Propranolol hydrochloride 10 mg, 20mg, 40 mg, 60mg, 80 mg film-coated tablets What Propranolol is used for Propranolol can be used for: Hypertension (high blood pressure) Angina (chest pain) Some arrhythmias (disorders of heart rhythm) Protection of the heart after a myocardial infarction (heart attack) Migraine Essential tremor (involuntary and rhythmic shaking) Certain thyroid conditions Hypertrophic cardiomyopathy (thickened heart muscle) Phaeochromocytoma (high blood pressure due to a tumour usually near the kidney) Bleeding in the oesophagus caused by high blood pressure in the liver. Do not takePropranolol if you Talk to your doctor or pharmacist before taking Propranolol if you: Get allergic reactions to such things as insect stings. Have diabetes as Propranolol may change your normal response to low blood sugar. Have thyrotoxicosis. Propranolol may hide the symptoms of thyrotoxicosis. Have kidney or liver problems (including cirrhosis of the liver). Have heart problems. Suffer from muscle weakness (myasthenia gravis) Have conditions like chronic obstructive pulmonary disease and bronchospasm. Use channel blockers with negative inotropic effects like verapamil and diltiazem Warnings and precautions Talk to your doctor or pharmacist before taking Propranolol if you: if you have (ever had) or are developing any medical condition or symptoms. if you become confused/disoriented, agitated, aggressive. If you or someone close to you has noticed that you have unusual cravings or impulsive behavior. Possible side effects These include cold fingers and toes, the heart beating more slowly, numbness and spasm in the fingers which is followed by warmth and pain (Raynaud’s syndrome), disturbed sleep/nightmares, fatigue, breathlessness, nausea, vomiting and diarrhea. Other medicines and Propranolol Propranolol should not be used in combination with calcium channel blockers with negative inotropic effects (e.g. verapamil, diltiazem), as it can lead to an exaggeration of these effects. This may result in severe hypotension and bradycardia. Other medicines which can cause problems when taken together with your medicine: Nifedipine, nisoldipine, nicardipine, isradipine, lacidipine Lidocaine (local anesthetic) Disopyramide, quinidine, amiodarone, propafenone and glycosides (to treat heart problems) Adrenaline (a heart stimulant) Ibuprofen and indomethacin (for pain and inflammation) Ergotamine, dihydroergotamine or rizatriptan (for migraine) Chlorpromazine and thioridazine (for certain psychiatric disorders) Cimetidine (for stomach problems) Rifampicin (for the treatment of tuberculosis) Theophylline (for asthma) Warfarin (to thin the blood) and hydralazine (for hypertension) Fingolimod (for treating multiple sclerosis) Fluvoxamine and barbiturates (to treat anxiety and insomnia) MAO inhibitors (to treat depression) How to take Propranolol Adults: Hypertension (high blood pressure): Initially 40 mg two or three times daily, which may be increased by 80 mg per day at weekly intervals. Angina (chest pains) and tremor: Initially 40 mg two to three times daily, which may be increased by 40 mg per day at weekly intervals. Protection of the heart after a heart attack: Initially 40 mg four time a day and after a few days changes to 80mg twice a day Arrhythmias: 10 to 40 mg three or four times daily Phaeochromocytoma: Before an operation: 60 mg daily. Non-operable treatment dose: 30 mg daily Liver disease due to high blood pressure: Initially 40mg twice daily, increasing to 80mg twice daily Pediatric population Propranolol can also be used to treat children with migraine and arrhythmias: For migraine, the dose under the age of 12 is 20 mg two or three times daily and the adult dose for children 12 years or older. For arrhythmias, the dosage will be adjusted by the doctor according to the child’s age or weight. How to store Propranolol Keep this medicine out of the sight and reach of children. Do not use this medicine after the expiration date shown on the package. This medicinal product does not require any special storage conditions. * Dosage form and route of administration of Propranolol hydrochloride 60mg, 80mg, 120mg, 160mg capsules, extended release should be prescribed according to therapeutic indication and disease severity of each individual patient.