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What is inderal


Propranolol: medicine for heart problems, anxiety and migraine

1. About propranolol

Propranolol belongs to a group of medicines called beta blockers. It's used to treat heart problems, help with anxiety and prevent migraines.

If you have a heart problem, you can take propranolol to:

  • treat high blood pressure
  • treat conditions that cause an irregular heartbeat (arrhythmia), like atrial fibrillation
  • help prevent future heart disease, heart attacks and strokes
  • help prevent chest pain caused by angina

Propranolol can help reduce your symptoms if you have too much thyroid hormone in your body (thyrotoxicosis). You'll usually take it together with medicines to treat an overactive thyroid.

This medicine is only available on prescription. It comes as tablets, slow release capsules, or as a liquid that you swallow.

2. Key facts

  • Propranolol slows down your heart rate and makes it easier for your heart to pump blood around your body.
  • It's usually prescribed for high blood pressure and other heart problems, but it can also help with the physical signs of anxiety, like sweating and shaking.
  • Your very first dose of propranolol may make you feel dizzy, so take it at bedtime. After that, if you do not feel dizzy, you can take it in the morning.
  • The main side effects of propranolol are feeling dizzy or tired, cold hands or feet, difficulties sleeping and nightmares. These side effects are usually mild and short-lived.

3. Who can and cannot take propranolol

Most adults and children aged 12 and over can take propranolol. But it is not officially approved for treating high blood pressure in children under 12 years old.

Propranolol is not suitable for everyone. To make sure it's safe for you, tell your doctor before starting to take propranolol if you:

  • have ever had an allergic reaction to propranolol or any other medicine
  • have low blood pressure or a slow heart rate
  • have heart failure which is getting worse
  • have diabetes
  • have liver or kidney problems
  • have severe blood circulation problems in your limbs (such as Raynaud's phenomenon), which may make your fingers and toes tingle or turn paler than usual or blue
  • have metabolic acidosis, when there is too much acid in your blood
  • have lung disease or asthma
  • are pregnant, trying to get pregnant or breastfeeding

4.

How and when to take propranolol

Propranolol comes as 2 different types of medicine:

  • standard release – this releases propranolol into your body quickly, so you may need to take it several times a day depending on your dose
  • slow release – this releases the medicine slowly so you do not have to take it as often, once a day is usually enough

If you are taking it once a day, your doctor may advise you to take your first dose before bedtime, because it can make you feel dizzy. After the first dose, if you do not feel dizzy, take propranolol in the morning.

Important: Important

Keep taking propranolol even if you feel well. You will still be getting the benefits of the medicine.

Dosage and strength

Propranolol tablets come in strengths of 10mg, 40mg, 80mg or 160mg. The slow release capsules are 80mg or 160mg. The liquid comes in strengths of 5mg, 10mg, 40mg or 50mg in 5ml.

How much you take depends on why you need propranolol.

The usual doses for adults are:

  • high blood pressure – the starting dose is usually 80mg, taken twice a day. If this dose is not working well enough to reduce your blood pressure, your doctor may increase it to a maximum of 160mg twice a day
  • migraine or angina (chest pain) – 40mg, taken 2 or 3 times a day. This can be increased to 120mg to 240mg a day. Your doctor or pharmacist will explain how to split the dose over the day
  • irregular heartbeat (arrhythmia) – 10mg to 40mg, taken 3 or 4 times a day
  • anxiety – 40mg taken once a day which can be increased to 40mg taken 3 times a day
  • too much thyroid hormone (thyrotoxicosis) – 10mg to 40mg, taken 3 or 4 times a day

Doses are usually lower for people aged over 65 or people with a kidney or liver problem.

If your child needs propranolol, your doctor will usually use your child's weight to work out the right dose.

How to take it

Propranolol does not usually upset your stomach so you can take it with or without food. It's best to do the same each day.

Swallow the tablets whole with a drink of water. If you find the tablets difficult to swallow, some brands have a score line to help you break the tablet in half. Check the information leaflet for your brand to see if you can do this.

If you're taking capsules, swallow them whole with a drink of water. Do not break, chew or crush them.

If you're taking propranolol as a liquid, it will come with a plastic syringe or spoon to help you measure out the right dose. If you do not have one, ask your pharmacist for one. Do not use a kitchen teaspoon as it will not measure the right amount of medicine.

If you forget to take it

If you forget to take a dose of propranolol, take it as soon as you remember, unless it's nearly time for your next dose. In this case, just leave out the missed dose and take your next dose at the usual time.

Never take 2 doses at the same time. Never take an extra dose to make up for a forgotten one.

If you often forget doses, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to help you remember to take your medicine.

If you take too much

An overdose of propranolol can slow down your heart rate and make it difficult to breathe. It can also cause dizziness and trembling.

The amount of propranolol that can lead to an overdose varies from person to person.

Urgent advice: Contact 111 for advice now if:

  • you take more than your prescribed dose of propranolol

Call 111 or go to 111 online

If you need to go to A&E, do not drive yourself. Get someone else to drive you or call for an ambulance.

