Inderal (generic name Propranolol) belongs to the drug class called beta blockers and is used to treat several conditions including high blood pressure, irregular heart rhythms, chest pain, migraines, tremors, and anxiety. It works by blocking the effects of a natural chemical called epinephrine on the body. This chemical causes an increase in blood pressure, heartbeat rate, muscle tension, and narrowing of blood vessels in situations like stress, anxiety, or heavy exercise. By blocking epinephrine’s effects, propranolol helps relax these effects on the cardiovascular system.
Propranolol was approved for medical use in 1964 and was the first successful beta blocker developed. It is available under numerous brand names worldwide including Inderal, Deralin, Dociton, Avlocardyl, etc. In Pakistan, Inderal by GlaxoSmithKline (GSK) and Betacard by Barrett Hodgson are commonly available brands. Inderal is available in tablet form in multiple strengths including 10mg, 20mg, 40mg, 60mg, and 80mg tablets.
Medical Uses of Inderal
- Hypertension – It is commonly prescribed for mild to moderate high blood pressure control. Relaxing blood vessels, allows blood to flow more easily and lowers blood pressure.
- Angina Pectoris – It helps prevent chest pain episodes in patients with coronary artery disease by dilating blood vessels and increasing blood flow to the heart.
- Cardiac Arrhythmia – It helps control abnormal heart rhythms and prevent the recurrence of arrhythmias. It regulates heartbeat intervals.
- Migraine Headaches – It can prevent migraine attacks or reduce their severity and frequency. It works by constricting dilated blood vessels in the brain that cause migraines.
- Essential Tremor – It is used for treating shaking or trembling in hands, arms, head, and voice caused by neurological conditions.
- Performance Anxiety – Stage fright, social phobias, and fear of public speaking can improve with Inderal by reducing physical symptoms associated with anxiety like increased heart rate, sweating, tremors, etc.
- Thyrotoxicosis – Along with medications for hyperthyroidism, Inderal provides symptomatic relief and controls rapid heartbeat caused by excess thyroid hormones.
- Pheochromocytoma – It controls high blood pressure episodes and rapid heart rate caused by adrenaline-secreting tumors.
- Portal Hypertension – It lowers blood pressure in the abdomen and prevents bleeding from esophageal varices.
Dosage Guidelines
- The commonly prescribed Inderal dosage for adults is 10mg to 40mg twice daily. The dosage is individualized based on the condition being treated.
- For high blood pressure, the starting dose is 10mg twice daily which can be increased to 40mg twice daily if needed. The full effect may take 1-2 weeks.
- For arrhythmias, migraine or tremors – 40mg twice daily is commonly prescribed. The dosage can be adjusted based on individual responses.
- For performance anxiety – 10mg to 20mg before the anxiety-inducing event provides relief without excessive sedation.
- It is also safe for use in children for conditions like migraine, hypertension, heart disorders, etc under medical supervision.
- In elderly patients, a lower starting dose is advised due to reduced kidney function.
- The tablets should be taken with meals as food helps absorption. Do not crush or break the tablets.
Contraindications and Precautions
- Propranolol is contraindicated in patients with asthma, COPD, and certain heart blocks as it can trigger bronchospasm and worsen breathing.
- It should be used cautiously in patients with diabetes, kidney disease, liver disease, thyroid disorders, and peripheral artery disease where dosage adjustments may be needed.
- It should not be withdrawn suddenly after long-term use as it can cause rebound hypertension. The dose needs to be tapered slowly under medical supervision.
- Patients should inform doctors about any other medications they are taking as Inderal can interact with various drugs and supplements.
- It is not recommended in pregnancy unless the benefits outweigh the potential risks to the fetus. It is excreted in breast milk so caution must be taken while breastfeeding.
