section name header

Pronunciation ⬇

proe-PRAN-oh-lole audio

Indications ⬆ ⬇

High Alert

Unlabeled Use:

Action ⬆ ⬇

Therapeutic Effects:

Pharmacokinetics ⬆ ⬇

Absorption: Well absorbed but undergoes extensive first-pass hepatic metabolism.

Distribution: Moderate CNS penetration. Crosses the placenta; enters breast milk.

Protein Binding: 93%.

Metabolism/Excretion: Almost completely metabolized by the liver (primarily for CYP2D6 isoenzyme) (the CYP2D6 enzyme system exhibits genetic polymorphism; 7% of population may be poor metabolizers and may have significantly ↑ propranolol concentrations and an ↑ risk of adverse effects).

Half-life: 3.4–6 hr.

Contraind./Precautions ⬆ ⬇

Contraindicated in:

Use Cautiously in:

Adv. Reactions/Side Effects ⬆ ⬇

CV: ARRHYTHMIAS, BRADYCARDIA, HF, PULMONARY EDEMA, orthostatic hypotension, peripheral vasoconstriction.

Derm: ERYTHEMA MULTIFORME, EXFOLIATIVE DERMATITIS, STEVENS-JOHNSON SYNDROME (SJS), TOXIC EPIDERMAL NECROLYSIS, itching, rash.

EENT: blurred vision, dry eyes, nasal stuffiness.

Endo: hyperglycemia, hypoglycemia (↑ in children).

GI: constipation, diarrhea, nausea.

GU: erectile dysfunction, ↓ libido.

MS: arthralgia, back pain, muscle cramps, myopathy.

Neuro: paresthesia , fatigue, weakness, anxiety, dizziness, drowsiness, insomnia, memory loss, mental depression, mental status changes, nervousness, nightmares.

Resp: bronchospasm, wheezing.

Misc: HYPERSENSITIVITY REACTIONS (INCLUDING ANAPHYLAXIS), drug-induced lupus syndrome.

Interactions ⬆ ⬇

Drug-Drug:

Route/Dosage ⬆ ⬇

see Calculator

Implementation ⬆ ⬇

US Brand Names ⬆ ⬇

Hemangeol, Inderal, Inderal LA, InnoPran XL

Classifications ⬆ ⬇

Therapeutic Classification: antianginals, antiarrhythmics (Class II), antihypertensives, vascular headache suppressants

Pharmacologic Classification: beta blockers

Availability ⬆ ⬇

(Generic available)

Time/Action Profile ⬆ ⬇

(cardiovascular effects)

ROUTEONSETPEAKDURATION
PO30 min60–90 min†6–12 hr
PO–ERunknown6 hr24 hr
IVimmediate1 min4–6 hr

†Following single dose, full effect not seen until several wk of therapy.

Assessment ⬆ ⬇

Lab Test Considerations: Toxicity and Overdose:

Patient/Family Teaching ⬆ ⬇

Evaluation/Desired Outcomes ⬆ ⬇

Code ⬆

NDC Code*