Take the propranolol packet or leaflet inside it plus any remaining medicine with you.

5. Side effects

Like all medicines, propranolol can cause side effects in some people, but many people have no side effects or only minor ones.

Side effects often improve as your body gets used to the medicine.

Common side effects

These common side effects happen in more than 1 in 100 people. They're usually mild and short-lived.

Talk to your doctor or pharmacist if the side effects bother you or last more than a few days:

  • headaches
  • feeling tired, dizzy or weak
  • cold fingers or toes
  • feeling or being sick (nausea or vomiting), or diarrhoea
  • stomach pain

Serious side effects

It happens rarely, but some people have serious side effects when taking propranolol.

Tell a doctor or contact 111 straight away if:

  • the whites of your eyes turn yellow, your skin turns yellow although this may be less obvious on brown on black skin, or you have pale poo or dark pee – these can be signs of liver problems
  • you get nosebleeds that last for more than 10 minutes, unexplained bruising, or you bruise more easily than usual – these can be signs of low numbers of platelets in your blood (thrombocytopenia)

Go to 111.nhs.uk or call 111.

Immediate action required: Call 999 or go to A&E now if:

  • you have shortness of breath with a cough which gets worse when you exercise (like walking up stairs), swollen ankles or legs, chest pain, or an irregular heartbeat – these are signs of heart problems
  • you have shortness of breath, wheezing and tightening of your chest – these can be signs of lung problems
Serious allergic reaction

In rare cases, propranolol may cause a serious allergic reaction (anaphylaxis).

Immediate action required: Call 999 or go to A&E now if:

  • you get a skin rash that may include itchy, red, swollen, blistered or peeling skin
  • you're wheezing
  • you get tightness in the chest or throat
  • you have trouble breathing or talking
  • your mouth, face, lips, tongue or throat start swelling

You could be having a serious allergic reaction and may need immediate treatment in hospital.

These are not all the side effects of propranolol. For a full list, see the leaflet inside your medicine packet.

Information:

You can report any suspected side effect using the Yellow Card safety scheme.

Visit Yellow Card for further information.

6. How to cope with side effects of propranolol

What to do about:

  • headaches – make sure you rest and drink plenty of fluids. Try not to drink too much alcohol. Ask your pharmacist to recommend a painkiller. Talk to your doctor if the headaches last longer than a week or are severe.
  • feeling tired, dizzy or weak – as your body gets used to propranolol, these side effects should wear off. If propranolol makes you feel dizzy, sit or lie down until you feel better. It's best not to drink alcohol as it will make you feel worse. Do not drive or ride a bike until you feel better.
  • cold fingers or toes – put your hands or feet under warm running water, massage them and wiggle your fingers and toes. Do not smoke or have drinks with caffeine in, as this can make your blood vessels narrower and further restrict blood flow to your hands and feet. Try wearing mittens (they're warmer than gloves) and warm socks. Do not wear tight watches or bracelets.
  • feeling or being sick or diarrhoea – stick to simple meals and do not eat rich or spicy food. It might help to take your propranolol after a meal or snack. Drink lots of fluids, such as water or squash, to avoid dehydration. Take small, frequent sips if you're being sick. Signs of dehydration include peeing less than usual or having dark, strong-smelling pee. Do not take any other medicines to treat diarrhoea and vomiting without speaking to a pharmacist or doctor. If you take contraceptive pills and you're being sick or have severe diarrhoea, your contraception may not protect you from pregnancy. Check the pill packet for advice.
  • stomach pain – try to rest and relax. It can help to eat and drink slowly and have smaller and more frequent meals. Putting a heat pad or covered hot water bottle on your tummy may also help. If you are in a lot of pain, speak to your pharmacist or doctor.

7. Pregnancy and breastfeeding

Propranolol and pregnancy

Propranolol is not thought to be harmful during pregnancy, but it may affect your baby's growth in later pregnancy. Discuss taking propranolol with your doctor or midwife as you may need extra scans to check your baby's growth.

If you're trying to get pregnant or you're already pregnant, talk to your doctor about the benefits and possible harms of taking propranolol. There may be other medicines that are better to use during pregnancy.

Propranolol and breastfeeding

If your doctor or health visitor says that your baby is healthy, it's OK to take propranolol while breastfeeding.

Propranolol passes into breast milk in tiny amounts. It has not been known to cause any side effects in breastfed babies.

It's important to treat your high blood pressure to keep you well. Breastfeeding will also benefit both you and your baby.

If you notice that your baby is not feeding as well as usual, or seems unusually sleepy, or if you have any other concerns about your baby, then talk to your doctor or health visitor.

Non-urgent advice: Tell your doctor if you're:

  • trying to get pregnant
  • pregnant
  • breastfeeding

For more information about how propranolol can affect you and your baby during pregnancy, visit the Best Use of Medicines in Pregnancy (BUMPS) website.

8. Cautions with other medicines

There are some medicines that may affect the way propranolol works.

