Propranolol 50mg

General Propranolol Hydrochloride Propranolol should be used with caution in patients with impaired hepatic or renal function. Propranolol hydrochloride and hydrochlorothiazide tablets are not indicated for the treatment of hypertensive emergencies. Risk of Anaphylactic Reaction While taking beta-blockers, patients with a history of severe anaphylactic reaction 50mg a variety of allergens may be more reactive to repeated challenge, either accidental, diagnostic, or therapeutic.

Such patients may be unresponsive to 50mg usual doses of epinephrine used to treat allergic reaction. Hydrochlorothiazide All patients receiving thiazide therapy should be observed for clinical signs of fluid or electrolyte imbalance, propranolol 50mg, namely hyponatremia, hypochloremic alkalosis, and hypokalemia. Serum and urine electrolyte determinations are particularly important when the patient is vomiting excessively propranolol receiving parenteral fluids.

Medication such as digitalis may also influence propranolol electrolytes. Warning signs, irrespective of cause, are: Hypokalemia may develop, especially with brisk diuresis or when severe cirrhosis is present.

Beta Blocker Side Effects

Interference with adequate oral electrolyte intake will also contribute to hypokalemia, propranolol 50mg. Hypokalemia can sensitize or exaggerate the response of the heart to the toxic propranolol of 50mg e. Propranolol may be avoided or treated by use of potassium supplements or foods 50mg a high potassium content.

Atenolol vs Propranolol

Any chloride deficit is generally mild, and usually does not require specific treatment except under extraordinary circumstances as in liver or renal disease, propranolol 50mg. Dilutional hyponatremia may occur in edematous patients in hot weather; appropriate therapy is water restriction rather than administration of salt, except in rare instances when the hyponatremia is life threatening. In actual salt depletion, appropriate replacement is the therapy of choice.

Hyperuricemia may occur or frank gout may be precipitated in certain patients propranolol thiazide therapy. Diabetes mellitus which has been latent may become manifest during thiazide administration. The antihypertensive effects of 50mg drug may be enhanced in the postsympathectomy patient.

If progressive renal impairment becomes evident, consider withholding or discontinuing diuretic therapy. Calcium excretion is decreased by thiazides, propranolol 50mg. Pathologic changes in the propranolol gland with hypercalcemia and hypophosphatemia have been observed in a few patients on prolonged thiazide therapy. The common complications of hyperparathyroidism, such as renal lithiasis, bone resorption, and peptic ulceration, have not been seen.

Information for Patients Beta-adrenoreceptor blockade can cause reduction of intraocular pressure. Patients should be told that propranolol hydrochloride and hydrochlorothiazide may interfere with the glaucoma screening test.

50mg

Withdrawal may lead to a return of increased intraocular pressure. Laboratory Tests Propranolol Hydrochloride Elevated blood urea levels in patients with severe heart disease, elevated serum transaminase, alkaline phosphatase, lactate dehydrogenase. Hydrochlorothiazide Periodic determination of serum electrolytes to detect possible electrolyte imbalance should be performed at appropriate intervals. 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.

50mg should be exercised when patients receiving a beta-blocker are administered a calcium-channel blocking drug, especially intravenous verapamil, propranolol 50mg, for both agents may depress myocardial contractility or atrioventricular conduction. On rare occasions, propranolol 50mg, the concomitant intravenous use of a beta-blocker and verapamil has resulted in 50mg adverse reactions, especially in patients with severe cardiomyopathy, congestive heart failure, or recent myocardial infarction.

Both digitalis glycosides and beta-blockers slow atrioventricular conduction and decrease heart rate. Concomitant use can increase the risk of bradycardia.

Blunting of the antihypertensive effect of beta-adrenoceptor blocking agents by nonsteroidal anti-inflammatory drugs has been reported. Hypotension and cardiac arrest have been 50mg with the concomitant use of propranolol and haloperidol.

Aluminum hydroxide gel greatly reduces intestinal absorption of propranolol. Alcohol, when used concomitantly with propranolol, may increase plasma levels of propranolol. Phenytoin, phenobarbitone, and rifampin accelerate propranolol clearance.

Chlorpromazine, when used concomitantly with propranolol, results propranolol increased plasma levels of both drugs. Antipyrine and lidocaine have reduced clearance when propranolol concomitantly propranolol propranolol. Thyroxine may result in a lower than expected Finasteride cheap prices concentration when used concomitantly with propranolol.

Cimetidine decreases the hepatic metabolism of propranolol, delaying elimination and increasing blood levels. Theophylline clearance is reduced when used concomitantly with propranolol.

Hydrochlorothiazide Thiazide drugs may increase the responsiveness to tubocurarine. Thiazides may decrease arterial responsiveness to norepinephrine, propranolol 50mg. This diminution is not sufficient to preclude effectiveness of the pressor agent for therapeutic use. Insulin requirements in diabetic patients may be increased, decreased, propranolol unchanged.

Hypokalemia may develop during concomitant use of corticosteroids or ACTH. Carcinogenesis, Mutagenesis, Impairment of Fertility Combinations of propranolol and hydrochlorothiazide have not been evaluated for carcinogenic or mutagenic potential or for potential 50mg adversely affect fertility. In a study in which both male and female rats were exposed to propranolol in their diets at concentrations of up to 0. Based on differing results from Ames Tests performed by different laboratories, there is equivocal evidence for a genotoxic effect of propranolol in bacteria S.

sertraline & propranolol

The NTP, however, found equivocal evidence for hepatocarcinogenicity in male mice. Hydrochlorothiazide was not genotoxic in vitro in propranolol Ames bacterial mutagen assay S, propranolol 50mg. Nor was it genotoxic in vivo in assays using mouse germinal cell chromosomes, Chinese hamster bone marrow chromosomes, and the Drosophila sex-linked recessive lethal trait gene. Pregnancy Category C Combinations of propranolol and hydrochlorothiazide have not been evaluated for effects on pregnancy in animals.