Side Effects
- Tiredness, drowsiness, fatigue
- Dizziness, lightheadedness
- Cold extremities like hands and feet
- Gastrointestinal distress like nausea, vomiting, diarrhea
- Constipation, indigestion
- Abnormal blood sugar levels
- Changes in mood and sex drive
- Breathing problems like wheezing, and tightness in the chest
- Disturbed sleep, nightmares
- Slow heart rate
Rare but serious side effects that warrant medical attention include:
- Allergic reaction – rash, itching, swelling, trouble breathing
- Worsening depression and suicidal thoughts
- Hallucinations
- Fever, sore throat, mouth ulcers
- Yellowing of skin and eyes, dark urine (liver problems)
- Shortness of breath, swelling in legs (heart failure signs)
Interactions
The following drugs may interact with Inderal:
- Blood pressure medications
- Heart rhythm drugs like digoxin
- Migraine medications
- Thyroid hormones
- Antidepressants
- Antipsychotics
- Quinolone antibiotics
- Antidiabetic drugs
- NSAIDs like ibuprofen
- Certain supplements like glucosamine
It is vital for patients to inform the prescribing doctor about any medications they are already taking to assess if dose adjustments are required. Taking Inderal with meals helps reduce absorption-related interactions.
Overdose
In case of Inderal overdose, patients may experience excessive slowing of heart rate, very low blood pressure, severe breathing issues, seizures, collapse, and even cardiac arrest in severe cases. Immediate emergency medical care is required for overdose management.
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Warnings
- Do not stop Inderal suddenly without medical advice
- Avoid driving or operating heavy machinery when starting treatment as dizziness is common initially.
- Avoid alcohol consumption as it may alter drug effects.
- Seek immediate care if you experience any serious reactions.
- Always follow your doctor’s instructions carefully regarding the dose, timing, and duration of Inderal therapy.
Inderal Tablet Price In Pakistan
The exact price may vary depending on the manufacturer, pharmacy location, and city. Generic propranolol tablets are also available at lower prices.
| Q | Medicine Details |
|---|---|
| Brand Name | Inderal |
| Generic Name | Propranolol |
| Strength | 10mg |
| Pack Size | 30 tablets |
| Price (MRP) | Rs. 127.13 |
| Manufacturer | GlaxoSmithKline (GSK |
Always consult your doctor before taking Inderal tablets and follow the prescribed dosage instructions carefully. Do not adjust your dosage without medical advice. Maintaining regular heart rate and blood pressure is important while taking this medication.
Last Words
Inderal (Propranolol) is an effective beta blocker medication but it requires close medical monitoring and dosage tailoring as per the individual patient’s needs. When used correctly under professional care, it can greatly help improve the management of various cardiovascular and neurological conditions.
FAQs(Frequently Asked Question)
Q1. What is Inderal used for?
A1. Inderal is used to treat conditions like high blood pressure, irregular heartbeat, chest pain, migraines, tremors, and anxiety. It belongs to the drug class called beta blockers.
Q2. How does Inderal work?
A2. It works by blocking the effects of epinephrine, a natural chemical that increases blood pressure, heart rate, and anxiety. This allows the relaxation of blood vessels and a slower heart rate.
Q3. What is the dosage of Inderal?
A2. The commonly prescribed adult dosage is 10mg to 40mg taken twice daily. Dosage varies based on the specific condition being treated.
Q4. How should Inderal be taken?
A4. Take Inderal tablets at the same times each day with meals to improve absorption. Do not chew, crush, or break the tablets.
Q5. What are the side effects of Inderal?
A5. Common side effects include tiredness, dizziness, cold extremities, gastrointestinal problems, disturbed sleep, etc. Serious side effects are rare but can include breathing issues, low blood pressure, hallucinations, etc.
Q6. What precautions are needed with Inderal?
A6. It should be used cautiously in patients with lung conditions like asthma and certain heart blocks. Dose adjustments may be required in kidney or liver disease. Gradual withdrawal is recommended.
Q7. Can Inderal be taken with other medicines?
A7. It can potentially interact with many drugs so your doctor needs to know about all your medications before prescribing Inderal. Take it with meals to reduce interactions.
Q8. What should I avoid while taking Inderal?
A8. Avoid suddenly stopping the medicine, alcohol use, and activities requiring alertness like driving when starting treatment as dizziness is common initially.
Q9. What should I do in case of an Inderal overdose?
A9. Seek emergency care immediately if you suspect an overdose. Symptoms may include dangerously slow heartbeat and breathing difficulties.
Q10. How much does Inderal cost in Pakistan?
A10. Inderal 10mg tablets may cost around Rs. 90-150 per pack of 30 tablets. Brands available are Inderal and Betacard. Price may vary.
