proe-PRAN-oh-lole
Therapeutic Classification: antianginals, antiarrhythmics (Class II), antihypertensives, vascular headache suppressants
Pharmacologic Classification: beta blockers
High Alert
Absorption: Well absorbed but undergoes extensive first-pass hepatic metabolism.
Distribution: Moderate CNS penetration. Crosses the placenta; enters breast milk.
Protein Binding: 93%.
Half-Life: 3.4–6 hr.
(cardiovascular effects)
| ROUTE | ONSET | PEAK | DURATION |
|---|---|---|---|
| PO | 30 min | 60–90 min‡ | 6–12 hr |
| PO–ER | unknown | 6 hr | 24 hr |
| IV | immediate | 1 min | 4–6 hr |
‡Following single dose, full effect not seen until several wk of therapy.
Contraindicated in:
Use Cautiously in:
CV: ARRHYTHMIAS, BRADYCARDIA, HF, orthostatic hypotension, peripheral vasoconstriction, PULMONARY EDEMA
Derm: ERYTHEMA MULTIFORME, EXFOLIATIVE DERMATITIS, itching, rash, STEVENS-JOHNSON SYNDROME (SJS), TOXIC EPIDERMAL NECROLYSIS
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: fatigue, weakness, anxiety, depression, dizziness, drowsiness, insomnia, memory loss, mental status changes, nervousness, nightmares, paresthesia
Resp: bronchospasm, wheezing
Misc: drug-induced lupus syndrome, HYPERSENSITIVITY REACTIONS (INCLUDING ANAPHYLAXIS)
Drug-drug:
Lab Test Considerations:
Toxicity and Overdose:
IV vasoactive medications are inherently dangerous. Before administering intravenously, have second practitioner independently check the original order, dose calculations, and infusion pump settings. Also, patient harm or fatalities have occurred when switching from oral to IV propranolol; oral and parenteral doses are not interchangeable. IV dose is 1/10 of the oral dose. Change to oral therapy as soon as possible.
Do not confuse Inderal with Adderall .
IV Administration:
NDC Code