Propranolol table. 20 mg. 50 tablets
Propranolol table. 20 mg. 50 tablets
What is Propranolol is and what it is used
Propranolol Actavis is a medicine of the so -called beta-blockers. It has a stabilizing effect on the excitability of the heart muscle . The main effects of the product on the cardiovascular system is to improve the heart 's supply of oxygen and the reduction of pain associated with angina, cardiac pacemakers , and a decrease in blood pressure. After myocardial infarction ( heart attack) significantly reduces oxygen demand of the heart muscle , significantly reduced the incidence of reinfarction and mortality after myocardial infarction .
Propranolol is used for treatment of:
High blood pressure of various origins (hypertension ) - alone or in combination with other blood pressure lowering products;
Angina pectoris ( chest pain breakthrough ) due to narrowing of the coronary arteries (the vessels that supply the heart with oxygen) - for prevention and long-term treatment ;
Disturbances in cardiac rhythm with high ventricular rate ;
Myocardial infarction - continued treatment after the acute phase of myocardial infarction ;
Hypertrophic cardiomyopathy ( enlarged heart muscle ) alone or combination therapy , thyrotoxicosis ( overactive thyroid gland) - the complex therapy;
Pheochromocytoma (high blood pressure caused by a tumor of the adrenal gland ) - for the treatment of rapid heartbeat , in combination with other agents ( alpha - adrenergic blocking agents ) ;
Migraine - prevention of relapses;
Essential tremor (shaking) .
2 . BEFORE YOU USE propranolol
Do not use Propranolol
If you are allergic ( hypersensitive) to the active substance or any of the excipients ;
In severe cardiovascular disease ( heart disease that can occurs with fatigue , shortness of breath , swollen legs , etc. . )
Under conditions with a marked decrease in blood pressure ( hypotension , cardiogenic shock ) ;
In slow heartbeat with heart pulse rate below 50 beats per minute ;
Infringements in cardiac impulse conduction (AV block II-III degree and BSA block, sick sinus syndrome node) ;
Raynaud's disease (impaired blood supply to the fingers and toes, with the result that they become stiff and pale ) ;
Angina (chest lady- ) of the so-called type angina ;
Take special care when using Propranolol Actavis
Treatment with Propranolol Actavis begins with small doses that are gradually increased according to individual sensitivity .
Discontinuation should be a gradual reduction in the dose for 8 to 10 days, especially in patients with angina pectoris (chest pain) , as abrupt discontinuation may cause heart attack from God's (angina) or rhythm disorder .
Upon treatment with Propranolol Actavis appropriate monitor pulse . At rest it should not fall below 50-55 beats / min .
The product is used with caution in patients with impaired hepatic or renal function .
As with all other products of this group are at risk of low blood pressure , which requires observation of the patient by a health professional .
Propranolol Actavis not apply to the treatment of hypertensive crisis . In elderly patients should be used with caution as it can be observed increased or decreased sensitivity to his normal doses.
The product may change the symptoms of a drop in blood sugar ( particularly accelerated heartbeat) , and to cause such even in patients who do not suffer from diabetes.
In need of surgery (including dental or emergency ) , physicians should be aware that the patient is on regular treatment with a beta- blocker.
In pheochromocytoma ( adrenal tumor) , the product should only be used after prior primary treatment with an alpha -adrenergic blocker, otherwise it could lead to an excessive increase in blood pressure .
Care should be taken to increase physical activity in patients with angina pectoris, in which chest pain has decreased due to treatment.
If necessary, laboratory and functional tests should be given to possible changes in some tests of beta-blockers ( increased levels of serum lipoproteins and triglycerides , increased serum potassium, false positive levels of catecholamines and their breakdown products in the urine and blood , elevated of antinuclear antibodies , negative screening tests for glaucoma) .
Patients with evidence of severe allergies to foods , drugs, or insect bite must be taken with the use of beta- blockers, as they may worsen the allergy . In all allergic reactions during treatment should be carried out medical attention.
When taking antacids such as Almagel or koalgel (to treat excess stomach acid ) , propranolol Actavis be given no earlier than two hours before or after their adoption.
The test for glaucoma can be compromised , since the use of beta- blockers results in a reduction of intraocular pressure .
Taking other medicines
Please tell your doctor or pharmacist if you are taking or have recently taken any other medicines, including medicines obtained without a prescription.
With concomitant use of propranolol Actavis with verapamil , diltiazem and MAOIs increases its depressing effect on heart function.
Concurrent use with insulin or oral antidiabetic produktirezerpin , methyldopa, klonidi can mask the symptoms of a drop in blood sugar levels and increase the risk of occurrence and difficult recovery from it.
