Propranolol 40mg TV.Pharm treat hypertension, angina (10 blisters x 10 tablets)

Dosage form Box of 10 blisters x 10 tablets
Specifications Propranolol hydrochlorid

Ingredient

Composition information	Content
Propranolol hydrochlorid	40mg

Uses

indications

Propranolol 40mg drug indicated in the following cases:

Hypertension, angina due to coronary atherosclerosis; arrhythmia (tachycardia on ventricular), myocardial infarction, migraine, idiopathic tremor, hypertrophic aorta in the valve, chromium cell tumor. Treatment of supporting arrhythmia and tachycardia in patients with short -term hyperthyroidism (2-4 weeks). When they mainly choose the betat receptor in the heart tissue, it is considered to be selected with the heart. When they choose both Beta1 receptors and beta2 receptors (mainly localized in other tissues), it is considered not selective.

Propranolol 40mg is an unsatisfactory beta-adrenergic blocker. The factors that can contribute to the anti -hypertension effect of Propranolol are reduced supply in the heart, inhibiting renal releasing renin, sealing the sympathetic nerve from the vascular center in the brain out.

At first the barrier of the peripheral circuit may increase, after the long -term treatment will decrease. The drug has little influence on plasma volume. In patients with hypertension, propranolol causes slight increase in potassium. Selongido

The effect of treating angina pain is to reduce the need for oxygen use of the heart muscle due to preventing the effect of increasing the heart frequency of catecholamine, reducing systolic blood pressure, reducing the speed and level of myocardial contraction.

The beta-adrenergic blocker is very beneficial, manifested by slow appearance in exertion and increased work. Propranolol shows anti-arrhythmia effects in concentrations related to beta-adrenergic blockers, and that seems to be the main mechanism of anti-arrhythmia of the drug: With a larger dose than the beta-adrenergic, drugs that have a similar effect

Propranolol also has the effect of reducing and preventing migraine due to the acting on the beta-adrenergic receptors in the vessels on the brain soft and thus closing the artery spasm on the cerebral cortex.

In hyperthyroidism, propranolol reduces T3 concentration, and does not affect T4.

Propranolol 40mg also works to reduce the portal vein pressure, reduce the circulating flow of the burden-owner in patients with cirrhosis.

Propranolol's specific anti -tremor effect (tremor) has not yet been clarified; It may be the effect in the beta2 receptor (not in the heart) or may be the effect in the central nervous system. Propranolol is effective in physiological tremor and tremor.

Beta blockers cause bronchospasm due to the prevention of beta-adrenergic bronchiectasis effect, so be cautious in patients with bronchial asthma when indicated using propranolol.

Dynamic pharmacokinetics

Propranolol 40mg is absorbed completely close to the digestive tract. After 30 minutes of drinking, appeared in plasma, and after 60 - 90 minutes reach the maximum concentration.

Propranolol is widely distributed into the tissues in the body including lungs, liver, kidneys, and heart. The drug is easy through the bloody barrier, the placenta and the distribution of both breast milk.

Over 90% propranolol binds to plasma proteins.

is fully metabolized in the liver; There are at least 8 metabolites found in urine.

Only 1 - 4% of the dose is discharged through the form of non -metabolic and metabolic use. In patients with severe renal impairment, there is an increase in clearing elimination through stool. Propranolol is clearly excreted not as significant as the cup.

Before taking Propranolol 40mg TV.Pharm treat hypertension, angina (10 blisters x 10 tablets)

How to use

Dropranolol 40mg drug used orally.

Dosage

Dosage for hypertension treatment:

Dosage must be based on the response of each individual. Start: 9 - 1 capsule/time, 2 times/day, use alone or in combination with diuretics. Increase the dose from 3 to 7 days, until the blood pressure is stable at the required level. Usually effective dose: 4 - 12 tablets daily.

Some cases require up to 16 tablets/day. The time to achieve the lower pressure response from a few days to a few weeks. The maintenance dose is 3-6 tablets/day. When it is necessary to coordinate with thiazid diuretics, first dose each drug.

Dosage to treat angina:

Dosage daily can be 2-8 capsules/day depending on the individual, divided into 2 or 3, 4 times a day, with this dose may increase physical activity, reduce the manifestation of myocardial ischemia on the electrocardiogram.

If the treatment stops, the dose must be reduced slowly within a few weeks. Should combine propranolol with nitroglycerin.

Dosage to treat myocardial infarction:

daily dose 5 - 6 tablets, divided into several times. It is not clear the effect and safety of the dose higher than 240 mg to prevent the death of the heart. However, for higher doses may be necessary for effective treatment when there is an accompanying disease such as angina or hypertension.

To prevent recurrent infarction and sudden death from the heart, after acute myocardial infarction, give 2 capsules/time, 2 times/day, sometimes take 3 times a day.

Dosage to treat migraine:

Must detect propranolol 40mg dose for each patient. The starting dose of 2 capsules/day, divided into several times. The effective dose is usually 4 - 6 capsules/day. The dose can be gradually increased to achieve maximum efficiency. If the effect does not reach after 4 - 6 weeks, the maximum dose is used, so the propranolol should be stopped by reducing the dose slowly within a few weeks.

Dosage of idiopathic tremor treatment:

Must detect doses for each patient. Starting dose: 1 tablet/time, 2 times/day. Often good effects with a dose of 3 capsules/day, sometimes up to 6-8 capsules/day.

Agent hypertrophic aorta stenosis:

Take the dose of 1/2 - 1 capsule/time, 3-4 times/day, before eating and going to bed.

