Propranolol can aggravate breathing difficulties in patients with asthma, chronic bronchitis, or emphysema. In patients with existing slow heart rates (bradycardias) and heart blocks (defects in the electrical conduction of the heart), propranolol can cause dangerously slow heart rates, and even shock. Propranolol reduces the force of heart muscle contraction and can aggravate symptoms of heart failure.
In patients with coronary artery disease, abruptly stopping propranolol can suddenly worsen angina, and occasionally precipitate heart attacks. If it is necessary to discontinue propranolol, its dosage should be reduced gradually over several weeks.
GENERIC AVAILABLE: Yes
PREPARATIONS: Tablets: 10, 20, 40, 60, and 80 mg. Capsules: 60, 80, 120, and 160 mg. Oral Solution: 20 mg/5 ml, Injection: 1 mg/ml
STORAGE: Tablets and capsules should be stored at room temperature, 15 to 30 C (59 to 86 F), in a tightly closed container.
DOSING: The recommended dose for hypertension using short acting formulations is 80-240 mg twice daily. The maximum dose is 640 mg daily.
The usual dose using long acting formulations is 80-160 mg daily.
The recommended dose for chest pain is 80-320 mg daily using short acting formulations and 80-160 mg daily using long acting formulations.
The usual dose for treatment of abnormal heart rhythms is 10-30 mg 3-4 times daily of short acting formulations.
The recommended dose for preventing migraines is 80-240 mg daily.
DRUG INTERACTIONS: Calcium channel blockers and digoxin (Lanoxin) can lower of blood pressure and heart rate to dangerous levels when administered together with propranolol. Propranolol can mask the early warning symptoms of low blood sugar (hypoglycemia) and should be used with caution in patients receiving treatment for diabetes. Propranolol reduces the metabolism of thioridazine (Mellaril), increasing the concentration of thioridazine in the body and potentially causing abnormal heart beats.
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