Other antihypertensive drugs , vasodilators or medications to treat mental illness, co-administered with Propranolol Actavis intensified blood pressure reduction .
Centrally acting drugs for high blood pressure such as reserpine , methyldopa , clonidine when used together with Actavis Propranolol can further enhance its effects on heart rate .
Concomitant use of amiodarone occurs with complementary effects on cardiac conduction .
By concomitant use of anesthetics increases the risk of lowering blood pressure , suppression of cardiac muscle and slow heart rate .
When given in combination with haloperidol have been reports of sudden cardiac death.
Alcohol reduces the entry of the product in the organism.
Phenytoin and phenobarbital increase the excretion of the product
Co-administration of thyroxine leads to a low concentration of Ts ( thyroid hormone ) .
Lidocaine decreases the release of propranolol with concomitant use
Cimetidine reduced hepatic elimination of propranolol and leads to increased plasma levels and therapeutic effect .
Antacids containing magnesium and aluminum salts reduce absorption.
Nonsteroidal antiinflammatory drugs and , in particular, reduces the effect of indomethacin on lowering blood pressure of the product.
Cocaine reduces the therapeutic effect of propranolol Actavis . Application of the product in cocaine abuse increases the risk of excessive fall in blood pressure, cardiac arrest and cardiac arrest .
With the iodinated X-ray contrast agents may enhance the risk of moderate to severe allergic reaction , which is resistant to therapy .
Estrogens decrease the blood pressure lowering effects of Beta-blockers, due to estrogen-induced fluid retention .
Neuromuscular blockers may intensify and prolong the effects of muscle relaxants to the extent of incomplete recovery of neuromuscular blockade.
Cessation of smoking may increase the therapeutic effect of propranolol, since it reduces the metabolic rate of the product and increase its content in the blood.
Concurrent use with phenothiazine derivatives induced an increase in blood levels of both products .
In immunotherapy with allergens or use of allergen skin test beta- blockers may increase the risk of serious allergic reactions to these drugs.
Concurrent use of aminophylline , theophylline and caffeine can neutralize the therapeutic effects of the two drugs and , moreover, the plasma levels of theophylline may be increased .
Pregnancy and lactation
Ask your doctor or pharmacist before taking any medicine .
Propranolol not used during pregnancy because of the fact that beta- blockers reduce the blood flow to the placenta and can lead to death of the fetus in utero , or premature birth . There is an increased risk of cardiac and pulmonary complications in newborns .
Propranolol is excreted in breast milk and is not used during breastfeeding.
Driving and using machines
The product should be administered with caution to drivers of motor vehicles and machine operators due to the influence of reactions and induce dizziness and fatigue.
Important information about some of the ingredients of Propranolol Actavis
This medicinal product contains lactose as an ingredient , which makes it unsuitable for people with lactose intolerance.
The composition of the excipients included wheat starch , which can be dangerous for people with celiac disease (an inherited disease of the small intestine , manifested by disorder in the use of wheat products).
3 . HOW TO TAKE propranolol
The dosage and duration of treatment with Propranolol Actavis be determined by the attending diagnostician, as a gradual increase in the dose until the desired therapeutic effect.
Administered orally with a moderate amount of fluid during or immediately after a meal.
Recommended doses :
Hypertension ( high blood pressure ) - initial dose 20-40 mg three times a day, individually or in combination with a diuretic ( a drug that produces an additive effect in terms of lowering high blood pressure), usual maintenance dose is 120 mg to 240 mg per day ;
Angina pectoris ( chest pain), - the initial dose is 40 mg three times daily , a therapeutic dose is from 80 mg to 320 mg per day , divided into 3 doses.
Arrhythmias - 40-160 mg daily , divided into three doses . The dose is gradually changed by the physician according to the therapeutic needs and to achieve an optimal effect;
Myocardial infarction - a long-term treatment after acute stage of myocardial infarction - 20-40 mg three times daily, and the total daily dose may be increased to 240 mg, divided in three administrations , according to the therapeutic needs ;
Hypertrophic cardiomyopathy - 40 mg three times daily.
Thyrotoxicosis - 10 -40mg three times daily.
Pheochromocytoma ( adrenal gland tumor ) / is used only in conjunction with an alpha receptor blocker / - recommended dose to 40-60 mg per day for three days prior to surgery . In case of inoperable malignant tumor dose of 40 mg daily.
Migraine - initial dose of 20 mg three times daily , if necessary , the dose may be gradually increased to 120 mg ( according to individual tolerance or signs of optimal beta- blockade ) .
