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Introduction About PROLOL TR 40MG CAPSULE

PROLOL TR 40MG CAPSULE is used to manage hypertension (high blood pressure), angina (chest pain) and arrhythmia (irregular heart rhythm).

It can also be used to control abnormal increase in blood pressure and/or heart rate caused due to various underlying conditions such as anxiety, overactive thyroid gland, phaeochromocytoma (tumours of adrenal gland) or Hypertrophic Subaortic Stenosis (thickening of heart muscles).

It contains Propranolol which belongs to the group of medicines called Beta blockers.

It can also be used to manage heart attacks and migraine headaches. It also controls shakiness of the body by blocking abnormal nerve signals between the brain and the muscles.

Before taking PROLOL TR 40MG CAPSULE inform your doctor if you have any liver or kidney problems. You must also inform your doctor if you have any other types of anginas (unstable or Prinzmetal angina) or arrhythmia (such as Wolf-Parkinson-White Syndrome), any breathing problems, or diabetes as a precaution.

PROLOL TR 40MG CAPSULE is not recommended for use in patients with severe asthma, hypotension (low blood pressure) or shock. It is also not suitable for use in patients with heart block, history of heart attack or heart failure.

Do not take PROLOL TR 40MG CAPSULE without consulting your doctor if you are pregnant or breastfeeding. The most common side effects of taking PROLOL TR 40MG CAPSULE are cold fingers and toes, slow heartbeat, tiredness, sleep disturbances and Raynaud’s syndrome (numbness and spasm in the fingers followed by warmth and pain). Consult your doctor if any of these side effect troubles you.

Uses Of PROLOL TR 40MG CAPSULE

hypertension (high blood pressure)
angina pectoris (chest pain)
arrhythmia (irregular heart rhythm)
migraine (severe headache on side of the head)
Reduce tremor (shakiness) and anxiety
Signs and symptoms of overactive thyroid gland (such as palpitation, nervousness, tremor, fixed stare, severe myopathy and sweating)
phaeochromocytoma (signs include high blood pressure and fast heart rate caused due to tumour of adrenal glands)
Hypertrophic Subaortic Stenosis (signs include thickening of heart muscles causing strain on heart while pumping blood)

Benefits of PROLOL TR 40MG CAPSULE in Hypertension:

This medication works by reducing the workload on the heart and relaxing blood vessels, resulting in improved blood flow and lower blood pressure levels.

Benefits of PROLOL TR 40MG CAPSULE in Angina pectoris:

It reduces chest pain episodes, improves exercise tolerance by minimizing the heart’s exertion, allowing individuals to perform daily activities with reduced discomfort. It also helps manage stress-induced angina by mitigating the physical effects of stress and anxiety on the heart, providing comprehensive protection for patients with this condition.

Benefits of PROLOL TR 40MG CAPSULE in arrhythmia:

It helps stabilize the heart by slowing electrical signals in the heart muscle. This action restores a regular rhythm, preventing episodes of rapid or irregular heartbeats.

Benefits of PROLOL TR 40MG CAPSULE in migraine:

It helps in preventing migraines by stabilizing blood vessels, modulating nerve activity and blood flow in the brain and reducing the triggers that cause migraine episodes. Many users report a noticeable decline in the frequency and severity of migraines over time.

Benefits of PROLOL TR 40MG CAPSULE in tremor and anxiety:

It works by blocking adrenaline’s effect on the body, which calms the overactive signals causing tremors. It is particularly effective in controlling physical symptoms of anxiety, such as a racing heart, sweating, and trembling. By calming the heart rate, it helps individuals feel more at ease in stressful situations. Blocks the body’s adrenaline response, it allows users to remain calm and confident during high-pressure scenarios.

How PROLOL TR 40MG CAPSULE Works

PROLOL TR 40MG CAPSULE is a beta-blocker. It works by blocking the actions of certain chemical messengers (such as adrenaline and noradrenaline) in our body that controls the function of the heart, brain and kidneys and lungs.

In the heart, stopping the actions of these chemical messengers reduces the heart rate and force of contraction. This helps to control abnormal heart rate in patients suffering from arrhythmia.

It can also reduce the risk of abnormal heart signs (such as racing heartbeat, nervousness and high blood pressure) associated with phaeochromocytoma or anxiety.

