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Introduction About INDERAL 10MG TABLET

INDERAL 10MG TABLET 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 INDERAL 10MG TABLET 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.

INDERAL 10MG TABLET 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 INDERAL 10MG TABLET without consulting your doctor if you are pregnant or breastfeeding. The most common side effects of taking INDERAL 10MG TABLET 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 INDERAL 10MG TABLET

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 INDERAL 10MG TABLET 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 INDERAL 10MG TABLET 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 INDERAL 10MG TABLET 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 INDERAL 10MG TABLET 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 INDERAL 10MG TABLET 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 INDERAL 10MG TABLET Works

INDERAL 10MG TABLET 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.

INDERAL 10MG TABLET 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, INDERAL 10MG TABLET 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 INDERAL 10MG TABLET

Take INDERAL 10MG TABLET 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 INDERAL 10MG TABLET:

If you miss a dose of INDERAL 10MG TABLET 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 INDERAL 10MG TABLET:

Taking more than the prescribed dose of INDERAL 10MG TABLET 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 INDERAL 10MG TABLET

Like all medicines, INDERAL 10MG TABLET may cause certain side effects, although not everybody gets them.

The most common side effects of taking INDERAL 10MG TABLET 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

INDERAL 10MG TABLET 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 INDERAL 10MG TABLET if you are pregnant, think you might be pregnant or planning to have a baby.

Breastfeeding

Use with Caution

INDERAL 10MG TABLET 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

INDERAL 10MG TABLET 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 INDERAL 10MG TABLET as it might make you feel dizzier and drowsier.

Kidney

Use with Caution

INDERAL 10MG TABLET should be used with caution in patients with kidney problems. Therefore, consult your doctor before taking it.

Liver

Use with Caution

INDERAL 10MG TABLET should be used with caution in patients with liver problems. Therefore, consult your doctor before taking it.

Allergy

Contraindicated

Do not take INDERAL 10MG TABLET if you are allergic to propranolol.

Lungs

Consult your doctor

INDERAL 10MG TABLET 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

INDERAL 10MG TABLET 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 INDERAL 10MG TABLET 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

INDERAL 10MG TABLET 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

INDERAL 10MG TABLET 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 INDERAL 10MG TABLET, 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 INDERAL 10MG TABLET:

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 INDERAL 10MG TABLET

Q: Can INDERAL 10MG TABLET used in asthmatic patients?

A: No, INDERAL 10MG TABLET 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 INDERAL 10MG TABLET.

Q: Does INDERAL 10MG TABLET make you feel sleepy?

A: INDERAL 10MG TABLET 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 INDERAL 10MG TABLET before or after food?

A: INDERAL 10MG TABLET 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 INDERAL 10MG TABLET?

A: INDERAL 10MG TABLET 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 INDERAL 10MG TABLET as prescribed by your doctor to get its full benefits.

Q: What are the uses of INDERAL 10MG TABLET?

A: INDERAL 10MG TABLET 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 INDERAL 10MG TABLET?

A: INDERAL 10MG TABLET 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 INDERAL 10MG TABLET reduce anxiety?

A: Yes. INDERAL 10MG TABLET helps to control racing heartbeat and nervousness associated with anxiety.

Q: What happens when I stop taking INDERAL 10MG TABLET?

A: Do not stop taking INDERAL 10MG TABLET without consulting your doctor as your symptoms may re-appear once again. Make sure to take INDERAL 10MG TABLET for the stipulated duration recommended by your doctor to achieve maximum results.

Q: What is the best time to take INDERAL 10MG TABLET?

A: INDERAL 10MG TABLET is preferably taken before meals. Your doctor will decide the best time for you to take INDERAL 10MG TABLET based on your age, body weight and disease condition.

Q: What to do if I forgot to take a dose of INDERAL 10MG TABLET?

A: If you forgot to take a dose of INDERAL 10MG TABLET, take it as soon as you remember. However, if it is time for the next dose of INDERAL 10MG TABLET, skip the missed dose and take the next one regularly. Do not take a double dose of INDERAL 10MG TABLET to compensate the missed ones.

Q: What precautions should be followed while taking INDERAL 10MG TABLET?

A: Before taking INDERAL 10MG TABLET 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 INDERAL 10MG TABLET 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 INDERAL 10MG TABLET?

A: Avoid consumption of alcohol while taking INDERAL 10MG TABLET as it might make you feel dizzier and drowsier.

Q: What happens if I accidentally take more INDERAL 10MG TABLET?

A: If you or anyone else accidentally took more INDERAL 10MG TABLET, 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 INDERAL 10MG TABLET daily?

A: Take INDERAL 10MG TABLET as advised by your physician. Your doctor will evaluate your health condition and suggests whether can you take INDERAL 10MG TABLET every day or not.

Q: Is INDERAL 10MG TABLET safe to use in diabetic patients?

A: INDERAL 10MG TABLET may alter the blood sugar levels in your body. Therefore, it is necessary to inform your doctor if you have diabetes before taking INDERAL 10MG TABLET 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 INDERAL 10MG TABLET?

A: The most common side effects of taking INDERAL 10MG TABLET 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 INDERAL 10MG TABLET once my symptoms subside?

A: No. Do not stop taking INDERAL 10MG TABLET without consulting your doctor as it may make your symptoms reappear. Therefore, take INDERAL 10MG TABLET as advised by your doctor for the stipulated duration.

Q: Can INDERAL 10MG TABLET be taken during pregnancy?

A: INDERAL 10MG TABLET 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 INDERAL 10MG TABLET if you are pregnant, think you might be pregnant or planning to have a baby.

Q: Is INDERAL 10MG TABLET safe to use in kidney disease?

A: INDERAL 10MG TABLET 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 INDERAL 10MG TABLET affect the liver?

A: Yes. INDERAL 10MG TABLET 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. Sankara Babu Gorle - MBBS, MD (Pharmacology)

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