Propranolol (capsule): Difference between revisions
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{{DrugProjectFormSinglePage | {{DrugProjectFormSinglePage | ||
|genericName= | |authorTag={{Alonso}} | ||
|genericName=Propranolol | |||
|aOrAn=a | |aOrAn=a | ||
|drugClass= | |drugClass=[[beta-adrenergic blocker]] | ||
|indication= | |indication=[[hypertension]], [[angina pectoris]], [[migraine]], [[Hypertrophic cardiomyopathy|hypertrophic subaortic stenosis]] | ||
| | |adverseReactions=[[dermatitis]], [[pruritus]], [[diarrhea]], [[dizziness]], [[sleep disorder]], [[fatigue]] | ||
|adverseReactions= | |||
|blackBoxWarningTitle=Warning Title | |blackBoxWarningTitle=Warning Title | ||
|blackBoxWarningBody=<i><span style="color:#FF0000;">Condition Name:</span></i> (Content) | |blackBoxWarningBody=<i><span style="color:#FF0000;">Condition Name:</span></i> (Content) | ||
|fdaLIADAdult==== | |fdaLIADAdult====Hypertension=== | ||
The usual initial dosage is 80 mg propranolol once daily, whether used alone or added to a [[diuretic]]. The dosage may be increased to 120 mg once daily or higher until adequate [[blood pressure]] control is achieved. The usual maintenance dosage is 120 to 160 mg once daily. In some instances a dosage of 640 mg may be required. The time needed for full hypertensive response to a given dosage is variable and may range from a few days to several weeks. | |||
===Angina Pectoris=== | |||
Starting with 80 mg propranolol once daily, dosage should be gradually increased at three- to seven-day intervals until optimal response is obtained. Although individual patients may respond at any dosage level, the average optimal dosage appears to be 160 mg once daily. In [[angina pectoris]], the value and safety of dosage exceeding 320 mg per day have not been established. | |||
If treatment is to be discontinued, reduce dosage gradually over a period of a few weeks. | |||
=== | ===Migraine=== | ||
The initial oral dose is 80 mg propranolol once daily. The usual effective dose range is 160 to 240 mg once daily. The dosage may be increased gradually to achieve optimal [[migraine]] prophylaxis. If a satisfactory response is not obtained within four to six weeks after reaching the maximal dose, propranolol therapy should be discontinued. It may be advisable to withdraw the drug gradually over a period of several weeks depending on the patient's age, comorbidity, and dose of propranolol. | |||
===Hypertrophic Subaortic Stenosis=== | |||
The usual dosage is 80 to 160 mg propranolol once daily. | |||
|offLabelAdultGuideSupport======Thyroid Storm===== | |||
: | * Developed by: American Thyroid Association and American Association of Clinical Endocrinologists | ||
* | * Class of Recommendation: 1 (high recommendation) | ||
* Strength of Evidence: + (poor quality of evidence) | |||
* Strength of Evidence: ( | |||
* Dosing Information/Recommendation | * Dosing Information/Recommendation | ||
:* | :* 10–40 mg.<ref name="pmid21510801">{{cite journal| author=Bahn Chair RS, Burch HB, Cooper DS, Garber JR, Greenlee MC, Klein I et al.| title=Hyperthyroidism and other causes of thyrotoxicosis: management guidelines of the American Thyroid Association and American Association of Clinical Endocrinologists. | journal=Thyroid | year= 2011 | volume= 21 | issue= 6 | pages= 593-646 | pmid=21510801 | doi=10.1089/thy.2010.0417 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21510801 }} </ref> | ||
|offLabelAdultNoGuideSupport======Anxiety===== | |||
===== | =====Congestive Heart Failure===== | ||
* | * Dosing Information | ||
* | :* Initial dose of 10 mg/day followed by 10-mg increments until a dose of 30 mg q8h.<ref name="pmid9230162">{{cite journal| author=Aronow WS, Ahn C, Kronzon I| title=Effect of propranolol versus no propranolol on total mortality plus nonfatal myocardial infarction in older patients with prior myocardial infarction, congestive heart failure, and left ventricular ejection fraction > or = 40% treated with diuretics plus angiotensin-converting enzyme inhibitors. | journal=Am J Cardiol | year= 1997 | volume= 80 | issue= 2 | pages= 207-9 | pmid=9230162 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9230162 }} </ref> | ||
=====Gastrointestinal Hemorrhage===== | |||
=====Percutaneous Coronary Intervention===== | |||
