Quick Links

Introduction About AP COBAL CAPSULE

AP COBAL CAPSULE is a combination of Alprazolam and Propranolol which belongs to the group of medicines called Anxiolytics and Antihypertensive agents respectively. It is used to manage anxiety and panic attacks. It can also be used to reduce elevated heart rate and blood pressure associated with anxiety. It is also capable of reducing tremor (shakiness), restlessness and migraine headache among the affected patients.

Before taking AP COBAL CAPSULE inform your doctor if you have any problems in your heart, liver or kidneys. You must also inform your doctor if you have diabetes, muscle weakness, depression with suicidal thoughts, any mental illnesses, history of alcoholism or drug abuse or thyroid problems as a precaution. Avoid consumption of alcohol while taking this medicine as it may make you feel more dizzy or drowsy.

Do not take AP COBAL CAPSULE without consulting your doctor if you are pregnant or breastfeeding. The most common side effects of taking this medicine are depression, headache, dizziness, drowsiness, forgetfulness, constipation, dry mouth, decreased sex drive, problems in erection, blurred vision, cold hands and feet, slow heartbeat and problems in sleeping. Consult your doctor if any of these side effects trouble you.

You must also inform your doctor immediately if you experience suicidal thoughts or any other unusual changes in behaviour (such as agitation, restlessness, aggressiveness, irritability, violence or anger).

Uses Of AP COBAL CAPSULE

Reduces anxiety and restlessness
Manage panic attacks, tremors (shakiness) and migraine headache
Reduces chest pain and high blood pressure caused due to anxiety

How AP COBAL CAPSULE Works

AP COBAL CAPSULE contains two medicines namely alprazolam and propranolol. Alprazolam is a hypnotic medicine. It suppresses the abnormal electrical activity within the brain and induces sleep.

Propranolol is a beta-blocker. It reduces the heart rate and force of contraction of the heart which, therefore reduces abnormal heart signs (such as racing heartbeat, nervousness and high blood pressure) associated with anxiety.

It can also relax the blood vessels supplying the heart and the brain which therefore reduces elevated blood pressure, chest pain and migraine.

It also stops the transfer of abnormal nerve signals between the brain and the muscles which helps in reducing tremors.

How to use AP COBAL CAPSULE

Take AP COBAL CAPSULE as directed by your physician. Swallow the medicine with a glass of water. Do not crush or chew the medicine.

Your doctor will decide the correct dose and duration of therapy for you depending upon your age, body weight and health condition. Do not take this medicine for more than 4 weeks without consulting your doctor.

Side Effects Of AP COBAL CAPSULE

Common

depression
headache, dizziness
drowsiness or sleepiness
jerky movements or unsteadiness
forgetfulness
slurred speech, nervousness
constipation, dry mouth, loss of appetite
tiredness, irritability, confusion, disorientation, loss of alertness
sexual problems, increased or decreased sex drive
problems in erection
feeling sluggish
shakiness or trembling
double or blurred vision
nausea
change in body weight
fingers and toes may become cold
slow heartbeat
signs of Raynaud’s syndrome (numbness and spasm in the fingers followed by warmth and pain)
sleep disturbances, nightmares

Uncommon

diarrhea
abnormally excited
hallucinations
urge to urinate
menstrual cramps (pain in thighs and lower back)
muscle spasms or weakness

Rare

dizziness while standing up
hair loss
tingling or pricking sensation of body parts
vision disturbances and dry eyes

Stop taking AP COBAL CAPSULE and contact your doctor immediately if you experience any of the following side effects such as:

signs of allergic reactions (such as skin rash, swelling of the face, lips, mouth or throat which can lead to difficulty in breathing or swallowing)
slow heart rate and low blood pressure causing dizziness, light-headedness, fainting or blurred vision
changes in behavior (such as feeling agitated, restless, aggressive, irritable, violent or angry, false beliefs, nightmares and hallucinations or other inappropriate behavior)
memory loss (amnesia)
yellowing of the skin and the whites of the eye (jaundice)

How To Manage Side Effects

Constipation

Eat plenty of fiber rich foods such as fresh fruits, vegetables and cereals. Drink plenty of fluids. Exercise more regularly. Consult your doctor if this side effect bothers you.

Dizziness Or Drowsiness

Try to rest and relax. Get enough sleep. Avoid driving or operating any tools or machines completely while you are feeling dizzy. Do not consume excessive alcohol, as it could aggravate your dizziness. Consult your doctor if your dizziness worsens.

Headache

Rest and relax. Keep yourself hydrated by drinking plenty of fluids such as water or electrolytes. Applying a pain-relieving balm on your forehead can be beneficial. Do not consume excessive alcohol, as it could aggravate your headache. Consult your doctor if your headache worsens.

