Propranolol (Inderal) Beta Blocker

Propranolol beta blocker. What is Propranolol? Uses and indications

Propranolol beta blocker. What is Propranolol? Uses and indications

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Dr. Gregg RegerDr. Gregg Reger, MD


Is Propranolol (Inderal) a blood thinner?

A group of the beta-blockers which Propranolol belongs to is used during various pathological disorders of the cardiovascular system. They help to reduce an aggregation of the blood plates and even take part in the fibrinolysis process (a clot lysis). However, neither Propranolol, not any other drug in this group has an ability to thin the blood. Drugs from the group of the anticoagulants and antiaggregants are responsible for this function in the pharmacological practice. These medications reduce the blood coagulability, do not let the platelets clot, and have a cumulative action.

propranolol 10 mg

If we consider the mechanisms of the pharmacological action of Propranolol, we can draw a parallel between a reduction of the platelet aggregation and the blood thinning. However, the drug does not provide a direct action.

Therefore, Propranolol is not prescribed patients with deep venous thrombosis because it will be ineffective. A task of the beta-blockers consists in a reduction of the load on the cardiac muscle, lowering the blood pressure and restoring a normal rhythm of the cardiac muscle.

What is Propranolol prescribed for? Propranolol uses and indications

Propranolol is prescribed for the treatment of many diseases of the cardiovascular system. This drug has a prolonged action that has an accumulative effect. Therefore, it is used as a disease-modifying agent to treat:

  • Arterial hypertension;
  • Cardiac angina;
  • Ischemic heart disease;
  • Tachycardia;
  • Arrhythmia;
  • Myocardial infarction;
  • Cardiomyopathy.

Besides the treatment of the cardiovascular system diseases, the drug may be used as a maintaining product during the mitral valve prolapse. It is not able to reduce the increase of the prolapse but due to the control of the cardiac muscle work, a danger of the complications is reduced during this pathology, and a need to have a surgery is decreased.

propranolol uses

Dr. Gregg RegerDr. Gregg Reger, MD: Bear in mind that Propranolol is a non-selective beta-blocker, and it means that it acts on the adrenoceptors in all tissues and organs. Due to this, a range of the drug application is higher than in many other medications in this group.

Propranolol is actively used for:

  • Panic attacks: the drug lowers anxiety and regulates the pulse;
  • Migraine: the drug lowers the intensity of the pain syndrome and reduces a frequency of the outbreaks;
  • Initial poor uterine contraction strength: it helps to lower the intraocular pressure;
  • Abstinent syndrome in alcoholics: the drug reduces the symptoms.

How does Propranolol work?

The active ingredient of Propranolol lowers a sensitivity of β-adrenergic receptors to adrenaline. But if the selective adrenoceptor blocking agents block not all β-adrenergic receptors but one type, Propranolol blocks all β-adrenergic receptors as a non-selective beta adrenoceptor blocking agent.

  • Β1-adrenoceptors are placed in the heart and kidneys;
  • Β2-adrenoceptors are placed in the lungs, gastro-intestinal tract, liver, uterus, in the smooth muscles of the blood vessels, and also in the skeletal muscles;
  • Β3-adrenoceptors are placed in the adipose tissues.

The advantage of the drug is an ability to penetrate into many fluids and tissues due to its unique chemical formula, and it can even cross the blood-brain barrier that protects the brain tissues. Therefore, it is used during migraine and many diseases where other drugs are ineffective.

propranolol beta blocker action

Propranolol provides a hypotensive, antiarrhythmic action, and has many pharmacological possibilities. Here are some tasks this drug copes with:

  • Lowering of the frequency of the cardiac contractions and restoring a normal heartbeat;
  • Lowering a need of the myocardium in the oxygen and relieving the heart work and increasing its tolerance during the loads;
  • Lowering the blood pressure by means of the reduction of the cardiac output (it is not a vasodilating agent);
  • Reducing the frequency of the attacks of the ischemic heart disease and reducing a need in the use of the additional doses of nitroglycerine.

An intensive cardioprotective action of Propranolol is clinically proved. The use of the drug lowers a risk of the formation of the repeated myocardial infarction up to 50%. And a risk of the stroke is reduced by 30% in patients with the arterial hypertonia.

Propranolol (Inderal) dosage

Propranolol dosage depends on a clinical image of the patient. The main criteria of the dose are:

  • Patient’s age;
  • Body mass;
  • A state of the cardiovascular system (how much pathologies have been detected during the examination);
  • Set of medications that are used to keep the health of the heart.

If Propranolol will be used as a disease-modifying agent, the dose should be higher. If the drug is used in combination with other medications, the dose should be adjusted depending on the pharmacological properties of the additional ingredients.

propranolol dosage

The dosage of Propranolol during the arterial hypertension:

  • The optimal dosage is 40 mg 1-3 times per day;
  • The complicated types of the disease and a low efficiency of small doses of Propranolol need the increase of the daily dose up to 160 mg, and in severe cases, up to 320 mg per day.
  • However, the use of more than 160 mg Propranolol per day is pointless. It is better to increase the dose of the hypotensive drugs of the fast action or use diuretics in the therapy.

