General information

Inderal (active ingredient – Propranolol) is a long-known medicine for treatment of stenocardia and other heart diseases helps a person in overcoming various old and acquired phobias.

People suffering from heart diseases very well know drugs in which Propranolol is an active ingredient. Among others, it is Inderal. These drugs help with angina, arterial hypertension, migraine and are used as a prophylactic agent for heart attack prevention.

Propranolol is a beta-blocker, which means that it suppresses the release of adrenaline in the blood and, accordingly, the emergence of feelings of anxiety and fear. Thus, this medicine can now be administered to relieve, for example, post-traumatic stress.

This medication is aimed at fighting the following health disorders: Essential and renal hypertension, cardiac angina, abnormal heart rhythms, migraine, anxiety, essential tremor, thyrotoxicosis, hypertrophic obstructive cardiomyopathy, pheochromocytoma (with alpha-adrenergic blockers).

A long treatment course which includes Inderal has to be canceled slowly, under the physician supervision. Those patients who use intraocular contact lenses should remember that during treatment course with the mentioned agent a production of tear fluid may decrease. At the same time simultaneous intake of insulin as well as blood sugar reducing medications, the effectiveness of the latter may increase.

Precautions

Treatment course with this remedy has to be performed under the physician supervision. It is reduces compensatory cardiovascular reactions in response to the general anesthetics administration. It ought to be stated that intravenous application in children is not recommended. Furthermore, elderly patients are prone to the risk of adverse reactions development manifested by the central nervous system. In case of abnormal hepatic function it is recommended to decrease a dose of the remedy. This agent can mask the signs of glycopenia and rapid heartbeat in those diabetic patients who take insulin and other hypoglycemic medications. During the treatment course it is advised to exclude the alcoholic beverages. People using vehicle drivers and people whose profession activity requires increased concentration of attention should use this medication with special caution. During treatment, there are some changes in the results of tests during laboratory tests are possible, like an level of urea increase, transaminases, phosphatases).

Contraindications to this Inderal use is hypersensitivity to active substance, cardiogenic shock, spasmodic asthma, and bronchospasm history, metabolic acidosis, peripheral arterial circulatory disorders, bradycardia, AV-block, decompensated heart failure, Prinzmetal’s angina, hypotension, pregnancy, lactation.

This drug cannot be used in the presence of the following health disorders:

• cardiac conduction disorders (blockade)
• heart rate less than 55 beats per minute
• low blood pressure
• congestive heart failure
• Raynaud’s disease and other vascular disease blocking blood flow
• bronchial asthma
• depression.

Inderal Dosage

In case of diagnosed arterial hypertension the dose of 40 mg 2 times a day is usually prescribed; if there is an insufficient expression of the hypotensive effect, the dosage has to be increased up to 40 mg 3 times a day or 80 mg two times a day. General recommendation that maximum daily dose should not exceed 320 mg

In case of diagnosed angina or heart rhythm disturbances the initial dosage of the agent is usually amounts to 20 mg three times a day; then it can be gradually increased up to 80 mg 2-3 times a day; in this case maximum daily dose amounts to 240 mg.

When using the prolonged form of this agent (depot capsules 0.08 g), the frequency of the medication intake amounts to 1 time per day.
For the purpose of migraines prevention, as well as in case of essential tremor the initial dose of the medication amounts to 40 mg 2-3 times per day; if necessary, the dosage can be gradually increase up to 160 mg a day.

In case of paroxysmal cardiac rhythms and thyroid crisis treatment this medication can be applied intravenously slowly in the amount of 1 mg (1 ml of 0.1% solution); then in 2 minutes it can be repeated in the same dosage. If there is no effect of intravenous introduction the treatment course shall be repeated until the maximum dosage of 10 mg is reached. All these manipulations should be performed only under the blood pressure and ECG control.

How to take Inderal?

This drug can be taken orally for 15-30 minutes before meals, 10 mg 3 times a day, followed by a gradual increase in dose up to 20-40 mg 3-4 times a day (sometimes up to 320-480 mg / day.). In order to stop (relieve) heart rhythm disorders the dose of 1 mg is initially administered intravenously, and then, depending on the effect and tolerability the dose can be increased up to 5-10 mg.

With caution the discussed medication should be prescribed to pregnant and lactating women, as well as to patients with impaired liver function, kidney disease, diabetes. Pregnant women using Propranolol must terminate using it 48-72 hours before giving birth; it is necessary to perform a constant control of the newborn baby condition. Patients with pheochromocytoma can prescribe the drug only after taking an alpha blocker. Termination of a prolonged course of treatment should occur gradually under the supervision of a physician.

