A1,
A2,
B,
C1,
C2,
D,
E,
F,
G-H,
I-K,
L,
M,
N,
O,
P1,
P2,
Q-R,
S,
T,
U-V,
W-Z
Inderal Side Effects, and Drug Interactions - Propranolol
Inderal Side Effects, and Drug Interactions - Propranolol
SIDE EFFECTS
Most adverse effects have been mild and transient
and have rarely required the withdrawal
of therapy.
Cardiovascular: Bradycardia; congestive heart failure;
intensification of AV block; hypotension; paresthesia
of hands; thrombocytopenic purpura; arterial
insufficiency, usually of the Raynaud type.
Central Nervous System: Light-headedness; mental
depression manifested by insomnia, lassitude, weakness, fatigue;
reversible mental depression
progressing to catatonia; visual
disturbances; hallucinations, vivid dreams, an acute
reversible syndrome
characterized by disorientation for time
and place, short-term memory loss, emotional lability, slightly
clouded sensorium, and decreased performance
on neuropsychometrics. Total daily doses above 160 mg
(when administered as divided doses of greater than 80 mg
each) may be associated with an increased incidence
of fatigue, lethargy, and vivid dreams.
Gastrointestinal: Nausea, vomiting, epigastric distress,
abdominal cramping,
diarrhea, constipation, mesenteric arterial thrombosis, ischemic
colitis.
Allergic: Pharyngitis and agranulocytosis, erythematous
rash, fever combined with
aching and sore throat,
laryngospasm, and respiratory distress.
Respiratory: Bronchospasm.
Hematologic: Agranulocytosis, nonthrombocytopenic
purpura, thrombocytopenic purpura.
Autoimmune: In
extremely rare instances, systemic lupus erythematosus has been
reported.
Miscellaneous: Alopecia, LE-like reactions, psoriasiform
rashes, dry eyes, male
impotence, and Peyronie's disease
have been reported rarely. Oculomucocutaneous reactions involving
the skin, serous membranes and conjunctivae reported for a beta
blocker (practolol)
have not been associated with propranolol.
DRUG INTERACTIONS
Patients receiving catecholamine-depleting drugs such as reserpine
should be closely observed if Propranolol HCl is administered. The
added catecholamine-blocking action may produce an excessive reduction
of resting sympathetic
nervous activity, which
may result in hypotension, marked bradycardia, vertigo, syncopal
attacks, or orthostatic
hypotension.
Caution should be exercised when patients receiving a beta
blocker are administered
a calcium-channel blocking
drug, especially intravenous
verapamil, for both agents may depress myocardial
contractility or atrioventricular
conduction. On rare occasions, the concomitant
intravenous use
of a beta blocker
and verapamil has resulted in serious adverse reactions, especially
in patients with severe cardiomyopathy, congestive heart
failure, or recent myocardial
infarction.
Blunting of the antihypertensive
effect of beta-adrenoceptor
blocking agents by nonsteroidal anti-inflammatory drugs has been
reported.
Hypotension and cardiac
arrest have been reported
with the concomitant use of propranolol and haloperidol.
Aluminum hydroxide
gel: Greatly reduces intestinal
absorption of propranolol.
Ethanol: Slows the rate
of absorption of
propranolol.
Phenytoin, phenobarbitone: and rifampin accelerate
propranolol clearance.
Chlorpromazine: When used concomitantly with propranolol,
results in increased plasma
levels of both drugs.
Antipyrine: and lidocaine have reduced clearance
when used concomitantly with propranolol.
Thyroxine: May result in a lower than expected T3
concentration
when used concomitantly with propranolol.
Cimetidine Decreases the hepatic
metabolism of propranolol,
delaying elimination
and incre:asing blood
levels.
Theophylline: Clearance is reduced when used concomitantly
with propranolol.
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