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 min6–12 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*