PROLOL TR 40MG CAPSULE can relax the blood vessels supplying the heart and the brain. This action improves blood flow and oxygen supply to the heart and makes the heart to pump blood more efficiently with less pressure. It also helps in managing and managing problems caused due to poor blood circulation such as chest pain (angina), heart attack or migraine.

Additionally, PROLOL TR 40MG CAPSULE reduces the production of thyroid hormones (triiodothyronine) in patients suffering from overactive thyroid gland. It also stops the transfer of abnormal nerve signals between the brain and the muscles which helps in reducing tremors.

How to use PROLOL TR 40MG CAPSULE

Take PROLOL TR 40MG CAPSULE as directed by your physician. Swallow the medicine with a glass of water. Do not crush or chew the medicine.

Dosage and Administration

Follow Prescribed Dosage- it varies based on the medical condition and individual response.
Always follow your doctor’s prescription. Do not adjust the dosage without consulting your healthcare provider.
Common starting doses include:

Hypertension: 40mg twice daily.

Migraine Prevention: 40mg two to three times daily.

Anxiety: 40mg taken as needed (30-60 minutes before a stressful situation).

Arrhythmias: 10-40mg three to four times daily.

It is best taken on an empty stomach or before meals for better absorption.

Missed Dosage instructions for PROLOL TR 40MG CAPSULE:

If you miss a dose of PROLOL TR 40MG CAPSULE take it as soon as you remember. If it is almost time for your next dose, skip the missed dose.
Do not double the dose to make up for the missed one.
Consistency is essential, especially for chronic conditions like hypertension and arrhythmias. Setting reminders can help ensure timely doses.

Overdosage of PROLOL TR 40MG CAPSULE:

Taking more than the prescribed dose of PROLOL TR 40MG CAPSULE can lead to serious complications, including extremely slow heart rate (bradycardia), difficulty breathing, low blood pressure (hypotension), seizures or loss of consciousness.
What to Do in Case of Overdose: Immediately seek medical attention or contact a poison control center. Symptoms of overdose require urgent intervention, which may include supportive measures like activated charcoal or IV fluids.

Side Effects Of PROLOL TR 40MG CAPSULE

Like all medicines, PROLOL TR 40MG CAPSULE may cause certain side effects, although not everybody gets them.

The most common side effects of taking PROLOL TR 40MG CAPSULE are:

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
fatigue (tiredness)

When to consult your doctor?

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
worsening of existing condition

How To Manage Side Effects

Sleep Disturbances

Practicing good sleep practices such as having a regular bedtime schedule, avoiding naps in the daytime, limiting caffeine and TV before bedtime can help you to sleep peacefully. If the symptom does not improve, consult your doctor.

Tiredness

Include whole grains, lean proteins, and fresh fruits and vegetables in your meals. These foods help maintain steady energy levels throughout the day. Stay hydrated, avoid heavy or processed foods. Get enough sleep, incorporate light exercise, limit alcohol and stimulants like caffeine

Warning & Precautions

Pregnancy

Monitoring required

PROLOL TR 40MG CAPSULE is generally not recommended for use in pregnant women unless considered necessary by the physician, as it may harm the growing baby. Studies in animals have reported developmental abnormalities, including reduced fetal weight and delayed ossification, at high doses of propranolol. Therefore, inform your doctor before taking PROLOL TR 40MG CAPSULE if you are pregnant, think you might be pregnant or planning to have a baby.

Breastfeeding

Use with Caution

PROLOL TR 40MG CAPSULE may excrete in breast milk. Limited animal data exists specifically on the excretion of propranolol in milk, but beta-blockers as a class are known to pass into milk. Therefore, it should be used with caution in breastfeeding women. Consult your doctor for advice before taking it.

Driving and Using Machines

Safe

PROLOL TR 40MG CAPSULE is unlikely to affect your ability for driving or handling any heavy tools or machines. However, if your experience any dizziness or drowsiness, do not drive or handle any heavy tools or machines as a precaution.

Alcohol

Consult your doctor

Avoid consumption of alcohol while taking PROLOL TR 40MG CAPSULE as it might make you feel dizzier and drowsier.

Kidney

Use with Caution

PROLOL TR 40MG CAPSULE should be used with caution in patients with kidney problems. Therefore, consult your doctor before taking it.

Liver

Use with Caution

PROLOL TR 40MG CAPSULE should be used with caution in patients with liver problems. Therefore, consult your doctor before taking it.