Tell your doctor if you're taking:

  • other medicines for high blood pressure. The combination with propranolol can sometimes lower your blood pressure too much. This may make you feel dizzy or faint. If this keeps happening to you, your doctor may change your dose
  • other medicines for an irregular heartbeat such as amiodarone or flecainide
  • other medicines which can lower your blood pressure. These include some antidepressants, nitrates (for chest pain), baclofen (a muscle relaxant), medicines for an enlarged prostate gland like tamsulosin, or Parkinson's disease medicines such as levodopa
  • asthma or chronic obstructive pulmonary disease (COPD) medicines
  • diabetes medicines, particularly insulin – propranolol may make it more difficult to recognise the warning signs of low blood sugar. Speak to your doctor if you have low blood sugar levels without getting any of the usual warning signs. Check your blood sugar after exercise, and follow usual advice about checking it before driving, cycling or operating machinery
  • medicines to treat nose or sinus congestion, or other cold remedies (including those you can buy in the pharmacy)
  • medicines for allergies, such as ephedrine, noradrenaline or adrenaline
  • non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, diclofenac or naproxen. These medicines may increase your blood pressure, so it's best to keep them to a minimum

Mixing propranolol with herbal remedies or supplements

There's very little information about taking herbal remedies and supplements with propranolol. They are not tested in the same way as pharmacy and prescription medicines.

Medicine safety

Tell your doctor or pharmacist if you're taking any other medicines, including herbal medicines, vitamins or supplements.

9. Common questions about propranolol

How does propranolol work?

Propranolol is a type of medicine called a beta blocker.

Like other beta blockers, propranolol works by changing the way your body responds to some nerve impulses, including in the heart. It slows down your heart rate and makes it easier for your heart to pump blood around your body.

It works differently if you're using it for anxiety. When you are anxious, your brain makes chemical messengers called adrenaline and noradrenaline. These make your heart rate faster and make you sweat or shake. Propranolol helps block the effects of these chemical messengers. This reduces the physical signs of anxiety.

It's not fully understood how propranolol prevents migraines. It may work by relaxing the blood vessels involved, or by reducing activity in the visual cortex. This is the part of the brain where migraines are believed to start.

How long does propranolol take to work?

Propranolol usually starts to work in a few hours.

For heart conditions or high blood pressure, propranolol can take up to a week to reach its full effect. You may not feel any different but that does not mean it is not working. It's important to keep taking your medicine.

For migraines, it can take several weeks for propranolol to start making a real difference, so keep taking it.

How long will I take it for?

This depends on why you're taking propranolol.

For heart conditions or high blood pressure, treatment is usually long term and may be for the rest of your life.

For anxiety, you'll usually take propranolol for a short amount of time, to help with your physical symptoms. Speak to your doctor about the risks and benefits of taking it for more than a few months. This will depend on your symptoms, whether it's a one-off or a recurring problem, how well propranolol works for you and whether you get side effects.

For migraines, treatment can last for several months or years, depending on how bad your symptoms are.

Can I take propranolol for a long time?

Propranolol is generally safe to take for a long time.

If you're taking it for a heart condition, or to prevent migraines, it works best when you take it long term.

If you're taking it for anxiety, there do not seem to be any lasting harmful effects if you take it for several months or years. But it's best to take propranolol only for as long as you need it.

You'll need to have your blood pressure checked regularly if you're taking propranolol for a long time for migraines or anxiety.

What will happen if I stop taking it?

Talk to your doctor if you want to stop taking propranolol. If you're bothered by side effects, your doctor may be able to prescribe a different medicine instead.

Stopping propranolol suddenly may make your health problem worse. In addition, if you stop suddenly after taking it for a long time, you may get extra side effects as a reaction to stopping it. These include an irregular heart rate, sweating and shaking.

If you stop taking propranolol, it will take about 1 to 2 days for it to be completely out of your body but the side effects can last for up to 1 week.

How does propranolol compare with other heart medicines?

Propranolol works as well as other beta blockers for reducing blood pressure. The main difference between propranolol and other beta blockers is that it does not just affect your heart. It can affect other parts of your body too, such as your lungs.

There are lots of other medicines to lower your blood pressure and treat chest pain. They work in a different way to beta blockers and include:

  • ACE inhibitors like ramipril and lisinopril
  • angiotensin receptor blockers like candesartan
  • calcium channel blockers like amlodipine
  • medicines that make you pee more (diuretics) like furosemide

Beta blockers are not usually the first choice for high blood pressure. The medicine your doctor prescribes depends on your age and ethnicity.

If you're under 55 and not of African Caribbean or black African origin, you'll usually be offered an ACE inhibitor or an angiotensin receptor blocker.

If you're 55 or older, or you're any age and of African Caribbean or black African origin, you'll usually be offered a calcium channel blocker.

Sometimes you may have to try other blood pressure-lowering medicines if you get side effects. Many people need to take a combination of different medicines to lower their blood pressure.

How does it compare with other medicines for preventing migraine?

Atenolol, metoprolol, timolol and nadolol are all beta blockers and they work well in preventing migraines. However, most doctors prescribe propranolol.

