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Inderal

Brand Names: Inderal, Sumial Retard (ER), Propranolol, Betachron ER, Inderal LA
Generic name:
Propranolol Hydrochloride
Manufacturer:
AstraZeneca

What is Inderal?
Inderal is a beta-blocker. Beta-blockers affect the heart and circulation (blood flow through arteries and veins).
Inderal is used to treat tremors, angina (chest pain), hypertension (high blood pressure), heart rhythm disorders, and other heart or circulatory conditions. It is also used to treat or prevent heart attack, and to reduce the severity and frequency of migraine headaches.

Important facts about Inderal
If you have high blood pressure, you must take Inderal regularly for it to be effective. Since blood pressure declines gradually, it may be several weeks before you get the full benefit of Inderal; and you must continue taking it even if you are feeling well. Inderal does not cure high blood pressure; it merely keeps it under control.

Indoral Dosage
ADULTS
All dosages of Inderal, for any problem, must be tailored to the individual. Your doctor will determine when and how often you should take Inderal. If you are over 65, the doctor will probably start with a relatively low dosage. Remember to take it exactly as directed.

Hypertension
The usual starting dose of Inderal is 40 milligrams 2 times a day. This dose may be in combination with a diuretic. Dosages are gradually increased to between 120 milligrams and 240 milligrams per day for maintenance. In some cases, a dose of 640 milligrams per day may be needed. Depending on the individual, maximum effect of this drug may not be reached for a few days or even several weeks. Some people may do better taking Inderal 3 times a day.

Angina Pectoris
The usual daily dosage is 80 milligrams to 320 milligrams, divided into 2, 3, or 4 smaller doses. When your treatment is being discontinued, your doctor will reduce the dosage gradually over a period of several weeks.

Irregular Heartbeat
The usual dose is 10 milligrams to 30 milligrams 3 or 4 times a day, before meals and at bedtime.

Heart Attack
The usual daily dosage is 180 milligrams to 240 milligrams divided into smaller doses. The usual maximum dose is 240 milligrams, although your doctor may increase the dose when treating heart attack with angina or high blood pressure.

Migraine
The usual starting dosage is 80 milligrams per day divided into smaller doses. Dosages can be increased gradually to between 160 milligrams and 240 milligrams per day. If this dose does not relieve your symptoms in 4 to 6 weeks, your doctor will slowly take you off Inderal.

Tremors
The usual starting dose is 40 milligrams, 2 times per day. Symptoms will usually be relieved with a dose of 120 milligrams per day; however, on occasion, dosages of 240 milligrams to 320 milligrams per day may be necessary.

Hypertrophic Subaortic Stenosis
The usual dose is 20 milligrams to 40 milligrams, 3 to 4 times a day, before meals and at bedtime.

Before Adrenal Gland Surgery
The usual dose is 60 milligrams a day divided into smaller doses for 3 days before surgery in combination with an alpha-blocker drug.

Inderal may also be taken by people with inoperable tumors in doses of 30 milligrams a day, divided into smaller doses.

CHILDREN
Inderal will be carefully individualized for use in children and is used only for high blood pressure. Doses in children are calculated by body weight, and range from 2 milligrams to 4 milligrams per 2.2 pounds daily, divided into 2 equal doses. The maximum dose is 16 milligrams per 2.2 pounds per day.

If treatment is stopped, Inderal must be gradually reduced over a 7- to 14-day period.

Inderal is also available in a sustained-release formulation, called Inderal (ER), for once-a-day dosing.

Administration
Should be taken on an empty stomach (Take before meals.).

Contraindications
History of bronchial asthma or bronchospasm, bradycardia, cardiogenic shock, hypotension, metabolic acidosis, after prolonged fasting, severe peripheral arterial circulatory disturbances, 2nd or 3rd degree heart block, sick sinus syndrome, untreated (w/ an α-adrenoceptor antagonist) phaeochromocytoma, uncontrolled heart failure, Prinzmetal's angina.

Special Precautions
Poor cardiac reserve, peripheral arterial circulatory disturbances, 1st degree heart block, hypoglycaemia, thyrotoxicosis, history of anaphylactic reaction to allergens, decompensated cirrhosis, portal HTN. W/draw gradually. Pregnancy & lactation.

What side effects when taking Inderal may occur?
Side effects of Inderal cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Inderal.

Side effects when taking Inderal may include:
Abdominal cramps, colitis, congestive heart failure, constipation, decreased sexual ability, depression, diarrhea, difficulty breathing, disorientation, dry eyes, fever with sore throat, hair loss, hallucinations, headache, light-headedness, low blood pressure, lupus erythematosus (a disease of the connective tissue), nausea, rash, reddish or purplish spots on the skin, short-term memory loss, slow heartbeat, tingling, prickling in hands, tiredness, trouble sleeping, upset stomach, visual changes, vivid dreams, vomiting, weakness, worsening of certain heartbeat irregularities.

Drug Interactions
If Inderal is taken with certain other drugs, the effects of either could be increased, decreased, or altered.
It is especially important to check with your doctor before combining Inderal with the following:

Alcohol
Aluminum hydroxide gel (Amphojel)
Antipyrine (Auralgan)
Calcium-blocking blood pressure drugs such as Cardizem, Procardia, and Calan
Certain high blood pressure medications such as Diupres and Ser-Ap-Es
Chlorpromazine (Thorazine)
Cimetidine (Tagamet)
Epinephrine (EpiPen)
Haloperidol (Haldol)
Insulin
Lidocaine (Xylocaine)
Nonsteroidal anti-inflammatory drugs such as Motrin and Naprosyn
Oral diabetes drugs such as Micronase
Phenobarbitone
Phenytoin (Dilantin)
Rifampin (Rifadin)
Theophylline (Theo-Dur and others)
Thyroid medications such as Synthroid

Why should Inderal not be prescribed?
If you have inadequate blood supply to the circulatory system (cardiogenic shock), certain types of irregular heartbeat, a slow heartbeat, bronchial asthma, or severe congestive heart failure, you should not take Inderal.

Special warnings about Inderal
If you have a history of congestive heart failure, your doctor will prescribe Inderal cautiously.

Inderal should not be stopped suddenly. This can cause increased chest pain and heart attack. Dosage should be gradually reduced.

If you suffer from asthma or other bronchial conditions, coronary artery disease, or kidney or liver disease, Inderal should be used with caution.

Ask your doctor if you should check your pulse while taking Inderal.Inderal can cause your heartbeat to become too slow.

Inderal may mask the symptoms of low blood sugar or alter blood sugar levels. In addition, diabetics who experience a severe drop in blood sugar after taking insulin may suffer a spike in blood pressure if they are also taking Inderal.

Notify your doctor or dentist that you are taking Inderal if you have a medical emergency, and before you have surgery or dental treatment.

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