* Dosing Information | * Dosing Information | ||
:* | :* 15 μg/kg injected through the catheter directly to the coronary artery.<ref name="pmid12771007">{{cite journal| author=Wang FW, Osman A, Otero J, Stouffer GA, Waxman S, Afzal A et al.| title=Distal myocardial protection during percutaneous coronary intervention with an intracoronary beta-blocker. | journal=Circulation | year= 2003 | volume= 107 | issue= 23 | pages= 2914-9 | pmid=12771007 | doi=10.1161/01.CIR.0000072787.25131.03 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12771007 }} </ref> | ||
===== | =====Portal Hypertention===== | ||
* Dosing Information | * Dosing Information | ||
:* | :* 40–120 mg/day.<ref name="pmid12663237">{{cite journal| author=Venon WD, Baronio M, Leone N, Rolfo E, Fadda M, Barletti C et al.| title=Effects of long-term Irbesartan in reducing portal pressure in cirrhotic patients: comparison with propranolol in a randomised controlled study. | journal=J Hepatol | year= 2003 | volume= 38 | issue= 4 | pages= 455-60 | pmid=12663237 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12663237 }} </ref> | ||
| | |offLabelPedNoGuideSupport======Congestive Heart Failure===== | ||
* Dosing Information | * Dosing Information | ||
:* | :* 1,6 mg/kg/day<ref name="pmid11461738">{{cite journal| author=Buchhorn R, Hulpke-Wette M, Hilgers R, Bartmus D, Wessel A, Bürsch J| title=Propranolol treatment of congestive heart failure in infants with congenital heart disease: The CHF-PRO-INFANT Trial. Congestive heart failure in infants treated with propanol. | journal=Int J Cardiol | year= 2001 | volume= 79 | issue= 2-3 | pages= 167-73 | pmid=11461738 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11461738 }} </ref> | ||
===== | =====Tetralogy of Fallot===== | ||
* Dosing Information | * Dosing Information | ||
:* (Dosage) | :* (Dosage) | ||
=====Portal Hypertension===== | |||
* | =====Neonatal Thyroid Storm===== | ||
|contraindications=* [[Cardiogenic shock]] | |||
* [[Sinus bradycardia]] | |||
* [[Second-degree AV block]] | |||
* [[Third-degree AV block]] | |||
* [[Bronchial asthma]] | |||
* [[Hypersensitivity]] | |||
|warnings======Angina Pectoris===== | |||
There have been reports of exacerbation of [[angina]] and, in some cases, [[myocardial infarction]], following abrupt discontinuance of propranolol therapy. Therefore, when discontinuance of propranolol is planned, the dosage should be gradually reduced over at least a few weeks, and the patient should be cautioned against interruption or cessation of therapy without the physician's advice. If propranolol therapy is interrupted and exacerbation of angina occurs, it usually is advisable to reinstitute propranolol therapy and take other measures appropriate for the management of unstable angina pectoris. Since [[coronary artery]] disease may be unrecognized, it may be prudent to follow the above advice in patients considered at risk of having occult [[atherosclerotic coronary disease]] who are given propranolol for other indications. | |||
=====Hypersensitivity and Skin Reactions===== | |||
[[Hypersensitivity]] reactions, including [[anaphylactic]]/[[anaphylactoid]] reactions, have been associated with the administration of propranolol | |||
Cutaneous reactions, including [[Stevens-Johnson Syndrome]], [[toxic epidermal necrolysis]], [[exfoliative dermatitis]], [[erythema multiforme]], and [[urticaria]], have been reported with use of propranolol. | |||
=====Cardiac Failure===== | |||
Sympathetic stimulation may be a vital component supporting circulatory function in patients with [[congestive heart failure]], and its inhibition by [[beta block]]ade may precipitate more severe failure. Although [[beta blockers]] should be avoided in overt [[congestive heart failure]], some have been shown to be highly beneficial when used with close follow-up in patients with a history of failure who are well compensated and are receiving [[diuretics]] as needed. [[Beta-blockers]] agents do not abolish the inotropic action of [[digitalis]] on [[heart muscle]]. | |||
In Patients without a History of [[heart failure]], continued use of [[beta blockers]] can, in some cases, lead to cardiac failure. | |||
=====Nonallergic Bronchospasm (e.g., Chronic Bronchitis, Emphysema)===== | |||