There are some other medicines that are known to prevent migraines but they are not officially approved in the UK. They include amitriptyline, sodium valproate and gabapentin and they may have different side effects.

Topiramate can also be used to prevent migraines. It works just as well as propranolol. However, topiramate has not been officially approved for migraine for children under the age of 16.

Ask your doctor or pharmacist which medicine is best for you.

How does it compare with other medicines for anxiety?

Propranolol treats the physical symptoms of anxiety – for example, it stops your heart beating too fast. You'll usually only take propranolol for a short time.

The physical symptoms of anxiety are caused by chemical imbalances in the brain. Your doctor may prescribe an antidepressant like sertraline to treat these imbalances. You usually take antidepressants long term.

Many doctors prefer medicine-free treatments for anxiety. These include talking therapies like cognitive behavioural therapy. If you're having talking therapy, your doctor may prescribe propranolol at the same time. This will help you with your physical symptoms.

Will I need to stop taking propranolol before surgery?

Tell your doctor that you're taking propranolol if you're going to be put to sleep using general anaesthetic, or you're having any kind of major operation.

Your doctor may advise you to stop taking propranolol before surgery. This is because propranolol can lower your blood pressure too much when it's combined with some anaesthetics.

Can I drink alcohol with it?

Drinking alcohol can increase the blood pressure-lowering effect of propranolol, which can make you feel dizzy or lightheaded.

During the first few days of taking propranolol or after an increase in your dose, it's best to stop drinking alcohol until you see how the medicine affects you.

If you find propranolol makes you feel dizzy it's best to stop drinking alcohol.

Is there any food or drink I need to avoid?

Apart from being careful with alcohol, you can eat and drink normally while taking propranolol.

Eating a healthy, balanced diet can help if you have high blood pressure or another heart condition.

Will it make me put on weight?

Some people on propranolol say they put on weight, especially in the first few months of taking it. This is not known to be a common side effect of taking propranolol, and there is not enough information to say for sure why some people put on weight.

It could, for example, be because propranolol can make you feel tired which could make you less active. It could also affect the way your body uses energy.

If you're worried about putting on weight with propranolol, speak to your doctor.

Will it affect my contraception?

Propranolol will not stop your contraception working.

However, some types of hormonal methods of contraception, like the combined pill and contraceptive patch, are not usually recommended if you're taking propranolol or other medicines for high blood pressure. This is because some hormonal contraceptives can raise your blood pressure and stop propranolol working properly.

Talk to your doctor if you're taking a hormonal contraceptive.

If propranolol makes you sick (vomit) or have severe diarrhoea for more than 24 hours, your contraceptive pills may not protect you from pregnancy. Look on the pill packet to find out what to do.

Read more about what to do if you're on the pill and you're being sick or have diarrhoea.

Will it affect my fertility?

There is no evidence that propranolol affects fertility in men or women.

If you're trying to get pregnant, or you're having problems getting pregnant while on propranolol, speak to your doctor.

Will it affect my sex life?

Some people on propranolol say their sex drive goes down and some men find they cannot get an erection. However, this is not a common side effect and there is not enough evidence to say for sure that propranolol is causing it.

If you're having problems with your sex life, talk to your doctor.

Do I need to avoid playing sports?

You do not need to stop playing sports if you take propranolol. But do not push yourself too much.

Regular exercise is good for you because it lowers blood pressure by keeping your heart and blood vessels in good condition.

Be aware, though, that in some sports propranolol is not allowed if you're competing at a high level.

Can I drive or ride a bike?

Propranolol can make some people feel dizzy, especially when they first start taking it or after taking a bigger dose. If this happens to you, do not drive a car, ride a bike, or use tools or machinery.

It's an offence to drive a car if your ability to drive safely is affected. It's your responsibility to decide if it's safe to drive. If you're in any doubt, do not drive.

Talk to your doctor or pharmacist if you're unsure whether it's safe for you to drive while taking propranolol. GOV.UK has more information on the law on drugs and driving.

Can lifestyle changes help?

If you have heart problems, you can boost the health of your heart by making some key lifestyle changes. These changes will also help if you have high blood pressure.

  • Quit smoking – smoking increases your heart rate and blood pressure. Quitting smoking brings down your blood pressure and relieves heart failure symptoms. Try to avoid second-hand smoke too.
  • Cut down on alcohol – drinking alcohol while you're taking propranolol can make you feel dizzy or light headed. Also drinking too much alcohol raises blood pressure over time and makes heart failure worse. It's best to keep to the recommended limit of no more than 14 units of alcohol a week. A standard glass of wine (175ml) is 2 units. A pint of lager or beer is usually 2 to 3 units of alcohol.
  • Exercise – regular exercise lowers blood pressure by keeping your heart and blood vessels in good condition. It does not need to be too energetic, walking every day will help.
  • Eat well – aim to eat a diet that includes plenty of fruit and vegetables, wholegrains, fat-free or low-fat dairy products and lean proteins. It's a good idea to follow these tips for a lower salt diet too. Eating too much salt is the biggest cause of high blood pressure. The more salt you eat, the higher your blood pressure will be. Aim for no more than 6g of salt a day.
  • Deal with stress – when you're anxious or upset, your heart beats faster, you breathe more heavily and your blood pressure often goes up. This can make heart failure worse too. Find ways to reduce stress in your life. To give your heart a rest, try napping or putting your feet up when possible. Spend time with friends and family to be social and help avoid stress.

