Propranolol
General
- Type: Beta blockers, nonselective
- Dosage Forms:
- IV: 1mg/mL
- PO conventional: 10, 20, 40, 60, 80 mg
- PO extended release: 60, 80, 120, 160 mg
- Common Trade Names: Inderal
Adult Dosing
- Thyroid storm
- 1-2mg IV over 10 min; if tolerates then 1-2mg boluses q15 minutes until HR <100
- May follow with gtt @ dose required for HR control (ie 3-5 mg/hr)
- Alternate 60-80 mg PO q4h
- Variceal bleed ppx
- 20 mg bid titrated up to max tolerated dose
- Migraine ppx
- Starting dose 80 mg daily as either XL or divided q6-8hr. Max 160-240 mg/day
- Essential tremor
- 40 mg bid starting dose
- HOCM
- 80-160 mg daily as either XL or divided q6-8 hr
Pediatric Dosing
Special Populations
- Pregnancy Rating: Category C; risk of IUGR, neonatal hypoglycemia/bradycardia/respiratory depression. Still preferred agent for thyrotoxicosis
- Lactation: Enters breast milk
- Renal Dosing: N/A
- Hepatic Dosing: N/A
Contraindications
- Allergy to class/drug
- Decompensated heart failure, except high output failure 2/2 tachyarrhythmia
- Bradycardia / high degree heart block
Adverse Reactions
Serious
- Rebound sx with abrupt withdrawal of tx
- Heart failure
- Agranulocytosis, thrombocytopenia
- Bronchospasm
- SJS/TEN
Common
- Bradycardia
- Orthostasis
Pharmacology
- Half-life:
- Metabolism:
- Excretion:
- Mechanism of Action: