Inderal-LA

Brand Names: Inderal-LA

Common Name: propranolol HCl

What is this drug used for?

Propranolol belongs to the class of medications called beta-blockers. It is used for the treatment of high blood pressure. It is also used for the prevention of angina (chest pain) and to treat certain types of abnormal heart rhythms. Propranolol works by relaxing blood vessels and reducing the demands on the heart.

Your doctor may choose to use a medication for conditions other than the ones listed in these drug information articles. If you're unsure why you are taking this medication, contact your doctor.

Is there any reason not to take this drug?

Propranolol should not be taken by anyone who has:

• an allergy to propranolol or any of the ingredients of the medication
• a severely slow heart rate
• serious heart block (2^nd and 3^rd degree AV block)
• overt heart failure
• right ventricular failure secondary to pulmonary hypertension (excessive blood pressure in the lungs)
• cardiogenic shock
• severe circulatory disorders
• asthma or severe chronic obstructive respiratory diseases (e.g., emphysema, chronic bronchitis)
• allergic rhinitis during the pollen season

What about possible side effects?

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor. Your health professional may be able to help you to deal with some of the effects.

The following side effects may go away as your body becomes used to the medicine; check with your doctor if they continue to become bothersome.

More common

• decreased sexual ability
• dizziness or lightheadedness
• drowsiness (slight)
• difficulty sleeping
• unusual tiredness or weakness

  Less common or rare

• anxiety
• nervousness
• constipation
• diarrhea
• dry, sore eyes
• itching of skin
• nausea or vomiting
• nightmares and vivid dreams
• numbness or tingling of fingers or toes
• stomach discomfort
• stuffy nose

Contact your doctor as soon as possible if any of the following side effects occur:

Less common

• breathing difficulty or wheezing
• cold hands and feet
• depression
• shortness of breath
• slow heartbeat (especially less than 50 beats per minute)
• swelling of ankles, feet, or lower legs

  Rare

• back or joint pain
• chest pain
• confusion
• dizziness upon arising (orthostatic hypotension)
• fever and sore throat
• hallucinations
• irregular heartbeat
• red, scaling, or crusted skin
• skin rash
• unusual bleeding or bruising

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

What if I am taking other drugs?

The following medications may affect the way that propranolol works or increase the risk of side effects:

• alcohol
• aluminum salts (e.g., aluminum hydroxide, attapulgite)
• anti-arrhythmic medications
• barbiturates (e.g., amobarbital, pentobarbital, butalbital)
• calcium channel blockers (e.g., nifedipine, verapamil)
• chlorpromazine
• cimetidine
• hydralazine
• MAO inhibitors
• medications that reduce blood pressure
• methimazole
• NSAIDs (nonsteroidal anti-inflammatory drugs; e.g., ibuprofen, naproxen)
• propafenone
• propylthiouracil
• quinidine
• ranitidine
• rifabutin
• rifampin
• SSRIs (selective serotonin reuptake inhibitors; e.g., citalopram, fluoxetine, paroxetine, sertraline)
• thioridazine

Propranolol may affect how the following medications work:

• anti-diabetes medications (e.g., insulin)
• clonidine
• epinephrine
• ergot alkaloids (e.g., dihydroergotamine, methysergide)
• lidocaine
• methyldopa
• prazosin
• theophyllines (e.g., theophylline, aminophylline, oxtriphylline)

If you are taking any medications containing this drug, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. In many cases, interactions are intended or are managed by close monitoring. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription) and herbal medications that you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or illegal drugs can affect the action of many medications, you should let your prescriber know if you use them.

Other information:

Breathing problems: People with asthma and certain other breathing problems should not take propranolol.

Diabetes: The signs of low blood sugar may not be as noticeable when taking propranolol. People with diabetes who take insulin or other drugs that work by reducing the sugar in the blood should be cautious and monitor blood sugar carefully while taking this medication.

Dizziness: Move slowly when moving from a lying or sitting position to a standing position as dizziness may occur, especially when this medication is first being started.

Hyperthyroidism (high level of thyroid hormones): People with hyperthyroidism should be cautious while taking propranolol as it may reduce the symptoms of this condition giving a false impression of improvement. Stopping the medication suddenly could worsen this condition.

Severe allergies: People with allergies severe enough to cause anaphylaxis (a severe allergic reaction where swelling of the face, lips, and throat make it difficult to breathe) should talk to their doctor about what to do if they have an allergic reaction. Propranolol may make it more difficult to treat their allergic reaction with epinephrine.

Stopping medication: Propranolol should not be stopped suddenly by people who are taking it to treat angina. There have been reports of severe worsening of angina, and of heart attack or abnormal heart rhythms occurring for people with angina pectoris who have done this.

Surgery: If you are scheduled for surgery, inform all doctors involved in your care that you take propranolol.

Pregnancy: Not enough information exists on the safe use of propranolol by pregnant women. Propranolol should be used during pregnancy only if the potential benefits justify the potential risks.

Breast-feeding: Propranolol passes into breast milk. Talk with your doctor about the risks and benefits of using this medication while nursing.

Children: There is limited experience in the use of propranolol by children. Caution is advised with its use by this age group.

Special Instructions:

The recommended adult dose of propranolol varies widely according to condition being treated and circumstances of the person using the medication. Propranolol may be taken with or without food. Do not stop taking this medication suddenly unless you have talked with your doctor first.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones given here, do not change the way that you are taking the medication without consulting your doctor.

It is very important that this medication be taken on a regular schedule as prescribed by the doctor. If you miss a dose of this medication, take it as soon as you remember it. If it is almost time for your next dose, skip the missed dose and carry on with your regular schedule. Do not double-up on doses.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

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