Insomnia

Try to have a regular bedtime schedule. Avoid having naps during the daytime. Limit caffeine intake and reduce watching TV before bedtime. If the symptom does not improve, consult your doctor.

Nausea And Vomiting

Take AP COBAL CAPSULE with or just after a meal or a snack. Stick to simple meals. Avoid eating rich or spicy food. Consult your doctor if your nausea worsens.

Warning & Precautions

Pregnancy

Contraindicated

AP COBAL CAPSULE is generally not recommended for use in pregnant women unless considered necessary by the physician, as it may harm the growing baby. Therefore, inform your doctor before taking AP COBAL CAPSULE if you are pregnant, think you might be pregnant or planning to have a baby.

Breastfeeding

Contraindicated

AP COBAL CAPSULE may excrete in breast milk. Therefore, it is not recommended for use in breastfeeding women. However, consult your doctor for advice before taking it.

Driving and Using Machines

Use with Caution

Do not drive or handle any heavy tools or machines if you experience dizziness or drowsiness after taking AP COBAL CAPSULE.

Alcohol

Consult your doctor

Avoid consumption of alcohol while taking AP COBAL CAPSULE as it might make you feel dizzier and drowsier.

Kidney

Use with Caution

AP COBAL CAPSULE should be used with caution in patients with kidney problems. Therefore, consult your doctor before taking it.

Liver

Consult your doctor

AP COBAL CAPSULE is not recommended for use in patients with severe liver problems. It should be used with caution in patients with other mild liver problems. Therefore, consult your doctor before taking it.

Allergy

Contraindicated

Do not take AP COBAL CAPSULE if you are allergic to propranolol, alprazolam or to any other sedative or hypnotic medicines (such as midazolam, nitrazepam, clonazepam).

Lungs

Contraindicated

AP COBAL CAPSULE is not recommended for use in patients suffering from asthma, chronic bronchitis, emphysema, COPD or bronchospasm. Therefore, consult your doctor before taking it.

Heart Disease

Consult your doctor

AP COBAL CAPSULE is not recommended for use in patients with sinus bradycardia (slow heart beat due to problems in SA nodes), heart block, severe hypotension (low blood pressure), congestive heart failure or heart defects. It should be used with caution in patients with a previous history of heart failure or other heart problems. Therefore, consult your doctor before taking it.

Others

AP COBAL CAPSULE is not recommended for use if you:

have cardiogenic shock (heart cannot pump blood suddenly)
have hypertensive emergency crisis (abnormal increase in blood pressure which is severe)
have an increased acidity of the blood (metabolic acidosis)
are on a strict fasting diet
suffer from other forms of angina (Prinzmetal’s angina)
suffer from myasthenia gravis (severe muscle weakness)
have sleep apnea (breathing stops and starts during sleep)

Before taking AP COBAL CAPSULE, inform your doctor if you:

have diabetes
suffer from unstable angina (chest pain that occurs in the absence of any stressful activity)
are going for glaucoma screening test
are planning for any major surgery
have other types of arrhythmias (such as Wolf-Parkinson-White Syndrome)
have any bleeding problems
have stroke or any circulatory problems
have swollen ankles
have previously experienced depression with thoughts of committing suicide
have any mental illnesses that required hospitalization
have a previous experience of drug abuse or alcoholism
have used any hypnotic medicine earlier

Use in Pediatrics:

AP COBAL CAPSULE is not recommended for use in children and adolescents (aged below 18 years) due to lack of safety data. Therefore, consult your doctor before taking it.

Use in Geriatrics:

AP COBAL CAPSULE should be used with caution in elderly patients (aged above 65 years). Therefore, consult your doctor before taking it.

Interactions

A. Drug - Drug interactions:

Before taking AP COBAL CAPSULE, inform your doctor if you are taking any of the following medicine such as:

