2 divided doses initially; 2-4 mg/kg/day maintenance; max 4 mg/kg/day
- Arrhythmia/Pheochromocytoma: 0.25-0.5 mg/kg 3-4 times daily
- Migraine prophylaxis: <12 years 10-20 mg 2-3 times daily; >12 years 40 mg 2-3 times daily
Administration
- Take on an empty stomach
- Avoid high-fat meals (olive oil, nuts, dark chocolate, meat)
- Take at the same time each day
Missed dose
If you miss a dose, take it as soon as you remember; skip if it's almost time for next dose; do not double the dose.
Side effects
Common Side Effects:
- Cold extremities
- Lassitude
- Nausea
- Dizziness
- Insomnia
- Paresthesia
- Fatigue
- Weakness
- Arrhythmia
- Raynaud phenomenon
Precautions & warnings
- May affect driving ability; do not drive if dizzy, confused, or tired
- Do not stop abruptly
- Monitor blood sugar in diabetic patients
- Caution in hepatic and renal impairment
- Caution in pregnancy and lactation
Contraindications
- Sinus bradycardia
- Cardiogenic shock
- Sick sinus syndrome
- Raynaud's syndrome
- 2nd and 3rd degree heart block
- Bronchial asthma, COPD
- Untreated pheochromocytoma
- Prinzmetal's angina
- Severe peripheral arterial disease
- Metabolic acidosis
- Concurrent use with thioridazine
Drug interactions
- Amiodarone, disopyramide, quinidine, flecainide, Ca channel blockers: Additive negative chronotropic and/or inotropic effect
- Phenothiazines: Additive hypotensive effect
- Sympathomimetics: Beta-adrenergic stimulating effects antagonized
- Reserpine: Additive effects, potentiate depression
- Aluminum, NSAIDs: Reduced antihypertensive effect
- Warfarin: Increased bioavailability and prothrombin time
- Antidiabetic agents and insulin: Altered antidiabetic response
- Potentially fatal: Increased risk of QT prolongation and torsades de pointes with thioridazine
Food interactions
Alcohol consumption with Propranolol Hydrochloride is unsafe.
Use in pregnancy
Use in Pregnancy: May be unsafe during pregnancy; animal studies have shown harmful effects; consult your doctor.
Pregnancy Category: C — always consult a doctor before taking during pregnancy.
Use in lactation
Use in Lactation: Probably safe; limited human data suggests no significant risk; excreted in human milk; caution required.
Pediatric use
Pediatric dose based on age and weight; consult your doctor.
Geriatric use
Caution required in elderly patients; dose adjustment may be needed.
Renal / hepatic impairment
Renal Impairment: Safe in kidney disease; no dose adjustment needed; start with low dose; monitor blood pressure; consult your doctor.
Hepatic Impairment: Caution in liver disease; dose adjustment may be needed; severe hepatic impairment: 20 mg three times daily; consult your doctor.
Overdose effects
Overdose: Bradycardia, hypotension, heart failure, bronchospasm; treatment: atropine, glucagon, beta-agonists, supportive care.
Storage conditions
Store in a cool and dry place, protected from light.
Chemical structure
Propranolol Hydrochloride