| name | Propranolol |
| classification | Beta-blocker |
| pharmacokinetics | | absorption | Rapidly absorbed from the gastrointestinal tract, peak plasma levels typically reached within 1-3 hours. First-pass effect significant. | | distribution | Distributed throughout the body, with high concentrations in the heart, lungs, and kidneys. Significant protein binding. | | metabolism | Extensive hepatic metabolism, primarily via CYP2D6 and CYP1A2 enzymes. | | excretion | Excreted primarily in the urine as metabolites. Excretion may be prolonged in patients with renal impairment. |
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| suggested dosage | | initial | 20-40 mg orally, 2-3 times daily, titrated to response | | maintenance | 40-320 mg orally per day, in divided doses | | notes | Individualized dosing is crucial and should be based on the patient's specific condition and response. Dosage should be adjusted according to the patient's clinical response. Dosage should be adjusted to maintain therapeutic blood levels. Consult with a healthcare professional. |
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| indications | | 1 | Hypertension | | 2 | Angina pectoris | | 3 | Arrhythmias | | 4 | Migraine prophylaxis | | 5 | Essential tremor | | 6 | Management of thyrotoxicosis (with caution) |
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| safety in pregnancy | | category | Category C | | description | Use during pregnancy only if the potential benefit outweighs the potential risk to the fetus. Monitor the fetus closely if used during pregnancy. |
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| safety in breastfeeding | | category | Limited data, potential risk to infant | | description | May be excreted in breast milk, which could affect the infant. Use with caution. Consult with a healthcare professional. |
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| side effects | | 1 | Bradycardia | | 2 | Hypotension | | 3 | Fatigue | | 4 | Dizziness | | 5 | Headache | | 6 | Lethargy | | 7 | Bronchospasm (especially in patients with asthma) | | 8 | Gastrointestinal upset (e.g., nausea, vomiting, diarrhea) | | 9 | Cold extremities | | 10 | Depression | | 11 | Sleep disturbances | | 12 | Impotence |
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| alternatives | |
| contraindications | | 1 | Severe bradycardia | | 2 | Second- or third-degree heart block | | 3 | Cardiogenic shock | | 4 | Significant bronchospastic disease | | 5 | Hypersensitivity to propranolol or other beta-blockers |
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| interactions | | 1 | Alcohol | | 2 | Verapamil | | 3 | Diltiazem | | 4 | Cimetidine | | 5 | MAO inhibitors | | 6 | Insulin | | 7 | Nonsteroidal anti-inflammatory drugs (NSAIDs) | | 8 | Other antihypertensives | | 9 | Warfarin |
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| warnings and precautions | | 1 | Patients with asthma or COPD should be monitored carefully. | | 2 | Patients with peripheral vascular disease should be monitored for potential exacerbations. | | 3 | Patients with diabetes mellitus should be closely monitored for changes in glucose control | | 4 | Abrupt discontinuation of propranolol may worsen angina or induce arrhythmias | | 5 | Use with caution in patients with liver or kidney impairment. | | 6 | Avoid use during acute myocardial infarction unless under close medical supervision. |
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| additional informations | | 1 | Propranolol is a non-selective beta-blocker, meaning it affects both beta1 and beta2 receptors. Beta1 receptors are primarily in the heart, and beta2 receptors are primarily in the lungs. | | 2 | Propranolol can mask the symptoms of hypoglycemia. | | 3 | Propranolol may mask the signs and symptoms of thyrotoxicosis. |
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| patient specific details | |