In general, patients with [[bronchospastic lung disease]] should not receive [[beta-blockers]]. Propranolol should be administered with caution in this setting since it may provoke a bronchial [[asthmatic]] attack by blocking bronchodilation produced by endogenous and exogenous catecholamine stimulation of [[beta-receptors]]. | |||
===== | =====Major Surgery===== | ||
Chronically administered [[beta-block]]ing therapy should not be routinely withdrawn prior to major surgery, however the impaired ability of the [[heart]] to respond to reflex adrenergic stimuli may augment the risks of general anesthesia and surgical procedures. | |||
=====Diabetes and Hypoglycemia===== | |||
Beta-adrenergic blockade may prevent the appearance of certain premonitory signs and symptoms (pulse rate and pressure changes) of acute [[hypoglycemia]], especially in labile [[insulin]]-dependent [[diabetics]]. In these patients, it may be more difficult to adjust the dosage of [[insulin]]. | |||
Propranolol therapy, particularly when given to infants and children, [[diabetic]] or not, has been associated with [[hypoglycemia]] especially during fasting as in preparation for surgery. [[Hypoglycemia]] has been reported in patients taking propranolol after prolonged physical exertion and in patients with [[renal insufficiency]]. | |||
=====Thyrotoxicosis===== | |||
[[Beta-block]]ade may mask certain clinical signs of [[hyperthyroidism]]. Therefore, abrupt withdrawal of propranolol may be followed by an exacerbation of symptoms of [[hyperthyroidism]], including [[thyroid storm]]. Propranolol may change [[thyroid-function tests]], increasing [[T4]] and reverse [[T3]], and decreasing [[T3]]. | |||
=====Wolff-Parkinson-White Syndrome===== | |||
[[Beta-block]]ade in patients with [[Wolff-Parkinson-White syndrome]] and [[tachycardia]] has been associated with severe [[bradycardia]] requiring treatment with a [[pacemaker]]. In one case, this result was reported after an initial dose of 5 mg propranolol. | |||
|clinicalTrials=======Central Nervous System====== | |clinicalTrials=======Central Nervous System====== | ||
| Line 208: | Line 192: | ||
|othersTitle=Others | |othersTitle=Others | ||
|useInOthers=(Description) | |useInOthers=(Description) | ||
|administration=(Oral/Intravenous/etc) | |administration=(Oral/Intravenous/etc) | ||
|monitoring======Condition 1===== | |monitoring======Condition 1===== | ||
| Line 440: | Line 423: | ||
|howSupplied=(Description) | |howSupplied=(Description) | ||
|fdaPatientInfo=(Patient Counseling Information) | |fdaPatientInfo=(Patient Counseling Information) | ||
| | |alcohol=Alcohol-Propranolol interaction has not been established. Talk to your doctor about the effects of taking alcohol with this medication. | ||
|lookAlike=* (Paired Confused Name 1a) — (Paired Confused Name 1b) | |lookAlike=* (Paired Confused Name 1a) — (Paired Confused Name 1b) | ||
* (Paired Confused Name 2a) — (Paired Confused Name 2b) | * (Paired Confused Name 2a) — (Paired Confused Name 2b) | ||
* (Paired Confused Name 3a) — (Paired Confused Name 3b) | * (Paired Confused Name 3a) — (Paired Confused Name 3b) | ||
|nlmPatientInfo=(Link to patient information page) | |||
|drugShortage=Drug Shortage | |drugShortage=Drug Shortage | ||
}} | }} | ||
Revision as of 14:53, 8 July 2014
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Alonso Alvarado, M.D. [2]
Disclaimer
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Overview
Propranolol (capsule) is a beta-adrenergic blocker that is FDA approved for the {{{indicationType}}} of hypertension, angina pectoris, migraine, hypertrophic subaortic stenosis. Common adverse reactions include dermatitis, pruritus, diarrhea, dizziness, sleep disorder, fatigue.
Adult Indications and Dosage
FDA-Labeled Indications and Dosage (Adult)
Hypertension
The usual initial dosage is 80 mg propranolol once daily, whether used alone or added to a diuretic. The dosage may be increased to 120 mg once daily or higher until adequate blood pressure control is achieved. The usual maintenance dosage is 120 to 160 mg once daily. In some instances a dosage of 640 mg may be required. The time needed for full hypertensive response to a given dosage is variable and may range from a few days to several weeks.