Allergy

Contraindicated

Do not take PROLOL TR 40MG CAPSULE if you are allergic to propranolol.

Lungs

Consult your doctor

PROLOL TR 40MG CAPSULE is not recommended for use in patients suffering from asthma. It should be used with caution in patients with other respiratory problems (such as chronic bronchitis, emphysema, COPD or bronchospasm). Therefore, consult your doctor before taking it.

Heart Disease

Consult your doctor

PROLOL TR 40MG CAPSULE is not recommended for use in patients with sinus bradycardia (slow heart beat due to problems in SA nodes), heart block, 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.

Use In Pediatrics

Consult your doctor

The safety and effectiveness of PROLOL TR 40MG CAPSULE have not been established in children and adolescents (aged below 18 years). Therefore, it should be used in children only if prescribed by the physician.

Use In Geriatrics

Use with Caution

PROLOL TR 40MG CAPSULE should be used with caution in elderly patients (aged above 65 years). Animal studies indicate increased sensitivity to beta-blockers in older populations due to age-related changes in cardiovascular physiology and drug metabolism. Therefore, consult your doctor before taking it.

Others

PROLOL TR 40MG 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 very low blood pressure
have can increased acidity of the blood (metabolic acidosis)
are on a strict fasting diet
suffer from other forms of angina (Prinzmetal’s angina)

Before taking PROLOL TR 40MG 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
have muscle weakness (myasthenia gravis)
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

Safety Advice

Expert advice to follow while taking PROLOL TR 40MG CAPSULE:

Take as prescribed and at the same time daily.
Monitor blood pressure and heart rate regularly.
Avoid sudden discontinuation of the medication.
Be mindful of alcohol, smoking, and other medications.
Protect yourself in cold weather.
Inform your doctor about any side effects or new medications.
Use caution during pregnancy and breastfeeding.
Monitor blood glucose levels if diabetic.
Visit your healthcare provider regularly for check-ups.

Interactions

A. Drug - Drug interactions:

1. Calcium Channel Blockers (e.g., Verapamil, Diltiazem)

Both calcium channel blockers and beta-blockers like Inderal reduce heart rate and blood pressure. When taken together, they can cause excessive bradycardia (slow heart rate) and hypotension (low blood pressure).

2. Clonidine (Alpha-2 Agonist)

Clonidine can synergistically lower blood pressure. However, abrupt discontinuation of clonidine while on propranolol can cause a rebound hypertensive crisis.

3.Antiarrhythmic Drugs (e.g., Amiodarone, Sotalol)

Combining antiarrhythmic drugs can increase the risk of heart block and severe bradycardia, particularly in patients with pre-existing heart conditions.

4.Antidepressants (e.g., Fluoxetine, Paroxetine)

Some selective serotonin reuptake inhibitors (SSRIs) may increase the plasma concentration of propranolol, potentially leading to an enhanced beta-blocking effect and increased risk of bradycardia.

5. Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) (e.g., Ibuprofen, Naproxen)

NSAIDs may reduce the effectiveness of Inderal in controlling blood pressure by inhibiting the production of prostaglandins, which help regulate kidney function.

6.Insulin and Oral Hypoglycemics

Beta-blockers like propranolol can mask the symptoms of hypoglycemia (low blood sugar), making it harder to recognize low blood sugar levels, especially in diabetics.

7.Monoamine Oxidase Inhibitors (MAOIs) (e.g., Phenelzine, Tranylcypromine)

The combination of MAOIs and Inderal can lead to a hypertensive crisis due to excessive catecholamine release.

8.Ergot Alkaloids (e.g., Ergotamine)

Ergotamine, often used to treat migraines, can cause vasoconstriction, and when combined with propranolol, it may further increase the risk of severe hypertension or poor circulation.

Refer the drug-drug interactions of propranolol, drugs.com

Synopsis

Drug	:	Propranolol
Pharmacological Category	:	Beta blockers
Therapeutic Indication	:	Hypertension, angina pectoris, atrial fibrillation, migraine, tremor and anxiety, thyrotoxicosis, phaeochromocytoma
Dosage Forms	:	Tablet, Capsule, Injection

More Information

Onset of Action: After taking a 40mg tablet of propranolol by mouth, the drug typically begins to take effect within 30 to 60 minutes. The maximum concentration of propranolol in the blood is usually reached around 1 to 2 hours after oral ingestion. At this point, the therapeutic effects are most pronounced, such as a reduction in heart rate, blood pressure, and anxiety symptoms.
Duration of Action: The effects of propranolol can last approximately 3 to 6 hours after a single dose. Propranolol also comes in extended-release formulations (such as Inderal LA), which can provide prolonged action, lasting up to 24 hours.

FAQs About PROLOL TR 40MG CAPSULE

Q: Can PROLOL TR 40MG CAPSULE used in asthmatic patients?

A: No, PROLOL TR 40MG CAPSULE cannot be used in patients suffering from asthma. This is because using it can cause breathing problems, which may trigger an asthma attack. Always inform your doctor if you have or ever had asthma or any kind of difficulty breathing difficulty, before starting management with PROLOL TR 40MG CAPSULE.

Q: Does PROLOL TR 40MG CAPSULE make you feel sleepy?

A: PROLOL TR 40MG CAPSULE can occasionally cause dizziness or tiredness while taking it. Don't drive, use machinery, or perform any activities that require alertness. If this occurs to you, consult your doctor for opinion.

Q: Should we take PROLOL TR 40MG CAPSULE before or after food?

A: PROLOL TR 40MG CAPSULE should preferably be taken before meals. It should be swallowed with a drink of water.

Q: When can I expect relief in my symptoms after taking PROLOL TR 40MG CAPSULE?

A: PROLOL TR 40MG CAPSULE usually starts working within a few hours of taking it. However, to notice considerable changes in the symptoms of high blood pressure or heart conditions, it may take a week. You will not be able to notice any difference, but that does not mean it is not working. However, keep taking PROLOL TR 40MG CAPSULE as prescribed by your doctor to get its full benefits.

Q: What are the uses of PROLOL TR 40MG CAPSULE?

A: PROLOL TR 40MG CAPSULE It is used to manage hypertension, angina and arrhythmia. It can also be used to manage signs and symptoms associated with anxiety, overactive thyroid gland, phaeochromocytoma or Hypertrophic Subaortic Stenosis. It can manage heart attacks and migraine headaches and reduce tremors.

Q: What type of a medicine is PROLOL TR 40MG CAPSULE?

A: PROLOL TR 40MG CAPSULE is a beta-blocker. It works by blocking the actions of certain chemical messengers (such as adrenaline and noradrenaline) in our body that controls the function of the heart, brain and kidneys and lungs. This helps in normalizing heart functions, migraine, anxiety and tremors. It also reduces heart signs associated with anxiety, overactive thyroid gland, phaeochromocytoma or Hypertrophic Subaortic Stenosis

Q: Can PROLOL TR 40MG CAPSULE reduce anxiety?

A: Yes. PROLOL TR 40MG CAPSULE helps to control racing heartbeat and nervousness associated with anxiety.

Q: What happens when I stop taking PROLOL TR 40MG CAPSULE?

A: Do not stop taking PROLOL TR 40MG CAPSULE without consulting your doctor as your symptoms may re-appear once again. Make sure to take PROLOL TR 40MG CAPSULE for the stipulated duration recommended by your doctor to achieve maximum results.

Q: What is the best time to take PROLOL TR 40MG CAPSULE?

A: PROLOL TR 40MG CAPSULE is preferably taken before meals. Your doctor will decide the best time for you to take PROLOL TR 40MG CAPSULE based on your age, body weight and disease condition.

Q: What to do if I forgot to take a dose of PROLOL TR 40MG CAPSULE?

A: If you forgot to take a dose of PROLOL TR 40MG CAPSULE, take it as soon as you remember. However, if it is time for the next dose of PROLOL TR 40MG CAPSULE, skip the missed dose and take the next one regularly. Do not take a double dose of PROLOL TR 40MG CAPSULE to compensate the missed ones.

Q: What precautions should be followed while taking PROLOL TR 40MG CAPSULE?

A: Before taking PROLOL TR 40MG CAPSULE inform your doctor if you have any liver or kidney problems. You must also inform your doctor if you have any other types of anginas or arrhythmia, any breathing problems, diabetes, asthma, heart failure as a precaution. Do not take PROLOL TR 40MG CAPSULE without consulting your doctor if you are pregnant or breastfeeding. Regularly visit your doctor and take all the necessary blood test recommended by your doctor without fail.

