If you have some cardio problems, such medicine as Propranolol may be quite familiar to you. Synthesized in the 1960s by James W. Black, this drug is one of the most popular non-selective beta-blockers prescribed all over the world and considered to be one of the most essential medicines by the World Health Organization.
Mechanism of Action
The active ingredient of the medicine is propranolol hydrochloride, which is white powder soluble in water and ethanol. As soon as it is absorbed, propranolol binds to ß1- and ß2-adrenoreceptors, thus, blocking the action of adrenaline and noradrenalin and providing membrane stabilization. Peripheral vasoconstriction is the main way to create hypotensive effect of this drug. Being non-selective, Propranolol decreases workload on the heart by blocking the release of rennin in kidneys and suppressing lipolysis, insulin and glucagon secretion. Actually, a definite mechanism of cardiovascular system improvement by propranolol hydrochloride hasn’t been properly studied yet.
Usage of Propranolol
This medicine is prescribed in various cases of cardiovascular system diseases and other conditions where beta-blockers appear to be helpful, including:
- High blood pressure;
- Heart attacks (prevention and treatment);
- Irregular heartbeats;
- Infantile hemangiomas;
- Supraventricular and ventricular arrhythmia;
- Mitral valve prolapse;
- Essential tremor;
- Panic attacks;
- Kidney problems;
- Migraine headaches.
There are several forms of Propranolol available: oral solution, Propranolol tablets and extended release capsules. It’s necessary to mention that these forms aren’t equal and the dosage must be defined by a doctor for each type, especially when taking into account the fact that this is a prescription drug. When you swallow an ordinary tablet, only 25% of the active agent comes into blood, but an extended release capsule allows increasing its amount by several times.
The medicine is usually taken 2-4 times a day before meals with water or other liquids, and the dose depends on the patient’s condition and personal sensitivity. Each diagnose requires some certain dosage of Propranolol:
- Hypertension – 80 mg twice a day, or 160 mg once a day (usually prescribed in a combination with diuretics). Maintenance dose is 160-320 mg daily. The term is at least half a year.
- Angina – 40 mg of conventional Propranolol 4 times a day.
- Irregular heart rate – 10-30 mg a day.
- Subaortic stenosis - 20 mg of Propranolol or more 3-4 times a day.
- Migraine headaches, tremor – begin with 40 mg 2-3 times a day.
- Heart attack – in 5 days after the attack take 40 mg 4 times a day within the term of 3 days, then 80 mg twice a day.
Children may also be prescribed the drug beginning with 0.5-1 mg per kilo a day; the maintaining dose is 2-4 mg per kilo a day divided into two administrations.
Propranolol prospect includes other diseases and corresponding doses. It is pleaded that this medicine leads to significant improvements in blood pressure, heart beating, bronchial and uterine tonus. Heart attack risk is much lower, especially in younger patients with good blood circulation.
What Is Prohibited?
Those people who are allergic to propranolol hydrochloride or any components contained in Propranolol tablets and capsules should not take the drug. Also, such illnesses as asthma, slow heartbeats, ick sinus syndrome and AV block are contraindications for the medicine. Children weighing less than 4.5 pounds are strictly prohibited to be given Hemangeol oral liquid which contains Propranolol.
In case you have got bronchitis, liver, kidney or thyroid disorders, diabetes, muscle or circulation problems, tumor of adrenal gland, depression, heart failures or low blood pressure, it’s necessary to consult your physician before purchasing the medicine and deciding how long and how much of it you need to take. Breastfeeding mothers and pregnant women are not recommended to take Propranolol unless there is no less harmful alternative.
It’s strictly forbidden to stop taking the medicine abruptly as it may affect your condition. Moreover, you mustn’t change the dose without informing your doctor, as it may result either in lack of effect or overdose. It’s important to inform your physician about all the drugs you are taking at the moment, as some may cause severe side effects in combination with Propranolol. In addition, it’s prohibited to drink alcohol when taking the drug, as it may lead to overdose.
Generics and Analogues
Although highly effective, Propranolol is a rather expensive drug. It is also produced under the following brand names: Inderal, Avlocardyl, Deralin, Dociton, Inderalici, etc. Generic versions are manufactured by six companies under the names Ciplar, Betacap, Mirgales, Norten and others. It must be noted that although both brand and generic drug contains propranolol as an active element, inactive ingredients may be different. However, they are the same effective and FDA approved.