Angina Pectoris
Starting with 80 mg propranolol once daily, dosage should be gradually increased at three- to seven-day intervals until optimal response is obtained. Although individual patients may respond at any dosage level, the average optimal dosage appears to be 160 mg once daily. In angina pectoris, the value and safety of dosage exceeding 320 mg per day have not been established.
If treatment is to be discontinued, reduce dosage gradually over a period of a few weeks.
Migraine
The initial oral dose is 80 mg propranolol once daily. The usual effective dose range is 160 to 240 mg once daily. The dosage may be increased gradually to achieve optimal migraine prophylaxis. If a satisfactory response is not obtained within four to six weeks after reaching the maximal dose, propranolol therapy should be discontinued. It may be advisable to withdraw the drug gradually over a period of several weeks depending on the patient's age, comorbidity, and dose of propranolol.
Hypertrophic Subaortic Stenosis
The usual dosage is 80 to 160 mg propranolol once daily.
Off-Label Use and Dosage (Adult)
Guideline-Supported Use
Thyroid Storm
- Developed by: American Thyroid Association and American Association of Clinical Endocrinologists
- Class of Recommendation: 1 (high recommendation)
- Strength of Evidence: + (poor quality of evidence)
- Dosing Information/Recommendation
- 10–40 mg.[1]
Non–Guideline-Supported Use
Anxiety
Congestive Heart Failure
- Dosing Information
- Initial dose of 10 mg/day followed by 10-mg increments until a dose of 30 mg q8h.[2]
Gastrointestinal Hemorrhage
Percutaneous Coronary Intervention
- Dosing Information
- 15 μg/kg injected through the catheter directly to the coronary artery.[3]
Portal Hypertention
- Dosing Information
- 40–120 mg/day.[4]
Pediatric Indications and Dosage
FDA-Labeled Indications and Dosage (Pediatric)
There is limited information regarding Propranolol (capsule) FDA-Labeled Indications and Dosage (Pediatric) in the drug label.
Off-Label Use and Dosage (Pediatric)
Non–Guideline-Supported Use
Congestive Heart Failure
- Dosing Information
- 1,6 mg/kg/day[5]
Tetralogy of Fallot
- Dosing Information
- (Dosage)
Portal Hypertension
Neonatal Thyroid Storm
Contraindications
- Cardiogenic shock
- Sinus bradycardia
- Second-degree AV block
- Third-degree AV block
- Bronchial asthma
- Hypersensitivity
Warnings
Angina Pectoris
There have been reports of exacerbation of angina and, in some cases, myocardial infarction, following abrupt discontinuance of propranolol therapy. Therefore, when discontinuance of propranolol is planned, the dosage should be gradually reduced over at least a few weeks, and the patient should be cautioned against interruption or cessation of therapy without the physician's advice. If propranolol therapy is interrupted and exacerbation of angina occurs, it usually is advisable to reinstitute propranolol therapy and take other measures appropriate for the management of unstable angina pectoris. Since coronary artery disease may be unrecognized, it may be prudent to follow the above advice in patients considered at risk of having occult atherosclerotic coronary disease who are given propranolol for other indications.
Hypersensitivity and Skin Reactions
Hypersensitivity reactions, including anaphylactic/anaphylactoid reactions, have been associated with the administration of propranolol
Cutaneous reactions, including Stevens-Johnson Syndrome, toxic epidermal necrolysis, exfoliative dermatitis, erythema multiforme, and urticaria, have been reported with use of propranolol.
Cardiac Failure
Sympathetic stimulation may be a vital component supporting circulatory function in patients with congestive heart failure, and its inhibition by beta blockade may precipitate more severe failure. Although beta blockers should be avoided in overt congestive heart failure, some have been shown to be highly beneficial when used with close follow-up in patients with a history of failure who are well compensated and are receiving diuretics as needed. Beta-blockers agents do not abolish the inotropic action of digitalis on heart muscle.
In Patients without a History of heart failure, continued use of beta blockers can, in some cases, lead to cardiac failure.
Nonallergic Bronchospasm (e.g., Chronic Bronchitis, Emphysema)
In general, patients with bronchospastic lung disease should not receive beta-blockers. Propranolol should be administered with caution in this setting since it may provoke a bronchial asthmatic attack by blocking bronchodilation produced by endogenous and exogenous catecholamine stimulation of beta-receptors.