Inderal Side-effects

Use of Inderal may lead to the following adverse reactions:

• cardiovascular system and blood (hematopoiesis, hemostasis): deceleration of the heart rate, cardiac insufficiency, atrioventricular block, hypotension, impaired peripheral circulation, thrombocytopenic purpura, leukopenia, agranulocytosis.
• nervous system and sensory organs: asthenia, dizziness, headache, insomnia, drowsiness, nightmares, reduced mental and motor response, emotional instability, depression, agitation, hallucinations, disorientation in time and space, short-term amnesia, impaired sensitivity, paresthesias; dry eyes, visual disturbances, keratoconjunctivitis.
• gastrointestinal tract: sickness, vomiting, abdominal ache, stomach upset or constipation, mesenteric artery thrombosis, ischemic colitis.
• respiratory system: pharyngitis, stethalgia, cough, shortness of breath, bronchospasm and laryngismus, respiratory distress syndrome.
• skin: alopecia, rash, pruritus, exacerbation of psoriasis.
• others: withdrawal syndrome, decreased libido, impotence, Peyronie’s disease, arthralgia, allergic reactions, lupus syndrome, hypoglycemia, fever.

Overdose

There are following symptoms of overdose: dizziness, bradycardia, arrhythmia, heart failure, hypotension, collapse, difficulty breathing, acrocyanosis, convulsions. Treatment: gastric lavage and prescription of adsorbing agents, symptomatic therapy: atropine, beta-adrenomimetics (isoprenaline, izadrin), sedatives (diazepam, lorazepam), cardiotonic (dobutamine, dopamine, epinephrine) drugs, vasopressor agents, glucagon, etc .; transvenous stimulation is possible. Hemodialysis in this case is ineffective.

Interactions

In case of concomitant use other drugs or supplements, the effectiveness of Inderal may change. The patient is required to inform the physician about taken drugs, vitamins, and nutritional supplements. This information will allow the doctor to make the corresponding treatment course, which will avoid negative interactions.

Inderal may interact with the following drugs and products:

1. Amiodarone
2. Ammitriptyline
3. Aspirin
4. Clomipramine
5. Diclofenac
6. Doxazosin
7. Warfarin

Propranolol strengthens (mutually) the negative impact of Verapamil and Diltiazem on the myocardium, prolongs the action of non-depolarizing muscle relaxants, and inhibits the excretion of lidocaine. Heparin, antacids lower plasma levels of this medication and Cimetidine and phenothiazines – increase. Concurrent use with monoaminooxidase inhibitors is not recommended. It slows down the metabolism of Theophylline and increases its concentration in the blood plasma.

Alcohol interaction

Ethyl alcohol, which is part of the alcoholic beverages can interact with drugs both at the stage of their distribution in the body, and in the process of their metabolism (transformation). Such effects can weaken or enhance the effect of drugs and provoke the development of undesirable side reactions, which can be extremely serious.

Compatibility of this substance with alcohol is very low. Their concomitant use is dangerous. Reviews of some patient relatives indicate that quite often the result of the concomitant use of Propranolol and alcohol is fatal. This indicates on an extremely high risk of taking this active ingrdient after alcohol. First of all, this combination can lead to the fact that blood pressure drops to a critically low level. The medical definition of such a condition is orthostatic collapse. The condition is manifested by a sharp decrease in pressure, for example, when a person gets up. Usually such a condition is accompanied by nausea, chills, weakness, cooling of the limbs and a lack of coordination.

The greater the amount of alcohol consumed by the patient, the lower the blood pressure can be. In addition, alcohol can greatly enhance the manifestations of side effects from taking the drug. There can be hypotension or even faint.

Hypotension is accompanied by headaches and dizziness, nausea, drowsiness, etc. If Propranolol is prescribed to treat hypertension or tachycardia, then its effectiveness will be reduced to nothing if the person consumes alcohol along with treatment course.
When being under treatment course with Propranolol, it is necessary to abandon the alcohol intake even in minimal doses. This can affect the work of almost all internal organs and body systems.

Thus, it is dangerous to underestimate the possible consequences of the co-administration of this drug and alcohol as it may lead to fatal results. It has to be remembered that the spectrum of the harmful impacts of alcohol on the body is so wide that it is almost impossible to predict all the consequences of such a combination.

Inderal Reviews

The feedback is mostly positive. The users and physicians report that drug treatment is often effective. In addition, many are satisfied with the low price of medication. Inderal maintains blood pressure at a normal level, quickly eliminates heart palpitations. The drug reduces the manifestations of heart disease, relieves a person from agitation.

Theo: I am hypertension sufferer. I have been taking pills for a long time. I was prescribed various pills.
Not long ago, the doctor decided to prescribe me Propranolol containing medication. It was Inderal. I use it for six months. So far there are no problems, the result is good.

Sarah: I have suffered from heart problems. The doctor prescribed me Inderal. After I started using this substance, I felt like in my youth, the pressure and pulse are normal.