If you get severe headaches, there are steps you can take to help prevent migraines. This includes working out what things trigger an attack so you can avoid them.

Inderal Drug / Medicine Information

NOTICE: This Consumer Medicine Information (CMI) is intended for persons living in Australia.

Consumer Medicine Information (CMI) summary

The full CMI on the next page has more details. If you are worried about using this medicine, speak to your doctor or pharmacist.

Why am I using INDERAL?

INDERAL contains the active ingredient propranolol hydrochloride . INDERAL is used to treat or prevent a number of conditions, most of which are related to the heart. For more information, see Section 1. Why am I using INDERAL? in the full CMI.

What should I know before I use INDERAL?

Do not use if you have ever had an allergic reaction to propranolol hydrochloride or any of the ingredients listed at the end of the CMI. Talk to your doctor if you have any other medical conditions, take any other medicines, or are pregnant or plan to become pregnant or are breastfeeding. For more information, see Section 2. What should I know before I use INDERAL? in the full CMI.

What if I am taking other medicines?

Some medicines may interfere with INDERAL and affect how it works. A list of these medicines is in Section 3. What if I am taking other medicines? in the full CMI.

How do I use INDERAL?

Your doctor will tell you what dose to take.

More instructions can be found in Section 4. How do I use INDERAL? in the full CMI.

What should I know while using INDERAL?

Things you should do

Remind any doctor, dentist or pharmacist you visit that you are using INDERAL.

If you are about to be started on any new medicine, remind your doctor and pharmacist that you are taking INDERAL.

Call your doctor straight away if you have a severe allergic reaction to foods, medicines or insect stings, feel light-headed, dizzy or faint, and this problem gets worse or continues, plan to have surgery (even at the dentist) that needs a general anaesthetic or become pregnant while taking INDERAL.

Things you should not do

Do not give INDERAL to anyone else even if they have the same condition as you.

Do not use INDERAL to treat any other complaints unless your doctor tells you to.

Do not stop taking INDERAL without checking with your doctor.

Driving or using machines

Be careful before you drive or use any machines or tools until you know how INDERAL affects you.

Drinking alcohol

Tell your doctor if you drink alcohol.

Alcohol may increase the effects of INDERAL.

Looking after your medicine

Store below 30°C.

Store in a cool, dry place away from young children.

For more information, see Section 5. What should I know while using INDERAL? in the full CMI.

Are there any side effects?

Common side effects include: nausea (feeling sick), vomiting, loss of appetite, diarrhoea, stomach pain, flatulence, cold hands or feet, dizziness, tiredness, rash, flushing, hair loss, feeling tired, lethargic or lack of energy. Serious side effects include: disturbed sleep, vivid dreams or nightmares, conjunctivitis, dry eyes, visual disturbances, trouble passing urine, unexplained bruising, mood changes, confusion, sexual problems, loss of hearing or slow heart beats. Very serious side effects include: extreme tiredness or breathlessness on mild exercise, wheezing, difficulty breathing or an asthma attack or fast heart beats (palpitations).

For more information, including what to do if you have any side effects, see Section 6. Are there any side effects? in the full CMI

Active ingredient(s): propranolol hydrochloride

Consumer Medicine Information (CMI)

This leaflet provides important information about using INDERAL. You should also speak to your doctor or pharmacist if you would like further information or if you have any concerns or questions about using INDERAL.

Where to find information in this leaflet:

1. Why am I using INDERAL?

2. What should I know before I use INDERAL?

3. What if I am taking other medicines?

4. How do I use INDERAL ?

5. What should I know while using INDERAL ?

6. Are there any side effects?

7. Product details

Why am I using INDERAL?

INDERAL contains the active ingredient propranolol hydrochloride. INDERAL belongs to a group of medicines called beta-blockers. It works by affecting the body's response to some nerve impulses, especially in the heart.

As a result, it decreases the heart's need for blood and oxygen and therefore reduces the amount of work the heart has to do. It also widens the blood vessels in the body, as well as helping the heart to beat more regularly.

INDERAL is used to treat or prevent a number of conditions, most of which are related to the heart:

to lower high blood pressure, also called hypertension

to prevent angina

to treat or prevent heart attacks, or reduce your risk of heart problems following a heart attack

to treat irregularities in heart beat, including those caused by anxiety

essential tremor (shaking of head, chin, hands)

phaeochromocytoma

Fallot's Tetralogy

to prevent migraine headaches

What should I know before I use INDERAL?

Warnings

Do not use INDERAL if:

you are allergic to propranolol hydrochloride , or any of the ingredients listed at the end of this leaflet.

you are allergic to other similar medicines such as beta blockers. Always check the ingredients to make sure you can use this medicine.

you have asthma or severe breathing problems.

you have certain other heart problems for example heart failure, low blood pressure, problems with your circulation, Prinzmetal's angina, or a slow heart beat.

you have low blood sugar levels.

