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Inderal (Propranolol) is a beta-adrenergic blocking agent. It works by slowing down the heart and reducing blood pressure, which helps it pump more efficiently and reduces the workload on the heart. It may also interfere with the action of adrenalin and other similar chemicals in the brain preventing migraine headaches.

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Uses

Propranolol (proe-PRAN-oh-lol) is used in the treatment of high blood pressure, angina pectoris (chest pain, usually caused by lack of oxygen to the heart due to clogged arteries), changes in heart rhythm, prevention of migraine headache, hereditary tremors, hypertrophic subaortic stenosis (a condition related to exertional angina), and tumors of the adrenal gland. It is also used to reduce the risk of death from recurring heart attack.

How to take

Take Propranolol by mouth with or without food, but it should be taken at the same time daily and consistently either on an empty stomach or with food. Do not take antacids containing aluminum within 2 hours of taking Propranolol. Do not miss any doses.

Side effects

Tell your doctor if any of these Propranolol symptoms are severe or do not go away: dizziness or lightheadedness, difficulty sleeping, excessive tiredness, upset stomach, vomiting, rash, diarrhea, constipation. If you experience any of the following Propranolol symptoms, call your doctor immediately: difficulty breathing, sore throat, unusual bleeding, swelling of the feet or hands; unusual weight gain, chest pain, slow, irregular heartbeat. Symptoms of overdose may include difficulty breathing, especially when lying down; lightheadedness, especially upon standing; pale or blue skin; seizures (convulsions); shortness of breath; swelling of ankles; unconsciousness, possibly leading to lack of heartbeat or breathing; very slow heart rate; wheezing. If you suspect an overdose of Propranolol, seek medical attention immediately.

Precaution

Do NOT use Propranolol if: You are allergic to any ingredient in Propranolol; You have a very slow heartbeat and heart block; had a heart attack and have very low blood pressure or uncontrolled heart failure or shock caused by heart failure; You have asthma or Raynaud phenomenon; You are taking mibefradil. Before taking Propranolol, tell your doctor if you have or have ever had asthma or other lung disease; heart, liver, or kidney disease; diabetes; severe allergies; or thyroid problems. Contact your doctor or health care provider right away if any of these apply to you. Propranolol may cause drowsiness, dizziness, or lightheadedness. These effects may be worse if you take it with alcohol or certain medicines. Use Propranolol with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it. Propranolol may cause dizziness, lightheadedness, or fainting; alcohol, hot weather, exercise, or fever may increase these effects. To prevent them, sit up or stand slowly, especially in the morning. Sit or lie down at the first sign of any of these effects. Check with your doctor before drinking alcohol while you are taking Propranolol. Patients who take medicine for high blood pressure often feel tired or run down for a few weeks after starting treatment. Be sure to take your medicine even if you may not feel "normal." Tell your doctor if you develop any new symptoms. Propranolol may mask the signs of hyperthyroidism (overactive thyroid). If you have an overactive thyroid and stop taking Propranolol too suddenly, symptoms of hyperthyroidism (eg, fast heartbeat) may occur. Patients with a history of severe allergic reactions may be more sensitive to allergens while taking Propranolol. These patients may not respond to the usual dose of epinephrine (adrenalin). Diabetes patients - Propranolol may hide signs of low blood sugar, such as a rapid heartbeat. Be sure to watch for other signs of low blood sugar. Low blood sugar may make you anxious, sweaty, weak, dizzy, drowsy, or faint. It may also make your vision change; give you a headache, chills, or tremors; or make you hungrier. Check blood sugar levels closely. Ask your doctor before you change the dose of your diabetes medicine. Tell your doctor or dentist that you take Propranolol before you receive any medical or dental care, emergency care, or surgery. Propranolol may interfere with certain lab tests, including the glaucoma screening test. Be sure your doctor and lab personnel know you are taking Propranolol. Lab tests, including blood pressure and heart function tests, may be performed while you use Propranolol. These tests may be used to monitor your condition or check for side effects. Propranolol helps control your condition but will not cure it. Continue to take Propranolol even if you feel well. If you suddenly stop taking Propranolol, you may experience withdrawal symptoms, including worsening chest pain along with possible heart attack. Talk to your doctor before using salt substitutes containing potassium. If your doctor prescribes a low-salt or low-sodium diet, follow these directions carefully. Tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. Propranolol is found in breast milk. If you become pregnant while taking Propranolol, call your doctor.

Drug interactions

Tell your doctor what prescription and nonprescription medications you are taking, especially cimetidine (Tagamet); medications for migraine headaches, asthma, allergies, colds, or pain; other medications for heart disease or high blood pressure; reserpine; vitamins, dietary supplements, or herbal preparations. Antiarrhythmics (eg, amiodarone, flecainide, quinidine), antipsychotics (eg, chlorpromazine, haloperidol), bupivacaine, calcium channel blockers (eg, mibefradil, nifedipine, verapamil), cimetidine, ketanserin, mefloquine, or thioamines (eg, tapazole) because potentially life-threatening heart-related side effects may occur, including very slow heart rate; abnormal heartbeat; lightheadedness, especially upon standing; difficulty breathing, especially when lying down; loss of function in the heart and lungs; and swelling of ankles. Barbiturates (eg, phenobarbital), clonidine, phenytoin, rifampin, or thyroid hormones (eg, levothyroxine) because they may decrease Propranolol's effectiveness. Certain stimulants (adrenalin, pseudoephedrine), hydralazine, insulin, lidocaine, quinazolines (eg, doxazosin), rizatriptan, or theophylline because their actions and the risk of their side effects may be increased by Propranolol.

Missed dose

If you miss a dose of Propranolol, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Storage

Store Propranolol between 68 and 77 degrees F (20 and 25 degrees C). Brief storage at temperatures between 59 and 86 degrees F (15 and 30 degrees C) is permitted. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Propranolol out of the reach of children and away from pets.