Propranolol

Tab: Should be taken on an empty stomach (i.e. At least one hour before food or two hours after food).
Cap: May be taken with or without food. Take consistently either always w/ or always w/o meals.

Current or 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, Prinzmetal's angina, uncontrolled heart failure, phaeochromocytoma that has not been treated with α-receptor blocker. Additional contraindications for Hemangeol: Heart rate <80 bpm, blood pressure <50/30 mmHg; premature infants with corrected age <5 weeks and infants weighing <2 kg.

Patient with 1st-degree heart block, compensated heart failure, diabetes mellitus, myasthenia gravis, history of anaphylactic reaction to allergens, less severe peripheral circulatory disturbances, Wolff-Parkinson-White Syndrome. Patient undergoing surgery. Avoid abrupt withdrawal (particularly in patients with ischaemic heart disease); chronic therapy must not be routinely withdrawn before major surgery. May mask the signs and symptoms of hypoglycaemia and hyperthyroidism (particularly tachycardia). Renal and hepatic impairment. Neonates, children, and elderly. Pregnancy and lactation. Monitoring Parameters Monitor blood pressure, heart rate, ECG; serum glucose (in patients with diabetes mellitus). For infantile haemangioma: Monitor blood pressure and heart rate for 2 hours following initiation or increase in dose.

Significant: Bradycardia (including heart block, sinus pause, and cardiac arrest), cardiac failure, bronchospasm, hypoglycaemia; exacerbation of angina and acute MI following abrupt withdrawal. Blood and lymphatic system disorders: Rarely, thrombocytopenia. Eye disorders: Rarely, visual disturbances, dry eye. Gastrointestinal disorders: Nausea, vomiting, diarrhoea, constipation. General disorders and administration site conditions: Fatigue. Immune system disorders: Hypersensitivity reactions (including anaphylactic reactions). Investigations: Increased serum K, serum transaminases, alkaline phosphatase. Nervous system disorders: Rarely, dizziness. Psychiatric disorders: Sleep disturbances, nightmares. Rarely, hallucinations, psychoses, confusion, mood changes. Skin and subcutaneous tissue disorders: Rarely, alopecia, purpura, psoriasiform skin reaction, rash. Vascular disorders: Cold extremities, Raynaud's phenomenon.

May have additive negative inotropic effect with anti-arrhythmic agents (e.g. disopyramide, amiodarone, quinidine) and Ca channel blockers with negative inotropic effect (e.g. verapamil, diltiazem). May increase AV conduction time with digitalis glycoside. Increased plasma concentration with CYP2D6 and CYP1A2 inhibitors (e.g. cimetidine). May cause vasospastic reactions with ergotamine, dihydroergotamine or related compounds. May decrease hypotensive effect with NSAIDs (e.g. ibuprofen, indometacin). Increased risk of hypotension and attenuation of the reflex tachycardia with anaesthetic drugs. May enhance the hypoglycaemic effect of insulin. May exacerbate the rebound hypertension following the withdrawal of clonidine. May enhance the hypotensive effect of prazosin, reserpine, MAO inhibitors, and TCAs. Concurrent use with sympathomimetic agents (e.g. epinephrine) may counteract the effects of propranolol. Concomitant use of propranolol and chlorpromazine may result in increased plasma concentrations and enhanced effects of both drugs. May increase the plasma concentration of lidocaine, rizatriptan, and warfarin.

Antimigraine Preparations / Beta-Blockers

C07AA05 - propranolol ; Belongs to the class of non-selective beta-blocking agents. Used in the treatment of cardiovascular diseases.