Taking INDERAL may make these conditions worse.

Check with your doctor if you:

have any other medical conditions, including

asthma or serious breathing problems

heart problems

low blood pressure

problems with your circulation

diabetes or low blood sugar

an overactive thyroid gland

liver problems

kidney problems

take any medicines for any other condition

have allergies to any other medicines, food, preservatives or dyes.

are fasting, or have been fasting recently

During treatment, you may be at risk of developing certain side effects. It is important you understand these risks and how to monitor for them. See additional information under Section 6. Are there any side effects?

Pregnancy and breastfeeding

Check with your doctor if you are pregnant or intend to become pregnant.

It may affect your baby if you take it at any time during your pregnancy.

Talk to your doctor if you are breastfeeding or intend to breastfeed.

Your baby can take in INDERAL from breast milk if you are breastfeeding.

What if I am taking other medicines?

Tell your doctor or pharmacist if you are taking any other medicines, including any medicines, vitamins or supplements that you buy without a prescription from your pharmacy, supermarket or health food shop.

Some medicines may interfere with INDERAL and affect how it works, and some medicines may affected by INDERAL. These medicines include:

calcium channel blockers - medicines used to treat high blood pressure

digoxin - a medicine used to treat heart failure

medicines for migraine

medicines for diabetes

warfarin - a medicine that stops blood clots

theophylline - a medicine used to treat asthma

rifampicin - a medicine used to treat tuberculosis

ibuprofen, indomethacin - medicines used to treat pain and inflammation

cimetidine - a medicine used to treat ulcers

chlorpromazine - a medicine used to treat psychotic illnesses

rizatriptan - a medicine used to treat migraine headaches

You may need to use different amounts of your medicines, or take different medicine. Your doctor will advise you. Your doctor and pharmacist have more information on medicines to be careful with or avoid while taking INDERAL.

Check with your doctor or pharmacist if you are not sure about what medicines, vitamins or supplements you are taking and if these affect INDERAL.

How do I use INDERAL?

How much to take

For high blood pressure:

The usual starting dose is one 40 mg tablet taken twice a day for one week.

The dose is then usually increased to between 120 mg to 320 mg daily.

If you are taking other medicines which lower blood pressure, your doctor may need to change the dose of them to obtain the best results for you.

For angina and tremor:

The usual dose is 40 mg taken two or three times a day.

To treat or prevent heart attack

The usual dose is 80 mg taken twice a day, often starting with 40 mg taken four times a day for 2 or 3 days

For migraine prevention

Adults: The usual dose is 40 mg taken twice a day. This may need to be increased up to 80 mg twice a day.

Children over 7 years: The starting dose is 10 mg taken once or twice daily. This can be increased if necessary.

Other conditions

Your doctor will tell you what dose to take.

Follow the instructions provided and use INDERAL until your doctor tells you to stop.

When to take INDERAL

INDERAL should be used regularly at the same time each day.

If you forget to use INDERAL

If it is almost time for your next dose (within 6 hours), skip the dose you missed and take your next dose when you are meant to.

Otherwise take it as soon as you remember, and then go back to taking your tablets as you would normally.

Do not take a double dose to make up for the dose you missed.

If you have trouble remembering when to take your medicine, ask your pharmacist for some hints.

If you use too much INDERAL

If you think that you have used too much INDERAL, you may need urgent medical attention. INDERAL is severely toxic if you take too much. Taking too much causes difficulty in breathing, light-headedness or dizziness, feeling very tired, fits, slowed heart beat or coma.

You should immediately:

phone the Poisons Information Centre
(by calling 13 11 26), or

contact your doctor, or

go to the Emergency Department at your nearest hospital.

You should do this even if there are no signs of discomfort or poisoning.

What should I know while using INDERAL?

Things you should do

If you are about to be started on any new medicine, remind your doctor and pharmacist that you are taking INDERAL.

Tell any doctors, dentists, and pharmacists who are treating you that you are taking this medicine

Call your doctor straight away if you:

Have a severe allergic reaction to foods, medicines or insect stings

If you have a history of allergies, there is a chance that INDERAL may cause allergic reactions to be worse and harder to treat.

feel light-headed, dizzy or faint, and this problem gets worse or continues

get up slowly when getting out of bed or standing up

You may feel light-headed or dizzy when you begin to take INDERAL.

Standing up slowly, especially when you get up from bed or chairs, will help your body get used to the change in position and blood pressure.

plan to have surgery (even at the dentist) that needs a general anaesthetic

Your blood pressure may drop suddenly if INDERAL interacts with the anaesthetic.

become pregnant while taking INDERAL

have diabetes and notice any blood sugar level changes

INDERAL may change how well your diabetes is controlled. It may also cover up some of the symptoms of low blood sugar (hypoglycaemia) such as increased heart rate.