Essential tremor , a starting dose 40mg three times daily.
The product is used with caution , as treatment is started with the lowest dose . The optimal dose is determined individually according to clinical response .
The initial daily dose is 0.5 to 1 mg / Kg of body weight, divided into 3 doses : maintenance dose - 2-4 mg / Kg, divided into three daily doses. Should not exceed 16 mg / kg daily dose.
If you take more dose Propranolol Actavis
When taking a higher dose than prescribed , immediately contact a doctor !
Overdose can be any of the following symptoms - slow heart rate , dizziness , low blood pressure , irregular heartbeat , difficulty breathing, wheezing , cold and blue fingers and toes .
In case of overdose, it is necessary to discontinue the product , gastric lavage and appoint charcoal and symptomatic agents. It is a constant medical supervision until the symptoms of overdose .
If you forget to take Propranolol Actavis
Do not take a double dose to make up for a missed dose. Do this in the next regular dose.
If you have any further questions on the use of this product, ask your doctor or pharmacist.
4 . POSSIBLE SIDE EFFECTS
Like all medicines , propranolol Actavis can cause side effects, although not everybody gets them .
Adverse reactions observed during treatment with propranolol are classified according to frequency of occurrence as follows : Very common (> 1/10 ), common (> 1/100 , <1 /10) , uncommon (> 1/1 000, < 1/100 ), rare (> 1/10 000, < 1/1 , 000), rare (> 1/10 , 000) .
Blood and lymphatic system
Rare : reduced number of platelets and inhibits the formation of white blood cell line to their absence .
Common: slow heart rate , palpitations (sensation of rapid heart beat and palpitations ) .
Rare: worsening heart failure, cardiac conduction disturbances (heart block).
Uncommon: conjunctivitis (inflammation of the eye's skin). Rare: visual disturbances , dry eyes .
Very rare: keratoconjunctivitis .
Common: fatigue, cold extremities, increased sweating .
Uncommon: diarrhea , nausea, vomiting , dry mouth .
Very rare: elevated liver enzymes.
Metabolism and nutrition
Rare: low blood sugar in children.
Disorders of the musculoskeletal system
Very rare inflammation of one or more joints .
Nervous System Disorders
Common: headache, drowsiness, sleep disturbances , nightmares .
Rare: hallucinations , paraesthesia ( tingling ) , dizziness .
Uncommon: psychosis , depression, confusion.
Renal and urinary disorders
Very rare: renal impairment.
Very rare: decreased libido , sexual dysfunction in men.
Respiratory and lung disorders
Common: dyspnoea .
Rare: bronchospasm ( narrowing of airways ) in patients with bronchial asthma or asthmatic complaints data .
Skin and subcutaneous tissue disorders
Common: itching, redness.
Rare: baldness , punctate rash , psoriasis skin reactions , exacerbation of psoriasis.
Rare: a sharp drop in blood pressure on standing (sometimes with fainting ) ..
Furthermore there is isolated cases of myasthenia gravis ( a chronic autoimmune disorder characterized by muscle weakness and fatigue after physical activity resulting from impaired neuromuscular transmission ) in patients treated with propranolol .
Can not exclude an increase in attacks of angina pectoris . There was also a rise in complaints from patients with disorders of peripheral circulation (including intermittent claudication and Raynaud's syndrome ) .
Very rare undeveloped until diabetes may occur or existing disease may worsen .
In patients with hyperthyroidism ( overactive thyroid gland ) is possible clinical signs of thyrotoxicosis ( palpitations and tremor) to be camouflaged .
There may occur and abnormal lipid metabolism . Decrease in the levels of high density cholesterol and elevated levels of triglycerides in the plasma of patients with normal levels of total cholesterol .
It may be necessary to discontinue the drug , medical evaluation if the general condition of the patient deteriorated as a result of the above reactions.
If any of the side effects gets serious, or you notice other effects not listed in this leaflet , please tell your doctor shi pharmacist.
5 . STORAGE
Keep out of reach of children. At temperatures below 25 ° C.
Do not use Propranolol Actavis after the expiry date stated on the carton .
The expiry date refers to the last day of that month. Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist how to dispose of medicines no longer required . These measures will help to protect the environment.
6 . ADDITIONAL INFORMATION
What does Propranolol
The active substance in a tablet is propranololov hydrochloride (propranolol hydrochloride) 20 mg.
The other ingredients are lactose monohydrate, corn starch , povidone, talc , magnesium stearate.
Propranolol looks like and contents of the pack
Propranolol is a round, flat tablets with a white or off-white , scored on one side.