other medicines used to reduce anxiety and to induce sleep (such as midazolam, clonazepam, nitrazepam, nefazodone, fluvoxamine, fluoxetine)
opioid analgesic medications (such as buprenorphine, morphine, codeine or propoxyphene, pethidine, fentanyl etc.)
other medicines used to manage psychiatric disorders (such as pimozide, haloperidol, risperidone, thioridazine)
medicines used to manage epilepsy (such as phenytoin, carbamazepine)
medicines used to manage allergic reactions (such as azelastine, cyproheptadine, mequitazine)
medicines used to manage fungal infections (such as ketoconazole)
oral contraceptives (birth control pill) such as ethinylestradiol, drospirenone
medicines used to manage bacterial infections (such as erythromycin)
medicines used to manage HIV infection (such as ritonavir, nelfinavir, atazanavir, saquinavir, indinavir)
general anaesthetic (used to create of loss of consciousness before surgery) such as methoxyflurane and trichloroethylene
other medicines used in the management of hypertension and other heart problems (Ex. nifedipine, nisoldipine, nicardipine, isradipine, lacidipine, verapamil, diltiazem, hydralazine, clonidine, enalapril, lisinopril, ramipril, disopyramide, quinidine, amiodarone, isoprenaline, dobutamine, propafenone and digoxin)
alpha blockers (used to manage hypertension and BPH) Ex. prazosin, doxazosin
reserpine (an antihypertensive from plant source)
lignocaine (used to locally numb body parts)
adrenaline (a medicine that can stimulate the heart)
ibuprofen and indomethacin (medicine used to relieve pain and inflammation)
medicines used to manage migraine headaches (Ex. ergotamine, dihydroergotamine or rizatriptan)
cimetidine, aluminium hydroxide gel (medicine used for stomach problems)
rifampicin (a medicine used to manage tuberculosis infection)
theophylline (a medicine used to manage asthma)
fingolimod (a medicine used to manage multiple sclerosis)
thyroxine (a medicine used to manage thyroid deficiency)

Overdosage:

If you or anyone else accidentally took more AP COBAL CAPSULE, consult your doctor immediately or visit the nearby hospital. Symptoms of overdose might include slow heartbeat, low blood pressure, drowsiness, confusion, feeling cold, slurred speech, breathing difficulties with symptoms such as fatigue, hallucinations, tremors, confusion, nausea, vomiting, body spasms and fainting.

Synopsis

Drug	:	Alprazolam, Propranolol
Pharmacological Category	:	Benzodiazepines, Beta-Blockers
Therapeutic Indication	:	Anxiety, Panic attack
Dosage Forms	:	Tablet

More Information

Keep AP COBAL CAPSULE out of reach of children
Store AP COBAL CAPSULE at room temperature

FAQs About AP COBAL CAPSULE

Q: What is the use of AP COBAL CAPSULE?

A: AP COBAL CAPSULE is used to manage anxiety and panic attacks. It can also be used to reduce elevated heart rate and blood pressure associated with anxiety. It is also capable of reducing tremor (shakiness), restlessness and migraine headache among the affected patients.

Q: How AP COBAL CAPSULE works in my body?

A: AP COBAL CAPSULE suppresses the abnormal electrical activity within the brain and induces sleep. It also reduces the heart rate and force of contraction of the heart which, therefore reduces abnormal heart signs (such as racing heartbeat, nervousness and high blood pressure) associated with anxiety.

Q: What precautions must be followed while taking AP COBAL CAPSULE?

A: Before taking AP COBAL CAPSULE inform your doctor if you have any problems in your heart, liver or kidneys. You must also inform your doctor if you have diabetes, muscle weakness, depression with suicidal thoughts, any mental illnesses, history of alcoholism or drug abuse or thyroid problems as a precaution. Avoid consumption of alcohol while taking this medicine as it may make you feel more dizzy or drowsy. Do not take AP COBAL CAPSULE without consulting your doctor if you are pregnant or breastfeeding. Inform your doctor immediately if you experience suicidal thoughts or any other unusual changes in behaviour (such as agitation, restlessness, aggressiveness, irritability, violence or anger).

Q: Can AP COBAL CAPSULE cause weight gain?

A: Yes. Weight gain is one of the common side effects of taking AP COBAL CAPSULE. If this side effect bothers you, contact your doctor.

Q: Will AP COBAL CAPSULE reduce my sex drive?

A: Yes. AP COBAL CAPSULE may affect your sexual life. It may decrease sex drive or cause problems in orgasm, ejaculation or erection. Therefore, consult your doctor if you experience any such symptoms.

Q: Can AP COBAL CAPSULE be used in children?

A: AP COBAL CAPSULE is not recommended for use in children and adolescents (aged below 18 years) due to lack of safety data. Therefore, consult your doctor before taking it.

Q: Can AP COBAL CAPSULE be used during pregnancy?

A: AP COBAL CAPSULE is generally not recommended for use in pregnant women unless considered necessary by the physician, as it may harm the growing baby. Therefore, inform your doctor before taking AP COBAL CAPSULE if you are pregnant, think you might be pregnant or planning to have a baby.

Q: Will the use of AP COBAL CAPSULE cause sleepiness?

A: Yes, AP COBAL CAPSULE can make your feel sleepy, drowsy or tired. Therefore, do not drive or handle heavy machines or tool if you feel drowsy or sleepy. Avoid consumption of alcohol as it can aggravate your drowsiness.

Q: Can I consume alcohol while taking AP COBAL CAPSULE?

A: Avoid consumption of alcohol while taking this medicine as it may make you feel more dizzy or drowsy.

Q: What to do if I forget to take a dose of AP COBAL CAPSULE?

A: If you forget to take a dose of AP COBAL CAPSULE, take it as soon as you remember. However, if it is time to take the next dose, skip the missed dose and take the next one at regular times. Do not take a double dose of AP COBAL CAPSULE to compensate a missed dose, as it could lead to toxicity.

Q: Will taking a higher dose of AP COBAL CAPSULE than the prescribed one be beneficial?

A: No, taking a higher dose of AP COBAL CAPSULE will not be effective rather it can lead to toxicity. Always take the dose prescribed by your doctor. If the prescribed dose is not effective for you, consult your doctor for advice. Your doctor might increase the dose or suggest an alternative therapy.

Q: Can I stop taking AP COBAL CAPSULE once my symptoms subside?

A: No. Do not stop taking AP COBAL CAPSULE without consulting your doctor even if you feel better during the mid-way of the therapy. Sudden discontinuation of therapy may cause withdrawal symptoms such as headaches, muscle pain, tension, restlessness, confusion, mood changes, difficulty in sleeping and irritability.

Q: Can AP COBAL CAPSULE be taken daily?

A: Yes. AP COBAL CAPSULE can be taken daily as per your doctor’s instruction. However, if you are doubtful, consult your doctor.

Q: How to take AP COBAL CAPSULE?

A: Take AP COBAL CAPSULE as advised by your physician. Swallow the medicine with a glass of water. Do not crush or chew the medicine.

Q: What are the common side effects of taking AP COBAL CAPSULE?

A: The most common side effects of taking this medicine are depression, headache, dizziness, drowsiness, forgetfulness, constipation, dry mouth, decreased sex drive, problems in erection, blurred vision, cold hands and feet, slow heartbeat and problems in sleeping. Consult your doctor if any of these side effects trouble you.

Q: What happens if I accidentally take more AP COBAL CAPSULE?

A: If you or anyone else accidentally took more AP COBAL CAPSULE, consult your doctor immediately or visit the nearby hospital. Symptoms of overdose might include slow heartbeat, low blood pressure, drowsiness, confusion, feeling cold, slurred speech, breathing difficulties with symptoms such as fatigue, hallucinations, tremors, confusion, nausea, vomiting, body spasms and fainting.

References

1. KD. Tripathi. Sedative-Hypnotics. Antiadrenergic drugs and Drugs for Glaucoma. Essentials of Medical Pharmacology. 7th Edition. Page – 405 & 145-151.

2. C L Ravaris, M J Friedman, P J Hauri, G J McHugo. A controlled study of alprazolam and propranolol in panic-disordered and agoraphobic outpatients. NIH. National Library of Medicine. National Center for Biotechnology Information. Pubmed.gov. December 1991. [Accessed on 25th January 2023]. https://pubmed.ncbi.nlm.nih.gov/1770152/

3. Pfizer Italia S.r.l. Xanax® 250 microgram and 500 microgram Tablets alprazolam. Electronic Medicines Compendium. [Revised in November 2022]. [Accessed on 25th January 2023]. https://www.medicines.org.uk/emc/files/pil.1656.pdf

4. Atnahs Pharma UK Limited. Electronic Medicines Compendium (EMC). [Revised in July 2021] [Accessed on 25th January 2023]. https://www.medicines.org.uk/emc/files/pil.12858.pdf

5. Accord. Electronic Medicines Compendium (EMC). [Revised in March 2021] [Accessed on 25th January 2023]. https://www.medicines.org.uk/emc/files/pil.5853.pdf

6. Leeford Healthcare Pvt Ltd. Prazonal Tablet. [Accessed on 25th January 2023]. https://www.leeford.in/product/779/prazonal

7. Central Drugs standard Control Organization. Alprazolam Dispersible Tab. 0.125mg/0.25mg/0.50mg. September 2006. Alprazolam tablets. June 1998. Alprazolam SR 0.5mg tablet. 1997. [Accessed on 25th January 2023]. https://cdscoonline.gov.in/CDSCO/Drugs

Useful Diagnostic Tests

Kidney Function Test

Author Details

Written By Srilekha. R - B.Pharm

Reviewed For Accuracy By Dr. Sankara Babu Gorle - MBBS, MD (Pharmacology)

Last updated on 28 Jan 2023 | 04:52 PM(IST)