Nor are there adequate and well controlled studies of propranolol, hydrochlorothiazide or the combination in pregnant women, propranolol 50mg. Propranolol and hydrochlorothiazide should be used during pregnancy only if the potential benefit justifies 50mg potential risk to the fetus. Propranolol Hydrochloride In a series of reproduction and developmental toxicology studies, propranolol was given to rats by gavage or in the diet throughout pregnancy and lactation.

No evidence of embryo or neonatal toxicity was noted. Intrauterine growth retardation, small placentas, and congenital abnormalities have been reported propranolol human neonates whose mothers received propranolol during pregnancy. Adequate facilities for monitoring these infants at birth should be available, propranolol 50mg. Thiazides cross the 50mg barrier 50mg appear in cord blood. The use of thiazides in pregnant women requires that the anticipated benefit be weighed against possible propranolol to the aciclovir creme ultrafarma. These hazards include fetal or neonatal jaundice, thrombocytopenia, and possibly other adverse reactions that have occurred in the adult.

Propranolol

Nursing Mothers Propranolol Hydrochloride Propranolol is excreted in human milk. Caution should propranolol exercised when propranolol hydrochloride and hydrochlorothiazide is propranolol to a nursing woman. Hydrochlorothiazide Thiazides appear in breast milk.

If the use of the drug is deemed propranolol, the patient should stop nursing. Pediatric Use Safety and effectiveness in pediatric patients have not been established. Geriatric Use Clinical studies of propranolol hydrochloride and hydrochlorothiazide did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects.

Other reported clinical experience has not identified differences in responses between the elderly and 50mg patients. In general, propranolol 50mg, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or 50mg function, and of concomitant disease or other drug therapy, propranolol 50mg.

Within each category, adverse reactions are listed in decreasing order of severity. Although many side effects are mild and transient, some 50mg discontinuation of 50mg. Congestive heart failure; propranolol intensification of AV block; bradycardia; thrombocytopenic purpura; arterial insufficiency, usually of the Raynaud type; paresthesia propranolol hands.

Reversible mental depression progressing to catatonia; mental depression manifested by insomnia, lassitude, weakness, fatigue; an acute reversible syndrome characterized by disorientation for time and place, propranolol 50mg, short-term memory loss, emotional lability, slightly clouded sensorium, decreased performance 50mg neuropsychometrics; hallucinations; visual disturbances; vivid dreams; light-headedness.

Total daily doses above mg propranolol administered as divided doses of greater than 80 mg each may be associated with an increased incidence of fatigue, lethargy, and vivid dreams. Mesenteric arterial thrombosis; ischemic colitis; nausea, vomiting, epigastric distress, abdominal cramping, diarrhea, constipation, propranolol 50mg.

Agranulocytosis; non-thrombocytopenic purpura; thrombocytopenic purpura. In extremely rare instances, systemic lupus erythematosus has been reported, propranolol 50mg.

Oculomucocutaneous reactions involving the skin, serous membranes, and conjunctivae reported for azithromycin order canada beta-blocker practolol have 50mg been associated with propranolol. Stevens-Johnson Syndrome; toxic epidermal necrolysis; exfoliative propranolol erythema multiforme; urticaria. Orthostatic hypotension may be aggravated by alcohol, barbiturates or narcotics.

Dizziness, vertigo, headache, xanthopsia, paresthesias. Pancreatitis; jaundice intrahepatic cholestatic jaundice ; sialadenitis; anorexia, nausea, vomiting, gastric irritation, 50mg, diarrhea, constipation.

Anaphylactic reactions; necrotizing angiitis vasculitis, cutaneous vasculitis ; respiratory distress including pneumonitis; fever; urticaria, rash, purpura, photosensitivity. Propranolol anemia, agranulocytosis, leukopenia, thrombocytopenia.

Erythema multiforme including Stevens-Johnson Syndrome, exfoliative dermatitis 50mg toxic epidermal 50mg. Hyperglycemia, propranolol 50mg, glycosuria; hyperuricemia; muscle spasm; weakness; restlessness; transient blurred vision.

Whenever adverse reactions are moderate or severe, thiazide dosage should be reduced or therapy withdrawn. Propranolol is not significantly dialyzable. The hydrochlorothiazide component can be expected to cause diuresis. Lethargy of varying degree may appear and may progress to coma within a few hours, propranolol 50mg, with minimal depression of respiration and cardiovascular function, propranolol 50mg, propranolol in the absence of significant serum electrolyte changes or dehydration, propranolol 50mg.

The mechanism of central nervous system depression with thiazide overdosage is unknown. Gastrointestinal irritation and hypermotility can occur, temporary elevation of BUN has been reported, and serum electrolyte changes could occur, especially in patients with impairment of renal function.

Treatment The following measures should be employed: If ingestion is, or may have been, recent, evacuate gastric contents, propranolol 50mg, taking care to prevent pulmonary aspiration.

If there is no response to vagal blockade, administer isoproterenol cautiously. Administer isoproterenol and aminophylline. Administer supportive therapy as clinically warranted.