Inderal

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Generic Name: Inderal Brand Name(s): Generics only. No brands available.

Uses

What is Inderal® (propranolol) used for?

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.

Inderal® may also be used for purposes not listed in this medication guide.

How should I take Inderal® (propranolol)?

Take Inderal® exactly as prescribed by your doctor. Follow all directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results. Do not take this medicine in larger or smaller amounts or for longer than recommended.

Adults may take Inderal® with or without food, but take it the same way each time.

Take this medicine at the same time each day.

Do not crush, chew, break, or open an extended-release capsule. Swallow it whole.

Your blood pressure will need to be checked often.

If you need surgery, tell the surgeon ahead of time that you are using Inderal®. You may need to stop using Inderal for a short time.

Do not skip doses or stop using Inderal suddenly. Stopping suddenly may make your condition worse. Follow your doctor’s instructions about tapering your dose.

This medicine can cause unusual results with certain medical tests. Tell any doctor who treats you that you are using Inderal.

If you are being treated for high blood pressure, keep using this medicine even if you feel well. High blood pressure often has no symptoms. You may need to use blood pressure medicine for the rest of your life.

Inderal® is only part of a complete program of treatment for hypertension that may also include diet, exercise, and weight control. Follow your diet, medication, and exercise routines very closely if you are being treated for hypertension.

How do I store Inderal® (propranolol)?

Inderal® is best stored at room temperature away from direct light and moisture. To prevent drug damage, you should not store Inderal® in the bathroom or the freezer. There may be different brands of Inderal® that may have different storage needs. It is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

You should not flush Inderal® down the toilet or pour them into a drain unless instructed to do so. It is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Precautions & warnings

What should I know before using Inderal® (propranolol)?

Before using this drug, tell your doctor if:

  • You are pregnant or breastfeeding. This is because, while you are expecting or feeding a baby, you should only take medicines on the recommendation of a doctor.
  • You are taking any other medicines. This includes any medicines you are taking which are available to buy without a prescription, such as herbal and complementary medicines.
  • You have allergy with any of active or inactive ingredients of Inderal® or other medications.
  • You have any other illnesses, disorders, or medical conditions.

You should not use Inderal® if you have:

  • Asthma
  • Very slow heart beats that have caused you to faint
  • A serious heart condition such as “sick sinus syndrome” or “AV block” (unless you have a pacemaker)

Is it safe during pregnancy or breastfeeding?

There are no adequate studies in women for determining risk when using Inderal® during pregnancy or while breastfeeding. Please always consult with your doctor to weigh the potential benefits and risks before taking Inderal®. Inderal® is pregnancy risk category C, according to the US Food and Drug Administration (FDA).

FDA pregnancy risk category reference below:

  • A=No risk
  • B=No risk in some studies
  • C=There may be some risk
  • D=Positive evidence of risk
  • X=Contraindicated
  • N=Unknown

Side effects

What side effects can occur from Inderal® (propranolol)?

Get emergency medical help if you have any signs of an allergic reaction to Inderal: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

  • Slow or uneven heartbeats
  • A light-headed feeling, like you might pass out
  • Wheezing or trouble breathing
  • Shortness of breath (even with mild exertion), swelling, rapid weight gain
  • Sudden weakness, vision problems, or loss of coordination
  • Cold feeling in your hands and feet
  • Depression, confusion, hallucinations
  • Liver problems – nausea, upper stomach pain, itching, tired feeling, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes)
  • Low blood sugar – headache, hunger, weakness, sweating, confusion, irritability, dizziness, fast heart rate, or feeling jittery
  • Low blood sugar in a baby – pale skin, blue or purple skin, sweating, fussiness, crying, not wanting to eat, feeling cold, drowsiness, weak or shallow breathing (breathing may stop for short periods), seizure (convulsions), or loss of consciousness
  • Severe skin reaction – fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling

Common side effects may include:

  • Nausea, vomiting, diarrhea, constipation, stomach cramps
  • Decreased sex drive, impotence, or difficulty having an orgasm
  • Sleep problems (insomnia)
  • Tired feeling

Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.

Interactions

What drugs may interact with Inderal® (propranolol)?

Inderal® may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs, and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval.

Products that may interact with this drug are:

  • A blood thinner – warfarin, Coumadin, Jantoven
  • An antidepressant – amitriptyline, clomipramine, desipramine, imipramine, and others
  • Drugs to treat high blood pressure or a prostate disorder – doxazosin, prazosin, terazosin
  • Heart or blood pressure medicine – amiodarone, diltiazem, propafenone, quinidine, verapamil, and others;
  • NSAIDs (nonsteroidal anti-inflammatory drugs) – aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac, indomethacin, meloxicam, and others
  • Steroid medicine-prednisone and others

Does food or alcohol interact with Inderal® (propranolol)?

Inderal® may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with Inderal® (propranolol)?

Inderal® may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have.

Dosage

The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using Inderal® (propranolol).

What is the dose of Inderal® (propranolol) for an adult?

Hypertension

The usual initial dosage is 40 mg Inderal® twice daily, whether used alone or added to a diuretic. Dosage may be increased gradually until adequate blood pressure control is achieved. The usual maintenance dosage is 120 mg to 240 mg per day.

In some instances, a dosage of 640 mg a day may be required. The time needed for full antihypertensive response to a given dosage is variable and may range from a few days to several weeks.

While twice-daily dosing is effective and can maintain a reduction in blood pressure throughout the day, some patients, especially when lower doses are used, may experience a modest rise in blood pressure toward the end of the 12-hour dosing interval. This can be evaluated by measuring blood pressure near the end of the dosing interval to determine whether satisfactory control is being maintained throughout the day. If control is not adequate, a larger dose, or 3‑times‑daily therapy may achieve better control.

Angina Pectoris

Total daily doses of 80 mg to 320 mg Inderal, when administered orally, twice a day, three times a day, or four times a day, have been shown to increase exercise tolerance and to reduce ischemic changes in the ECG. If treatment is to be discontinued, reduce dosage gradually over a period of several weeks.

Atrial Fibrillation

The recommended dose is 10 mg to 30 mg Inderal three or four times daily before meals and at bedtime.

Migraine

The initial dose is 80 mg Inderal® daily in divided doses. The usual effective dose range is 160 mg to 240 mg per day.

Essential Tremor

The initial dosage is 40 mg Inderal® twice daily. Optimum reduction of essential tremor is usually achieved with a dose of 120 mg per day. Occasionally, it may be necessary to administer 240 mg to 320 mg per day.

Hypertrophic Subaortic Stenosis

The usual dosage is 20 mg to 40 mg Inderal three or four times daily before meals and at bedtime.

Pheochromocytoma

The usual dosage is 60 mg Inderal® daily in divided doses for three days prior to surgery as adjunctive therapy to alpha-adrenergic blockade. For the management of inoperable tumors, the usual dosage is 30 mg daily in divided doses as adjunctive therapy to alpha-adrenergic blockade.

What is the dose of Inderal® (propranolol) for a child?

The dosage has not been established in pediatric patients. It may be unsafe for your child. It is always important to fully understand the safety of the drug before using. Please consult with your doctor or pharmacist for more information.

How is Inderal® (propranolol) available?

Inderal® is available in the following dosage forms and strengths:

  • Tablets: propranolol hydrochloride

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.

What should I do if I miss a dose?

If you miss a dose of Inderal®, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.

Review Date: September 7, 2017 | Last Modified: September 7, 2017

Sources
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