The propranolol dosage during the cardiac angina, arrhythmia, and ischemic heart disease:

  • The initial dose is 20 mg 3 times per day.
  • The gradual increase of the dose begins in 7-10 days after the started treatment.
  • The dose of Propranolol is increased up to 80-120 mg per day.
  • It is clinically proved that the highest effect is achieved during the division of the daily dose into 3 in comparison with dividing a daily dose into 2.
  • The maximal dose is 240 mg per day.

The dosage of Propranolol during migraine and essential tremor:

  • The initial dose is 80-120 mg (one pill of Propranolol 40 mg 2-3 times per day).
  • The dose may be increased up to 160 mg, if needed.

If a patient is prescribed Propranolol in the form of the injections, the dose should be lower because in case of the injection, the bioavailability is significantly higher.

How to get Propranolol prescription?

If you have the irregular heartbeat, high blood pressure, panic attacks, or migraine, you should not have any problem to get a prescription for Propranolol. In order to get a prescription for Propranolol, it is necessary to go to your doctor who will examine you and give a prescription. Of course, it is better to see a cardiologist who will detect a cause of the disease. Any doctor can give you a prescription.

how to get propranolol prescription

Also, the doctor should indicate a dose of the drug that will be the most effective for you. Propranolol prescription is given for 2-4 weeks depending on a doctor’s decision. You should discuss with a doctor the course of the treatment one in 3 months and change a dose or the scheme of the treatment, if needed.

Propranolol for social anxiety

Everybody experiences a social anxiety. It may be related to the various concerns that deal with work and relations. For example:

“A person wants to go to the bar with the colleagues but this person has an anxiety whether they want to see him/her.”

“A girl put on some weight and has an anxiety at the party with friends, and worries how she looks.”

Propranolol for social anxiety fighting

Although these symptoms appear from time to time, they cause a serious moral discomfort. Taking the sedative drugs to reduce the feeling of the light anxiety is not the best idea. These drugs have many side effects and may not work for some people.

So, these drugs may be replaced by Propranolol. It neutralizes anxiety and concomitant symptoms: tremor of hands, excess sweat, voice jitter, and others. If you feel social anxiety, it is necessary to take a pill Propranolol 40 mg 1-2 hours before the event, and you will relax without harming the body.

Propranolol for panic attacks

If the social anxiety is accompanied by the light symptoms, the panic attacks may be dangerous. The panic attack may grow with the outbreak of the arrhythmia, dizziness, and is very dangerous for the psychoemotional state. A severe fear is followed by the somatic and vegetative disorders in 99% of the cases, and so it is rather difficult to defeat the attack of the panic without the use of medications.

Propranolol tablets for panic attacks treatment

Dr. Gregg RegerDr. Gregg Reger, MD: The American psychiatrist association recommend beta-blockers, including Propranolol to arrest the fear symptoms, even though the clinical studies about the use of Propranolol for the panic attacks are absent.

The fear during the panic attack aggravates because of the somatic symptoms. In case of the irregular heartbeat, increased blood pressure, sweatiness, and others, the fear just grows, and so the symptoms of the panic disorder are out of control.

Propranolol helps to completely control the somatic disorders and reduce fear and panic. Propranolol is taken in the dose of 40 mg for the panic attacks, and if the effect is not achieved in 30 minutes, another 40 mg is taken.

Does Propranolol cause weight gain?

A research of the prolonged side effects of Propranolol have shown that some patients may have a weight gain during the use of the drug. There is still no data about the connection of the weight gain with the use of Propranolol but the clinical studies confirm the indirect influence of the beta-blockers on the percentage of the fatty mass in the body.

It is partially related to the fact that Propranolol influences on the metabolic processes blocking β3-adrenoceptors. Also, using the drug, patients may have a decrease of the sugar level in the blood, and it will be accompanied by the regular feeling of the light hunger. Feeling better, many patients start consuming junk food, and it affects the body mass.

Admittedly, that Propranolol does not influence on the carbohydrate metabolism and does not slow the metabolism. Therefore, if a patient follows the balanced diet, none problems with the body mass will happen even in 10 years of the use of Propranolol.

Can you drink alcohol with Propranolol?

A lot of medications for the treatment of the cardiovascular diseases that are taken to control the heart functions may be taken with alcohol. However, this rule is not applied to the beta-blockers. Alcohol does not influence on the bioavailability of Propranolol and its pharmacological properties, however the alcohol consumption influences on the central nervous system and may cause the attack of the arrhythmia. In this case, the effect of Propranolol disappears, and a patient’s state gets worse.

Moreover, alcohol increases the blood pressure, and it has a bad effect on patients with the arterial hypertension. The use of alcohol may also cause side effects peculiar for hypertonia, cardiac angina, and arrhythmia in patients with the high sensitivity to Propranolol.

So, if you are taking Propranolol and have severe cardiovascular diseases, it is better to refuse from the alcohol consumption.

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