Increased portal vein pressure:

The first dose 1 tablet, 2 times a day; The dose may increase as needed, up to 4 tablets, 2 times a day.

Note: The above dose is for reference only. Specific dosage depends on the condition and level of progression of the disease. For a suitable dose, you need to consult a doctor or medical specialist.What do

do when overdose?

Overdose methods: In general, when taken, it causes vomiting; Preventive disaster should be wary of gastroesophageal reflux.

Slow pace: Use atropine (0.25 - 1 mg) intravenous injection. If there is no chosen wire, use isoproterenol but must be cautious. In the case of drug resistance, the pacemaker may be placed through the vein.

Heart failure: Use digitalis and diuretic.

Hypotension: Using hypertension drugs such as noradrenalin or dopamine. Glucagon can also be helpful in treating myocardial and lower blood pressure.

Bronchospasm: Use isoproterenol and aminophylin.

In an emergency, call the 115 emergency center immediately or go to the nearest local health station.

What to do when forgetting 1 dose? However, if the time to relax with the next dose is too short, skip the dose and continue the calendar of the drug. Do not use double dose to compensate for missed dose.

Side Effects

Most of the light and transient effects, very rare to stop the drug.

rarely

Cardiovascular:

Slow pace, congestive heart failure, atrial clog.

Some unwanted effects on the nerves often recover after stopping the drug. Short -term memory, easy to touch. Perception in the hand, peripheral neuropathy.

allergies:

Sore throat, granulocytosis, erythema, fever accompanied by sore throat, larynx spasm, acute respiratory failure.

Respiratory:

Bronchospasm.

Blood:

granulocytes, platelet hemorrhage, or no platelets.

Digestive:

Nausea, vomiting, abdominal spasms, epigastric pain, diarrhea, constipation, flatulence.

rare

Autoimmune: Very rare but also recorded the whole body lupus.

Other effects: hair loss, dry eyes, impotence.

When experiencing side effects of the drug, patients need to stop using and notify the doctor or go to the nearest medical facility for timely treatment.

Warnings

Before using the drug you need to read the instructions carefully and refer to the information below.

contraindicated

Propranolol drugs are contraindicated in the following cases:

Cardioma, Raynaud syndrome; Slowed sinus rhythm and atrial atrial block of 2-3; Bronchial asthma.

Be cautious when using

Must stop the drug slowly, should be used carefully in people with poor heart reserves; Avoid using propranolol in case of clear heart failure, but can be used when signs of heart failure are controlled.

Due to the effect of slow heart rate, if the heart rate is too slow, the dose is needed.

In patients with myocardial ischemia, do not stop the drug suddenly. Or stop propranolol slowly, or use the equivalent dose of another beta blocker instead.

Be careful in people with kidney failure or liver failure. Needs to reduce the dose and monitor the results of kidney or liver function test for long -term drug users.

In patients with increased portal venous pressure, liver function is severely impaired and at risk of brainbells - Ganon

Be cautious when the patient changes the drug from clonidin to beta blockers.

used for nursing women and pregnant women

Pregnancy: Propranolol's safety for pregnant women has not been determined. Only use drugs when carefully considered between healing benefits and risks for pregnancy.

breastfeeding period:

The drug excreted milk, should be carefully used with breastfeeding women.

The effect of drugs when driving a train and operating machinery

Propranolol 40mg does not affect the ability to drive and operate machinery.

Drug interaction

Need to adjust the dose when used in combination with the following drugs: Amiodaron, Cimetidin, Diltiazem, Verapamil, Adrenalin, Phenyl propanolamin, fluvoxamine, quinidine, anti -arrhythmic drugs, clonidine, chlorpromazine, lidocaine, nicardipin, prazosine, prazosine, prazosine, prazosine, prazosine, prazosine Rifampicin, aminophylin.

Must be very careful when taking adrenalin -containing drugs for patients who are taking beta - adrenergic blockers, because the drug can cause slow rhythm, spasm and hypertension.

Use of propranolol combination with catecholamine reducing drugs such as reserpin need to be closely monitored because of excessive impairment of sympathetic nerves that will cause lower blood pressure, slow heart rate, dizziness, fainting, or posture lower blood pressure.

Be cautious when taking beta blockers along with calcium channel blockers, especially with Verapamil intravenously, as both of these factors can inhibit heart muscle contraction or reduce atrial transmission. There are cases where combined to inject Beta and Verapamil blockers that have caused serious complications, especially in people with severe heart disease, congestive heart failure or new myocardial infarction.

Steroid anti -inflammatory drugs can reduce the effect of lowering the blood pressure of beta blockers.

Simultaneous use of propranolol and haloperidol has caused hypotension and cardiac arrest.

aluminum Hydroxyd gel reduces propranolol absorption. Ethanol slowed down the absorption of propranolol.

phenytoin, phenobarbital, rifampicin increases croplanolol clearance.

Clopromazin is used in combination with propranolol to increase the concentration of both drugs in plasma.

Antyrin and Lidocaine reduce croplanolol clearance.

thyroxin (T4) when used with propranolol causes a decrease in T3 concentration (tri-iodothyronin).

cimetidine reduces metabolism in the liver eliminating slowly and increases the concentration of propranolol in the blood.

The deposhylin clearance is reduced when used in combination with propranolol.

insulin, sulfonylure hypoglycemia: Some symptoms of hypoglycemia such as brushing chest drums, fast heartbeat may be covered by beta blockers. It is advisable to advise people to prevent and increase blood sugar tests, especially when starting treatment.

Storage

Leave a cool place, avoid light, temperature below 30⁰C.

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