INDERAL may increase the time your body takes to recover from low blood sugar. Your doses of diabetic medicines, including insulin, may need to change.

do not have diabetes and notice a low blood sugar (hypoglycaemia)

These may include the newly born, toddlers, children, elderly, patients suffering from overdose, patients suffering from chronic liver disease, fasting patients or patients on haemodialysis.

Remind any doctor, dentist or pharmacist you visit that you are using INDERAL.

Things you should not do

Do not give INDERAL to anyone else even if they have the same condition as you.

Do not use INDERAL to treat any other complaints unless your doctor tells you to.

Do not stop taking INDERAL without checking with your doctor. Your doctor may want you to gradually reduce the amount of INDERAL you are taking before stopping completely. This may help reduce the possibility of your condition getting worse.

Driving or using machines

Be careful before you drive or use any machines or tools until you know how INDERAL affects you.

INDERAL may cause dizziness light-headedness, tiredness, or drowsiness in some people. Make sure you know how you react to INDERAL before you drive a car, operate machinery, or do anything else that could be dangerous if you are dizzy or light-headed.

Drinking alcohol

Tell your doctor if you drink alcohol.

Alcohol may increase the effects of INDERAL. Dizziness or light-headedness may be worse.

Things to be careful of

Dress warmly during cold weather, especially if you will be outside for a long time (for example when playing winter sports).

INDERAL, like other beta-blocker medicines, may make you more sensitive to cold temperatures, especially if you have circulation problems.

Please talk to your doctor or pharmacist about these possibilities if you think they may bother you.

Looking after your medicine

Keep your tablets in the bottle until it is time to take them.

Follow the instructions in the carton on how to take care of your medicine properly.

Store it in a cool dry place where the temperature stays below 30°C , away from moisture, heat or sunlight; for example, do not store it:

in the bathroom or near a sink, or

in the car or on window sills.

Keep it where young children cannot reach it.

Getting rid of any unwanted medicine

If you no longer need to use this medicine or it is out of date, take it to any pharmacy for safe disposal.

Do not use this medicine after the expiry date.

Are there any side effects?

All medicines can have side effects. If you do experience any side effects, most of them are minor and temporary. However, some side effects may need medical attention.

See the information below and, if you need to, ask your doctor or pharmacist if you have any further questions about side effects.

Less serious side effects

Less serious side effects

What to do

Gut-related:

nausea (feeling sick), vomiting

loss of appetite

diarrhoea, stomach pain, flatulence

Other:

cold hands or feet

dizziness, tiredness

rash, flushing

hair loss

feeling tired, lethargic, lack of energy

Speak to your doctor if you have any of these less serious side effects and they worry you.

Serious side effects

Serious side effects

What to do

Head-related:

disturbed sleep, vivid dreams or nightmares

visual disturbances

mood changes, confusion

loss of hearing

Other:

unexplained bruising

sexual problems

slow heart beats

conjunctivitis, dry eyes

trouble passing urine

Call your doctor straight away, or go straight to the Emergency Department at your nearest hospital if you notice any of these serious side effects.

Very Serious side effects

Very serious side effects

What to do

Allergic reaction-related:

extreme tiredness or breathlessness on mild exercise

wheezing, difficulty breathing or an asthma attack

fast heart beats (palpitations)

Stop taking this medicine and tell your doctor immediately, or go to Accident and Emergency at your nearest hospital.

Tell your doctor or pharmacist if you notice anything else that may be making you feel unwell.

Other side effects not listed here may occur in some people.

Reporting side effects

After you have received medical advice for any side effects you experience, you can report side effects to the Therapeutic Goods Administration online at www.tga.gov.au/reporting-problems . By reporting side effects, you can help provide more information on the safety of this medicine.

Always make sure you speak to your doctor or pharmacist before you decide to stop taking any of your medicines.

Product details

This medicine is only available with a doctor's prescription.

What INDERAL contains

Active ingredient

(main ingredient)

Propranolol hydrochloride

Other ingredients

(inactive ingredients)

Lactose monohydrate

Carmellose calcium

Gelatine

Magnesium stearate

Glycerol

Hypromellose

Titanium dioxide

Carmine

Potential allergens

None.

Do not take this medicine if you are allergic to any of these ingredients.

What INDERAL looks like

INDERAL tablets are pink, film coated and biconvex.

INDERAL 10mg is intagliated on one face with 10 and bisected on the reverse face. AUST R 11228.

INDERAL 40mg is intagliated on one face with 40 and bisected on the reverse face. AUST R 11230.

Inderal tablets are supplied in HDPE bottles of 100 tablets.

Who distributes INDERAL

Clinect Pty Ltd

120 - 132 Atlantic Drive

Keysborough VIC 3173

Australia

Free Call Australia: 1800 899 005

This leaflet was prepared in February 2022.

