INDERAL 10MG 50TAB; propranolol, cardiovascular agents .
ACTIVE-INGREDIENT OF INDERAL 10MG 50TAB
Each tablet contains: 10 mg Propranolol Hydrochloride.
INDICATION OF INDERAL 10MG 50TAB
i) Control of hypertension. ii) Management of angina pectories. iii) Long term prophylaxis after recovery from acute myocardial infarction. iv) Control of cardiac arrhythmias. V) Prophylaxis of migraine. Vi) Management of essential tremor. Vii) Control of anxiety and anxiety tachycardia. viii) Adjunctive management of thyrotoxicosis and thyrotoxic crisis. ix) Management of hypertrophic obstructive cardiomyopathy. x) Management of phaeochromocytoma ( ‘Inderal’ should only be started in the presence of effective alpha blockade).
DOSAGE OF INDERAL 10MG 50TAB
Follow all directions given to you by your pharmacist or doctor carefully . They may differ from the information contained in this leaflet
Ask your pharmacist or doctor for help if you do not understand the instructions on the box .
The recommended dose is : –
Since the half-life may be increased in patients with significant hepatic or renal impairment, caution must be exercised when starting treatment and selecting the initial dose. Oral dosage: Adults: Hypertension: A starting dose of 80 mg twice a day may be increased at weekly intervals according to response. The usual dose range is 160-320 mg per day and the maximum daily dose must not exceed 640 mg per day. With concurrent diuretic or other antihypertensive drugs a further reduction of blood pressure is obtained. Angina, anxiety, migraine and essential tremor: A starting dose of 40 mg two or three times daily may be increased by the same amount at weekly intervals according to patient responce. An adequate response in anxiety, migraine and essential tremor is usually seen in the range 80-160 mg/day, and in angina in the range 120-240 mg/day. A maximum daily dose of 240 mg for migraine and 480 mg for angina must not be exceeded. Arrhythmias, anxiety tachycardia, hypertrophic obstructive cardiomyopathy and thyrotoxicosis: A dosage range of 10-40 mg three or four times a day usually achieves the required response. A maximum daily dose of 240 mg for arrhythmias must not be exceeded. Post-myocarial infarction: Treatment should start between days 5 to 21 after myocardial infarction, with an initial dose of 40 mg four times a day for 2 to 3 days. In order to improve compliance the total daily dosage may thereafter be given as 80 mg twice a day. Phaeochromocytoma: (‘Inderal’ is to be used only in the presence of effective alpha-blockade). Preoperative: 60 mg daily for three days is recommended. Non-operable malignant cases: 30 mg daily. Summary table of inderal oral dosage – Adults ( in divided daily doses): In case of Hypertension : 160 mg Min/day, 640 mg Max/day. In case of Angina pectoris : 80 mg Min/day, 480 mg Max/day. In case of Arrhythmias: 30 mg Min/day, 240 mg Max/day. In case of Migraine : 80 mg Min/day, 240 mg Max/day. In case of Tremor : 40 mg Min/day, 160 mg Max/day. In case of Anxiety: 80 mg Min/day, 160 mg Max/day. In case of Anxiety Tachycardia: 30 mg Min/day, 160 mg Max/day. In case of Thyrotoxicosis: 30 mg Min/day, 160 mg Max/day. In case of Cardiomyopathy: 30 mg Min/day, 160 mg Max/day. In case of Phaeochromocytoma : 60 mg (pre op) or 30 mg (maintenance) Min/day , 60 mg or 30 mg Max/day. In case of Post-infarction: 160 mg Min/day, 160 mg Max/day. Elderly: Evidence concerning the relation between blood level and age is confilicting. With regard to the elderly, the optimum dose should be individuallu determined according to clinical response. Children: Dosage should be individually determined and the following is only a guide: Arrythmias, phaeochromocytoma, thyrotoxicosis: Oral: 0.25 – 0.5 mg/kg three or four times daily as required. Migraine: Oral : Under the age of 12:20 mg two or three times daily. Over the age of 12: the adult dose.
OVER-DOSAGE OF INDERAL 10MG 50TAB
The symptoms of overdosage may include bradycardia, hypotension, acute cardiac insufficiency and bronchospasm. General treatment should include: close supervision, treatment in an intensive care ward, the use of gastric lavage, activated charcoal and a laxative to prevent absorptionof any drug still present in the gastrointestinal tract, the use of plasma or plasma substitutes to treat hypotension and shock. Excessive bradycardia can be countered with atropine 1-2 mg intravenously and/or a cardiac pacemaker. If necessary, this may be followed by a bolus dose of glucagon 10 mg intravenously. If required, this may be repeated or followed by an intravenous infusion of glucagon 1-10 mg/hour depending on response. If no response to glucagon occurs or if glucagon is unavailable, a beta-adenoceptor stimulant such as dobutamine 2.5 to 10 micrograms/kg/minute by intravenous infusion may be given. Dobutamine, becauseof its positive inotropic effect could also be used to treat hypotension and acute cardiac insufficiency. It is likely that these doses would be inadequate to reverse the cardiac effects of beta-blockade if a large overdose has been taken. The dose of dobutamine should therefore be increased if necessary to achieve the required response according to the clinical condition of the patient.
CONTRA-INDICATION OF INDERAL 10MG 50TAB
Inderal MUST NOT BE USED IF THERE IS A HISTORY OF BRONCHIAL ASTHMA OR BRONCHOSPASM. ” Do not take Inderal if you have a history of asthma or wheezing” Bronchospasm can usually be reversed by beta2- agonist bronchodilators such as salbutamol. Large doses of the beta2-agonist bronchodilator may be required to overcome the beta-blockade produced by propranotol and the dose should be titrated according to the clinical response; both intravenous and inhalational administration should be considered. The use of intravenous aminophylline and/or the use of ipratropium, (give by nebulliser), may also be considered. Glucagon ( 1 to 2 mg given intravenously) has also been reported to produce a bronchodilitor effect in asthmatic patients. Oxygen or artificial ventilation may be required in severe cases. ‘Inderal’ as with other beta-blockers must not be used in patients with any of the following: Known hypersensitivity to the substance; bradycardia; cardiogenic shock; hypotension; metabolic acidosis; after prolonged fasting; severe peripheral arterial circulatory disturbances; second or third degree heart block; sick sinus syndrome; untreated (with an alpha adrenoceptor antagonist) phaeochromocytoma; uncontrolled heart failure; Prinzmetal’s angina. Inderal must not be used in patients prone to hypoglycaemic, i.e, patients after prolonged fasting or patients with restricted counter-regulatory reserves. Patients with restricted-counter regulatory reserves may have reduced autonomic and hormonal responses to hypoglycaemia which includes glycogenolysis, gluconeogenesis and/or impaired modulation of insulin secretion. Patients at risk for an inadequate response to hypoglycaemia includes individuals with malnutrition, prolonged fasting, starvation, chronic liver disease, diabetes and concomitant use of drugs with block the full response to catecholamines.
STORAGE OF INDERAL 10MG 50TAB
Do not store above 30 °C. Protect from light and moisture.
PACK OF INDERAL 10MG 50TAB
Carton Box contains 50 tablets.
INDERAL 10MG 50TAB MANUFACTURED BY