INDERAL 10MG TABLET (TABLET)

Dosage / Direction for Use Adult HTN 80 mg bid, may be increased at wkly intervals according to response. Usual dose: 160-320 mg/day. Max: 640 mg/day. Angina, anxiety, migraine & essential tremor 40 mg bid-tid, may be increased at wkly intervals according to response. Usual dose: 80-160 mg/day for anxiety, migraine & essential tremor; 120-240 mg/day for angina. Max for angina: 480 mg/day. Max for migraine: 240 mg/day. Arrhythmias, anxiety tachycardia, hypertrophic obstructive cardiomyopathy, thyrotoxicosis 10-40 mg tid-qid. Max for arrhythmias: 240 mg/day. Post MI Initially 40 mg between 5-21 days after MI qid for 2-3 days & 80 mg bid thereafter. Max: 160 mg/day. Pheochromocytoma (To be used only w/ α-blockers). Pre-op 60 mg daily for 3 days. Non-operable malignant cases 30 mg daily. Maintenance: 30 mg/day. Childn Arrhythmias, pheochromocytoma, thyrotoxicosis 0.25-0.5 mg/kg tid-qid. Migraine Childn >12 yr Adult dose; <12 yr 20 mg bid-tid. Administration Should be taken on an empty stomach. Contraindications Hypersensitivity. History of bronchial asthma or bronchospasm, bradycardia, cardiogenic shock, hypotension, metabolic acidosis, after prolonged fasting, severe peripheral arterial circulatory disturbances, 2nd or 3rd degree heart block, sick sinus syndrome, untreated pheochromocytoma, uncontrolled heart failure, Prinzmetal's angina. Patients prone to hypoglycemia. Special Precautions Poor cardiac reserve, 1st-degree heart block, history of anaphylactic reaction to allergens, decompensated cirrhosis, portal HTN. May aggravate less severe peripheral arterial circulatory disturbances; block/modify signs & symptoms of hypoglycemia; mask signs of thyrotoxicosis; reduce heart rate. Avoid abrupt w/drawal in patients w/ ischemic heart disease. Patients on hemodialysis, concomitant antidiabetic therapy, & w/ chronic liver disease. W/draw gradually. Hepatic or renal impairment. Pregnancy & lactation. Side Effects / Adverse Reactions Fatigue &/or lassitude; bradycardia, cold extremities, Raynaud's phenomenon, sleep disturbances, nightmares. Interactions May prolong hypoglycemic response to insulin. Increased AUC & Cmax of rizatriptan. May potentiate effect on atrial-conduction time & induce -ve inotropic effect w/ class I anti-arrhythmic drugs (eg, disopyramide) & amiodarone. May increase AV conduction time w/ digitalis glycosides. Severe hypotension, bradycardia & cardiac failure w/ Ca channel blockers (eg, verapamil, diltiazem). Increased risk of hypotension & cardiac failure w/ dihydropyridine Ca channel blockers (eg, nifedipine). May counteract effects of β-blockers w/ sympathomimetic agents eg, adrenaline. Increased plasma conc of lidocaine. Increased plasma levels w/ cimetidine, hydralazine, alcohol & chlorpromazine. May exacerbate rebound HTN following w/drawal of clonidine. Vasospastic reactions w/ ergotamine, dihydroergotamine or related compd. May decrease hypotensive effects w/ ibuprofen & indometacin. Enhanced antipsychotic effect of chlorpromazine & increased antihypertensive effect for propranolol. May attenuate reflex tachycardia & increase risk of hypotension w/ anaesth. Quinidine, propafenone, rifampicin, theophylline, warfarin, thioridazine.