Major Surgery
Chronically administered beta-blocking therapy should not be routinely withdrawn prior to major surgery, however the impaired ability of the heart to respond to reflex adrenergic stimuli may augment the risks of general anesthesia and surgical procedures.
Diabetes and Hypoglycemia
Beta-adrenergic blockade may prevent the appearance of certain premonitory signs and symptoms (pulse rate and pressure changes) of acute hypoglycemia, especially in labile insulin-dependent diabetics. In these patients, it may be more difficult to adjust the dosage of insulin.
Propranolol therapy, particularly when given to infants and children, diabetic or not, has been associated with hypoglycemia especially during fasting as in preparation for surgery. Hypoglycemia has been reported in patients taking propranolol after prolonged physical exertion and in patients with renal insufficiency.
Thyrotoxicosis
Beta-blockade may mask certain clinical signs of hyperthyroidism. Therefore, abrupt withdrawal of propranolol may be followed by an exacerbation of symptoms of hyperthyroidism, including thyroid storm. Propranolol may change thyroid-function tests, increasing T4 and reverse T3, and decreasing T3.
Wolff-Parkinson-White Syndrome
Beta-blockade in patients with Wolff-Parkinson-White syndrome and tachycardia has been associated with severe bradycardia requiring treatment with a pacemaker. In one case, this result was reported after an initial dose of 5 mg propranolol.
Adverse Reactions
Clinical Trials Experience
Central Nervous System
- (list/description of adverse reactions)
Cardiovascular
- (list/description of adverse reactions)
Respiratory
- (list/description of adverse reactions)
Gastrointestinal
- (list/description of adverse reactions)
Hypersensitive Reactions
- (list/description of adverse reactions)
Miscellaneous
- (list/description of adverse reactions)
Condition 2
Central Nervous System
- (list/description of adverse reactions)
Cardiovascular
- (list/description of adverse reactions)
Respiratory
- (list/description of adverse reactions)
Gastrointestinal
- (list/description of adverse reactions)
Hypersensitive Reactions
- (list/description of adverse reactions)
Miscellaneous
- (list/description of adverse reactions)
Postmarketing Experience
(Description)
Drug Interactions
- Drug 1
- Drug 2
- Drug 3
- Drug 4
- Drug 5
Drug 1
(Description)
Drug 2
(Description)
Drug 3
(Description)
Drug 4
(Description)
Drug 5
(Description)
Use in Specific Populations
Pregnancy
Pregnancy Category (FDA):
(Description)
Pregnancy Category (AUS):
(Description)
Labor and Delivery
(Description)
Nursing Mothers
(Description)
Pediatric Use
(Description)
Geriatic Use
(Description)
Gender
(Description)
Race
(Description)
Renal Impairment
(Description)
Hepatic Impairment
(Description)
Females of Reproductive Potential and Males
(Description)
Immunocompromised Patients
(Description)
Others
(Description)
Administration and Monitoring
Administration
(Oral/Intravenous/etc)
Monitoring
Condition 1
(Description regarding monitoring, from Warnings section)
Condition 2
(Description regarding monitoring, from Warnings section)
Condition 3
(Description regarding monitoring, from Warnings section)
IV Compatibility
Solution
Compatible
- Solution 1
- Solution 2
- Solution 3
Not Tested
- Solution 1
- Solution 2
- Solution 3
Variable
- Solution 1
- Solution 2
- Solution 3
Incompatible
- Solution 1
- Solution 2
- Solution 3
Y-Site
Compatible
- Solution 1
- Solution 2
- Solution 3
Not Tested
- Solution 1
- Solution 2
- Solution 3
Variable
- Solution 1
- Solution 2
- Solution 3
Incompatible
- Solution 1
- Solution 2
- Solution 3
Admixture
Compatible
- Solution 1
- Solution 2
- Solution 3
Not Tested
- Solution 1
- Solution 2
- Solution 3
Variable
- Solution 1
- Solution 2
- Solution 3
Incompatible
- Solution 1
- Solution 2
- Solution 3
Syringe
Compatible
- Solution 1
- Solution 2
- Solution 3
Not Tested
- Solution 1
- Solution 2
- Solution 3
Variable
- Solution 1
- Solution 2
- Solution 3
Incompatible
- Solution 1
- Solution 2
- Solution 3
TPN/TNA
Compatible
- Solution 1
- Solution 2
- Solution 3
Not Tested
- Solution 1
- Solution 2
- Solution 3
Variable
- Solution 1
- Solution 2
- Solution 3
Incompatible
- Solution 1
- Solution 2
- Solution 3
Overdosage
Acute Overdose
Signs and Symptoms
(Description)
Management
(Description)
Chronic Overdose
Signs and Symptoms
(Description)
Management
(Description)
Pharmacology
Propranolol (capsule)
| |
| Systematic (IUPAC) name | |
| ? | |
| Identifiers | |
| CAS number | ? |
| ATC code | ? |
| PubChem | ? |
| Chemical data | |
| Formula | ? |
| Mol. mass | ? |
| Pharmacokinetic data | |
| Bioavailability | ? |
| Metabolism | ? |
| Half life | ? |
| Excretion | ? |
| Therapeutic considerations | |
| Pregnancy cat. |
? |
| Legal status | |
| Routes | ? |
Mechanism of Action
(Description)
Structure
(Description with picture)
Pharmacodynamics
(Description)
Pharmacokinetics
(Description)
Nonclinical Toxicology
(Description)
Clinical Studies
Condition 1
(Description)
Condition 2
(Description)
Condition 3
(Description)
How Supplied
(Description)
Storage
There is limited information regarding Propranolol (capsule) Storage in the drug label.
Images
Drug Images
{{#ask: Page Name::Propranolol (capsule) |?Pill Name |?Drug Name |?Pill Ingred |?Pill Imprint |?Pill Dosage |?Pill Color |?Pill Shape |?Pill Size (mm) |?Pill Scoring |?NDC |?Drug Author |format=template |template=DrugPageImages |mainlabel=- |sort=Pill Name }}
Package and Label Display Panel
{{#ask: Label Page::Propranolol (capsule) |?Label Name |format=template |template=DrugLabelImages |mainlabel=- |sort=Label Page }}
Patient Counseling Information
(Patient Counseling Information)
Precautions with Alcohol
Alcohol-Propranolol interaction has not been established. Talk to your doctor about the effects of taking alcohol with this medication.
Brand Names
There is limited information regarding Propranolol (capsule) Brand Names in the drug label.
Look-Alike Drug Names
- (Paired Confused Name 1a) — (Paired Confused Name 1b)
- (Paired Confused Name 2a) — (Paired Confused Name 2b)
- (Paired Confused Name 3a) — (Paired Confused Name 3b)
Drug Shortage Status
Drug Shortage
Price
References
The contents of this FDA label are provided by the National Library of Medicine.
- ↑ Bahn Chair RS, Burch HB, Cooper DS, Garber JR, Greenlee MC, Klein I; et al. (2011). "Hyperthyroidism and other causes of thyrotoxicosis: management guidelines of the American Thyroid Association and American Association of Clinical Endocrinologists". Thyroid. 21 (6): 593–646. doi:10.1089/thy.2010.0417. PMID 21510801.
- ↑ Aronow WS, Ahn C, Kronzon I (1997). "Effect of propranolol versus no propranolol on total mortality plus nonfatal myocardial infarction in older patients with prior myocardial infarction, congestive heart failure, and left ventricular ejection fraction > or = 40% treated with diuretics plus angiotensin-converting enzyme inhibitors". Am J Cardiol. 80 (2): 207–9. PMID 9230162.
- ↑ Wang FW, Osman A, Otero J, Stouffer GA, Waxman S, Afzal A; et al. (2003). "Distal myocardial protection during percutaneous coronary intervention with an intracoronary beta-blocker". Circulation. 107 (23): 2914–9. doi:10.1161/01.CIR.0000072787.25131.03. PMID 12771007.
- ↑ Venon WD, Baronio M, Leone N, Rolfo E, Fadda M, Barletti C; et al. (2003). "Effects of long-term Irbesartan in reducing portal pressure in cirrhotic patients: comparison with propranolol in a randomised controlled study". J Hepatol. 38 (4): 455–60. PMID 12663237.
- ↑ Buchhorn R, Hulpke-Wette M, Hilgers R, Bartmus D, Wessel A, Bürsch J (2001). "Propranolol treatment of congestive heart failure in infants with congenital heart disease: The CHF-PRO-INFANT Trial. Congestive heart failure in infants treated with propanol". Int J Cardiol. 79 (2–3): 167–73. PMID 11461738.