Q: Can I consume alcohol while taking PROLOL TR 40MG CAPSULE?

A: Avoid consumption of alcohol while taking PROLOL TR 40MG CAPSULE as it might make you feel dizzier and drowsier.

Q: What happens if I accidentally take more PROLOL TR 40MG CAPSULE?

A: If you or anyone else accidentally took more PROLOL TR 40MG CAPSULE, consult your doctor immediately or visit the nearby hospital. Symptoms of overdose might include slow heartbeat, low blood pressure, breathing difficulties with symptoms such as fatigue, hallucinations, tremors, confusion, nausea, vomiting, body spasms and fainting.

Q: Can I take PROLOL TR 40MG CAPSULE daily?

A: Take PROLOL TR 40MG CAPSULE as advised by your physician. Your doctor will evaluate your health condition and suggests whether can you take PROLOL TR 40MG CAPSULE every day or not.

Q: Is PROLOL TR 40MG CAPSULE safe to use in diabetic patients?

A: PROLOL TR 40MG CAPSULE may alter the blood sugar levels in your body. Therefore, it is necessary to inform your doctor if you have diabetes before taking PROLOL TR 40MG CAPSULE as a precaution. Your doctor will closely monitor you blood sugar levels to avoid the risk of side effects.

Q: What are the side effects of PROLOL TR 40MG CAPSULE?

A: The most common side effects of taking PROLOL TR 40MG CAPSULE are cold fingers and toes, slow heartbeat, tiredness, sleep disturbances and Raynaud’s syndrome (numbness and spasm in the fingers followed by warmth and pain). Consult your doctor if any of these side effect troubles you.

Q: Can I stop taking PROLOL TR 40MG CAPSULE once my symptoms subside?

A: No. Do not stop taking PROLOL TR 40MG CAPSULE without consulting your doctor as it may make your symptoms reappear. Therefore, take PROLOL TR 40MG CAPSULE as advised by your doctor for the stipulated duration.

Q: Can PROLOL TR 40MG CAPSULE be taken during pregnancy?

A: PROLOL TR 40MG 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 PROLOL TR 40MG CAPSULE if you are pregnant, think you might be pregnant or planning to have a baby.

Q: Is PROLOL TR 40MG CAPSULE safe to use in kidney disease?

A: PROLOL TR 40MG CAPSULE should be used with caution in patients with kidney problems. Your doctor will access your health condition and suggest a suitable dose for you.

Q: Can the use of PROLOL TR 40MG CAPSULE affect the liver?

A: Yes. PROLOL TR 40MG CAPSULE may affect the way your liver work. It can elevate the levels of certain liver enzymes in your body. Therefore, it should be used with caution in patients with liver problems. Consult your doctor before taking it.

References

1. KD. Tripathi. Adrenergic drugs and drugs acting on glaucoma. Essentials of medical pharmacology. 7th Edition. 2019. Page – 145-151.

2. Sylvia Ojeda, Emily Blumenthal, Pamela Stevens, Clark R Andersen, Lucy Robles, David N Herndon, and Walter J Meyer, III. The Safety and Efficacy of Propranolol in Reducing the Hypermetabolic Response in the Pediatric Burn Population. NIH. National Library of Medicine. National Center for Biotechnology Information. PMC. PubMed Central. May 2018. [Accessed on 4th November 2024] click here

3. Mylan Pharmaceuticals Inc. Propranolol Hydrochloride Tablet. Dailymed.com. [Revised in March 2022]. [Accessed on 4th November 2024] click here

4. Atnahs Pharma UK Limited. Electronic Medicines Compendium (EMC). [Revised in July 2021] [Accessed on 4th November 2024] click here

5. Accord. Electronic Medicines Compendium (EMC). [Revised in March 2021] [Accessed on 4th November 2024] click here

6. Accord Healthcare Limited. Electronic Medicines Compendium (EMC). [Revised in March 2020] [Accessed on 4th November 2024] click here

7. Propranolol. NHS. UK. [Revised in November 2021]. [Accessed on 4th November 2024] click here

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Author Details

Written By Srilekha. R - B.Pharm

Reviewed For Accuracy By Dr. Thamada Manikanta Praveen - MBBS, MD (General Medicine)

Last updated on 18 Dec 2024 | 09:56 AM(IST)