Inderal LA - instructions for use, doses, side effects, reviews of the drug Inderal LA: - Encyclopedia of drugs RLS

Description of the drug Inderal LA (capsules, 160 mg) is based on official instructions, approved by the manufacturer in 1996

Date of approval: 07/31/1996

Content

  • Active substance
  • ATX
  • Pharmacological group
  • Nosological classification (ICD-10)
  • Composition and form of release
  • pharmachologic effect
  • pharmachologic effect
  • Indications
  • Contraindications
  • Dosage and administration
  • Side effects
  • Interaction
  • Storage conditions
  • Best before date
  • Reviews

Active ingredient

Propranolol* (Propranolol*)

ATX

C07AA05 Propranolol

Pharmacological group

Beta blockers

Nosological classification (ICD-10)

ICD-10 code list

  • I10 Essential (primary) hypertension
  • I15 Secondary hypertension
  • I20 Angina pectoris [angina pectoris]
  • R07. 2 Pain in the region of the heart

Composition and formulation

1 controlled release capsule contains propranolol hydrochloride 160 mg.

Pharmacological action

Pharmacological action - antihypertensive , antianginal .

Blocks beta-adrenergic receptors.

Blocks beta-adrenergic receptors.

Indications

Hypertension, angina.

Contraindications

Hypersensitivity, bradycardia, cardiogenic shock, hypotension, metabolic acidosis, peripheral circulatory arterial disorders, atrioventricular block II-III degree, weakness syndrome sinus node, untreated pheochromocytoma, decompensated heart failure, angina pectoris Prinzmetal, history of bronchial asthma and bronchospasm, pregnancy, lactation, childhood.

Dosage and administration

Inside 1 caps. 1-2 times a day. Adverse effects paresthesia, bronchospasm, alopecia.

Interaction

Incompatible with anesthetics and MAO inhibitors.

Storage conditions

In a dry place protected from light.
Keep out of reach of children.

Expiry date

Do not use after the expiry date which is stated on the packaging.

Inderal 40 mg 50 tablets

Trade name:

  • Inderal
  • Inderal

Composition:

Each tablet contains:

Propranolol hydrochloride - 40 mg

Properties:

Non-selective beta-blocker. It has antihypertensive, antianginal and antiarrhythmic effects. Due to the blockade of β-adrenergic receptors, it reduces the formation of cAMP from ATP stimulated by catecholamines, as a result, it reduces the intracellular intake of calcium ions, has a negative chrono-, dromo-, batmo- and inotropic effect (reduces heart rate, inhibits conductivity and excitability, reduces myocardial contractility). At the beginning of the use of beta-blockers, OPSS increases in the first 24 hours (as a result of a reciprocal increase in the activity of α-adrenergic receptors and the elimination of stimulation of β2-adrenergic receptors of skeletal muscle vessels), but after 1-3 days it returns to the original, and decreases with prolonged use.

Indications:

Arterial hypertension, angina pectoris, sinus tachycardia (including with hyperthyroidism), supraventricular tachycardia, tachysystolic form of atrial fibrillation, supraventricular and ventricular extrasystoles, hypertrophic cardiomyopathy, myocardial infarction, subcoorthoracic mitral valve prolapse, crisis in patients with diencephalic syndrome, neurocirculatory dystonia, portal hypertension, essential tremor, panic attacks, aggressive behavior, migraine (prevention), auxiliary treatment for pheochromocytoma (only in combination with alpha-blockers), thyrotoxicosis (including preoperative preparation) , thyrotoxic crisis, primary weakness of labor, menopausal vasomotor symptoms, withdrawal syndrome; treatment of akathisia caused by antipsychotics.

Method of application:

For adults, when taken orally, the initial dose is 20 mg, a single dose is 40-80 mg, the frequency of administration is 2-3 times / day.

Contraindications:

AV block II and III degree, sinoatrial block, severe bradycardia (less than 50 bpm), arterial hypotension, acute or chronic heart failure in the stage of decompensation, acute myocardial infarction (systolic blood pressure less than 100 mm Hg .st.), cardiogenic shock, pulmonary edema, SSS, Prinzmetal's angina, cardiomegaly (without signs of heart failure), severe peripheral vascular disorders, metabolic acidosis (including diabetic acidosis), pheochromocytoma (without the simultaneous use of alpha-blockers) , bronchial asthma, chronic obstructive pulmonary disease, a tendency to bronchospastic reactions, simultaneous use with antipsychotics and anxiolytics (chlorpromazine, trioxazine and others), MAO inhibitors.

Precautions:

  • Use with caution in patients with bronchial asthma, COPD, bronchitis, decompensated heart failure, diabetes mellitus, renal and / or hepatic insufficiency, hyperthyroidism, depression, myasthenia gravis, psoriasis, peripheral vascular occlusive diseases, during pregnancy, during lactation, in elderly patients, in children (efficacy and safety have not been determined).
  • Precautions in neonates and infants: cardiovascular disease, heart failure; diabetes; respiratory diseases; psoriasis; RNACE syndrome; hyperkalemia; allergic reactions in history.
  • Exacerbation of psoriasis is possible during the treatment period.
  • In pheochromocytoma, propranolol can only be used after taking an alpha-blocker.
  • After a long course of treatment, propranolol should be discontinued gradually, under the supervision of a physician.

Side effects: