Sumial 40 mg
50 tablets
Drug: propranolol
effect
Propranolol reduces blood pressure in hypertension and coronary heart disease.
The drug slows down and rhythm of heartbeats during rapid arrhythmia. Cardiac arrhythmias, the (a group of the nervous system stimulating drugs) were triggered by exercise, anesthesia or sympathomimetic agents, can be treated with propranolol. Moreover, Propranolol is used to treat heart complaints with no obvious physical cause, such as the hyperkinetic heart syndrome. In addition can be with the drug by eliminating the risk factor hypertension after a heart attack and seizures of heart Enge (angina pectoris) prevent. Propranolol can offset the effects of hyperthyroidism on the heart.
The active ingredient is used in the preventive treatment of migraine, with tremors with no known cause (essential tremor) and anxiety disorders.
For the following application areas of propranolol depth information are available:
migraine
high blood pressure
Arrhythmias
Heart attack
anxiety disorders
Hyperthyroidism
Heart failure
angina
Cardiovascular disorders
Further information
Please also read the information on the drug groups beta blockers, antihypertensives, to which the active ingredient Propranolol belongs.
dosage
The dosage of the tablets is set individually by the physician depending on the disease being treated image and the therapy success.
high blood pressure
Treatment is with two daily tablet started to three times (corresponding to 80 to 120 milligrams of propranolol hydrochloride per day). If necessary, the doctor may increase the dose up to two groups of four tablets.
Coronary artery disease, palpitations
At the beginning is taken daily three times a tablet. If necessary, the doctor may increase the dose to two to three times daily two tablets. The optimal dose for the duration of therapy should be determined individually.
Anxiety disorder, tremor with no apparent physical cause, migraine prevention
The usual starting dose is two to three times daily of a tablet. The dose and the intervals between doses must be determined individually in these applications by the doctor.
The tablets should be swallowed whole with liquid.
The duration of treatment is not limited in time. If the treatment is interrupted or ended after prolonged use, this should be done with slow reduced dose. Abrupt discontinuation can lead to resurgence of symptoms.
side effects
Common side effects:
Fatigue, dizziness, drowsiness, headache, confusion, nervousness, sweating, insomnia, depression, nightmares, hallucinations, paraesthesia, gastrointestinal discomfort, nausea and vomiting, constipation, diarrhea, hypotension, palpitations, cardiac conduction disturbances, heart muscle weakness gain, skin reactions, redness, itching, rash, hair loss.
Uncommon side effects:
Muscle weakness (myasthenia gravis-like), dry mouth, lacrimation-reduction, conjunctivitis, blood disorders (platelet reduction), bleeding into the skin.
Very rare side effects:
Reinforcement of myasthenia gravis, angina pectoris-reinforcing, Miss sensorineural gain, psoriasis, psoriasis gain, combined keratitis and conjunctivitis, blurred vision, joint pain, Sugar Disease exacerbation (diabetes mellitus), liver enzyme increase, libido decrease, impotence, with existing kidney disease: Renal Deterioration.
Particularities:
By beta2 effect can especially in patients with a sensitive bronchial asthma for example, to a narrowing of the airways and thus cause difficulty in breathing.
In patients with hyperthyroidism symptoms rapid heartbeat and trembling can be covered. After prolonged strict fasting or severe physical stress can lead to hypoglycemia, also faults can occur in fat metabolism.
interactions
When co-administered with insulin or other drugs for treating diabetes Propranolol may increase or prolong their effect. Warning signs of low blood sugar such as palpitations and tremors (shaking) can be mitigated, that they are no longer recognizable as symptoms (concealment). Therefore, regular blood sugar checks are necessary.
Propranolol may increase the effect of other antihypertensive agents and therefore lead to an excessive drop in blood pressure. This applies, for example, for use in combination with other beta-blockers as well as tricyclic and tetracyclic antidepressants, sleeping pills (barbiturates), agents for water excretion (diuretics), blutgefäßerweiternden agents (vasodilators), anesthetics (narcotics) and nitroglycerin. Similarly, propranolol may increase the effect of anti-arrhythmia (antiarrhythmics).
If propranolol combined with cardiac glycosides and acting in the brain antihypertensive agents such as reserpine, methyldopa, guanfacine and clonidine, can lead to a greater decrease in heart rate and a delay in the conduction at heart.
Concomitant administration of propranolol with the stress hormones norepinephrine or epinephrine can cause a very strong and rapid increase in blood pressure. With MAO inhibitors (for depression), the same effect is caused by the reduced degradation of propranolol HCl. Also taking cimetidine from the group of H2-receptor antagonists enhances the effects of propranolol.
Indomethacin from the group of non-steroidal anti-inflammatory drugs may reduce the antihypertensive effect of propranolol.
In the event that propranolol muscle-relaxing drugs (for example, for artificial respiration) can not be discontinued before surgery in general or prior to use, the anesthetist on the treatment needs to be informed.
Contraindications
Propranolol should not be used in case of hypersensitivity to the active substance or other beta-blockers, as well as heart failure, slowed heartbeat (resting heart rate before treatment is less than 50 beats per minute) and low blood pressure (hypotension).
The application is ruled out as well in a cardiovascular shock and serious illness of the conduction system of the heart (such as AV block II. Or III. Degree, sinus node syndrome).
The drug should not be used in severe circulatory disorders of the arms and legs. The same applies to a hypersensitivity of the bronchial system (such as asthma).
With MAO inhibitors for depression Propranolol may not be combined. Even with metabolic acidosis (acidosis) the application is prohibited.
Only with caution and strict medical supervision may propranolol are used in low conduction disturbances in the heart (AV block, first degree) in Diabetes (diabetes mellitus) with widely fluctuating blood glucose values or after prolonged severe fasts. Even heavy physical stress, pregnancy and lactation and renal or hepatic function require special medical care.
This medical care is required in patients with pheochromocytoma and psoriasis (psoriasis), even if this has occurred only when a family member. The same applies to the use of the drug, if ever severe hypersensitivity reactions to a drug occurred.
What should I watch for pregnancy and breastfeeding?
Propranolol should be used during pregnancy only in urgent cases. It may lead to growth retardation in the unborn. In addition, premature labor can occur.
The drug should be discontinued late least 48 to 72 hours prior to birth under medical supervision.
The drug passes into breast milk. Infants should be monitored medically in lactation.
What has to be considered in children?
Propranolol should not be used in children.
warnings
The drug can affect the responsiveness so that driving and using machines are dangerous.
Renal and liver function tests should be monitored regularly during treatment with the drug.
Contact lens wearers need to consider the possibly reduced by the drug lacrimation.
In diabetes, regular blood sugar checks are necessary.
The drug can lead in some cases allergic reactions.
Before anesthesia the anesthetist should be informed of the treatment with the drug.
Treatment with the drug not suddenly interrupted, but should be "tapered off" at a reduced dosage.
The drug is stored in the original package in order to protect from light and moisture.
Medicines can cause allergic reactions. The signs may be: rash, runny nose, itching, mucosal swelling, itching and redness of the eyes, narrowing of the airways (asthma). In rare cases there may be allergic shock with unconsciousness.
If you experience signs of an allergic reaction, so you immediately inform your doctor.
