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Introduction About NIGRAIN
NIGRAIN contains Propranolol which belongs to the group of medicines called Beta blockers. It is used to manage hypertension, angina 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).
NIGRAIN primarily exerts its effects on the heart and improves blood circulation to the heart and to other parts of body. Therefore, 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 NIGRAIN 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.
NIGRAIN is not recommended for use in patients with severe asthma, hypotension or shock. It is also not suitable for use in patients with heart block, history of heart attack or heart failure. Do not take NIGRAIN without consulting your doctor if you are pregnant or breastfeeding women. The most common side effects of taking NIGRAIN 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 the side effect troubles you.
Uses Of NIGRAIN
It is used to:
- manage hypertension (high blood pressure)
- manage angina pectoris (chest pain)
- manage arrhythmia (irregular heart rhythm)
- reduce migraine (severe headache on side of the head)
- reduce tremor (shakiness) and anxiety
- reduce gut bleeding (caused due to high blood pressure in the liver)
It can also be used to manage signs and symptoms associated with:
- overactive thyroid gland (such as palpitation, nervousness, tremor, fixed stare, severe myopathy and sweating)
- phaeochromocytoma (high blood pressure and fast heart rate caused due to tumour of adrenal glands)
- hypertrophic subaortic stenosis (thickening of heart muscles causing strain on heart while pumping blood)
How NIGRAIN Works
NIGRAIN is a beta-blocker 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. NIGRAIN 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, NIGRAIN 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 NIGRAIN
Take NIGRAIN 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 stop taking NIGRAIN unless advised by your doctor.
Side Effects Of NIGRAIN
Common
- 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)
Uncommon
- nausea, vomiting, diarrhoea
Rare
- dizziness while standing up
- hair loss
- changes in mood, confusion and memory loss
- signs of mind disturbances (psychosis or hallucinations)
- tingling or pricking sensation of body parts
- vision disturbances and dry eyes
Stop taking NIGRAIN 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
- worsening of existing condition
How To Manage Side Effects
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.
Nausea And Vomiting
Take NIGRAIN 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.
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.
Warning & Precautions
Pregnancy
Monitoring requiredNIGRAIN 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 NIGRAIN if you are pregnant, think you might be pregnant or planning to have a baby.
Breastfeeding
Use with CautionNIGRAIN may excrete in breast milk. Therefore, it should be used with caution in breastfeeding women. Consult your doctor for advice before taking it.
Driving and Using Machines
Use with CautionNIGRAIN 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 doctorAvoid consumption of alcohol while taking NIGRAIN as it might make you feel dizzier and drowsier.
Kidney
Use with CautionNIGRAIN should be used with caution in patients with kidney problems. Therefore, consult your doctor before taking it.
Liver
Use with CautionNIGRAIN should be used with caution in patients with liver problems. Therefore, consult your doctor before taking it.
Allergy
ContraindicatedDo not take NIGRAIN if you are allergic to Propranolol or any other ingredients of this medicine.
Lungs
Consult your doctorNIGRAIN 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 doctorNIGRAIN 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 doctorThe safety and effectiveness of NIGRAIN 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 CautionNIGRAIN should be used with caution in elderly patients (aged above 65 years). Therefore, consult your doctor before taking it.
Others
NIGRAIN 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 NIGRAIN, 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
Interactions
A. Drug-Drug interactions:
Before taking NIGRAIN, inform your doctor if you are taking any of the following medicine such as:
- 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
- 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)
- medicine used in the management of mental illness (Ex. chlorpromazine, thioridazine, haloperidol)
- cimetidine, aluminium hydroxide gel (medicine used for stomach problems)
- rifampicin (a medicine used to manage tuberculosis infection)
- medicines used to manage fits (Ex. phenytoin)
- theophylline (a medicine used to manage asthma)
- warfarin (a medicine that manages blood clot formation)
- fingolimod (a medicine used to manage multiple sclerosis)
- barbiturates (medicine used to reduce anxiety and to induce sleep) Ex. phenobarbitone, pentobarbitone
- medicines used to manage depression (Ex. isocarboxazid, phenelzine, Selegiline, fluvoxamine and Tranylcypromine)
- methoxyflurane and trichloroethylene (used as anaesthetic agents)
- thyroxine (a medicine used to manage thyroid deficiency)
Overdosage:
If you or anyone else accidentally took more of NIGRAIN, 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.
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
Storage
- Keep NIGRAIN out of reach of children
- Store at room temperature
FAQs About NIGRAIN
Q: Can NIGRAIN used in asthmatic patients?
A: No, NIGRAIN 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 NIGRAIN.
Q: Does NIGRAIN make you feel sleepy?
A: NIGRAIN 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 NIGRAIN before or after food?
A: NIGRAIN 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 NIGRAIN?
A: NIGRAIN 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 NIGRAIN as prescribed by your doctor to get its full benefits.
Q: What are the uses of NIGRAIN?
A: NIGRAIN 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 NIGRAIN?
A: NIGRAIN 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 NIGRAIN reduce anxiety?
A Yes. NIGRAIN helps to control racing heartbeat and nervousness associated with anxiety.
Q: What happens when I stop taking NIGRAIN?
A: Do not stop taking NIGRAIN without consulting your doctor as your symptoms may re-appear once again. Make sure to take NIGRAIN for the stipulated duration recommended by your doctor to achieve maximum results.
Q: What is the best time to take NIGRAIN?
A: NIGRAIN is preferably taken before meals. Your doctor will decide the best time for you to take NIGRAIN based on your age, body weight and disease condition.
Q: What to do if I forgot to take a dose of NIGRAIN?
A: If you forgot to take a dose of NIGRAIN, take it as soon as you remember. However, if it is time for the next dose of NIGRAIN, skip the missed dose and take the next one regularly. Do not take a double dose of NIGRAIN to compensate the missed ones.
Q: What precautions should be followed while taking NIGRAIN?
A: Before taking NIGRAIN 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 NIGRAIN 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 NIGRAIN?
A: Avoid consumption of alcohol while taking NIGRAIN as it might make you feel dizzier and drowsier.
Q: What happens if I accidentally take more NIGRAIN?
A: If you or anyone else accidentally took more NIGRAIN, 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 NIGRAIN daily?
A: Take NIGRAIN as advised by your physician. Your doctor will evaluate your health condition and suggests whether can you take NIGRAIN every day or not.
Q: Is NIGRAIN safe to use in diabetic patients?
A: NIGRAIN may alter the blood sugar levels in your body. Therefore, it is necessary to inform your doctor if you have diabetes before taking NIGRAIN 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 NIGRAIN?
A: The most common side effects of taking NIGRAIN 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 NIGRAIN once my symptoms subside?
A: No. Do not stop taking NIGRAIN without consulting your doctor as it may make your symptoms reappear. Therefore, take NIGRAIN as advised by your doctor for the stipulated duration.
Q: Can NIGRAIN be taken during pregnancy?
A: NIGRAIN 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 NIGRAIN if you are pregnant, think you might be pregnant or planning to have a baby.
Q: Is NIGRAIN safe to use in kidney disease?
A: NIGRAIN 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 NIGRAIN affect the liver?
A: Yes. NIGRAIN 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 2022] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6198736/
3. Mylan Pharmaceuticals Inc. Propranolol Hydrochloride Tablet. Dailymed.com. [Revised in March 2022] [Accessed on 4th November 2022] https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=b94dcec7-7633-4a33-9cea-48161adeaf93
4. Atnahs Pharma UK Limited. Electronic Medicines Compendium (EMC). [Revised in July 2021] [Accessed on 4th November 2022] https://www.medicines.org.uk/emc/files/pil.12858.pdf
5. Accord. Electronic Medicines Compendium (EMC). [Revised in March 2021] [Accessed on 4th November 2022] https://www.medicines.org.uk/emc/files/pil.5853.pdf
6. Accord Healthcare Limited. Electronic Medicines Compendium (EMC). [Revised in March 2020] [Accessed on 4th November 2022] https://www.medicines.org.uk/emc/files/pil.2903.pdf
7. Propranolol. NHS. UK. [Revised in November 2021]. [Accessed on 4th November 2022] https://www.nhs.uk/medicines/propranolol/
Useful Diagnostic Tests
- Kidney Function Test
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