Presnor
Generic Name
Propranolol Hydrochloride
Manufacturer
Example Pharma Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| presnor 20 mg tablet | ৳ 9.00 | ৳ 63.00 |
Description
Overview of the medicine
Presnor 20 mg Tablet contains Propranolol Hydrochloride, a non-selective beta-blocker. It is used to treat high blood pressure, angina, irregular heartbeats, migraine, and certain anxiety conditions.
Uses & Indications
Dosage
Adults
Dosage varies by indication. For hypertension, typically 40 mg twice daily, may be increased to 120-240 mg/day. For angina, 40 mg two to three times daily. Max 320 mg/day. A 20mg tablet might be used for initiation or lower doses.
Elderly
Start with lower doses (e.g., 10 mg two to three times daily) and titrate slowly due to potential for increased sensitivity and reduced elimination.
Renal_impairment
No significant dose adjustment needed for mild to moderate impairment. Use with caution in severe renal impairment. Hemodialysis is not effective in removing propranolol.
How to Take
Take orally, with or without food. To ensure consistent absorption, it is recommended to take the medicine either always with food or always on an empty stomach.
Mechanism of Action
Propranolol works by blocking beta-1 and beta-2 adrenergic receptors. This action reduces heart rate, myocardial contractility, cardiac output, and blood pressure. It also inhibits renin release and has antiarrhythmic effects.
Pharmacokinetics
Onset
Oral: 30-60 minutes.
Excretion
Mainly excreted via the kidneys as metabolites (90-95%). Less than 1% excreted unchanged in urine.
Half life
3-6 hours.
Absorption
Well absorbed from the gastrointestinal tract, but undergoes extensive first-pass metabolism, resulting in approximately 25% oral bioavailability. Peak plasma concentrations are reached within 1-2 hours.
Metabolism
Extensively metabolized in the liver, primarily by CYP2D6, CYP1A2, and CYP2C19. Metabolites include 4-hydroxypropranolol (active).
Side Effects
Contraindications
- Bronchial asthma or bronchospasm
- Cardiogenic shock
- Second or third-degree atrioventricular (AV) block
- Severe bradycardia (<50 bpm)
- Uncontrolled heart failure
- Sick sinus syndrome
Drug Interactions
Cimetidine, Alcohol
May increase propranolol plasma levels.
Insulin and Oral Hypoglycemics
Propranolol may mask symptoms of hypoglycemia (e.g., tremors, tachycardia) and prolong hypoglycemic episodes.
Phenytoin, Phenobarbital, Rifampicin
May decrease propranolol plasma levels.
NSAIDs (e.g., Ibuprofen, Indomethacin)
May reduce the antihypertensive effects of propranolol.
Calcium Channel Blockers (e.g., Verapamil, Diltiazem)
Increased risk of bradycardia, hypotension, and AV block.
Storage
Store in a cool, dry place below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include severe bradycardia, hypotension, cardiac failure, bronchospasm, and hypoglycemia. Treatment is symptomatic and supportive, including atropine for bradycardia, glucagon for severe hypotension/bradycardia, vasopressors, and bronchodilators.
Pregnancy & Lactation
Pregnancy Category C. Propranolol should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is excreted in human breast milk; therefore, caution should be exercised when administered to a nursing mother.
Side Effects
Contraindications
- Bronchial asthma or bronchospasm
- Cardiogenic shock
- Second or third-degree atrioventricular (AV) block
- Severe bradycardia (<50 bpm)
- Uncontrolled heart failure
- Sick sinus syndrome
Drug Interactions
Cimetidine, Alcohol
May increase propranolol plasma levels.
Insulin and Oral Hypoglycemics
Propranolol may mask symptoms of hypoglycemia (e.g., tremors, tachycardia) and prolong hypoglycemic episodes.
Phenytoin, Phenobarbital, Rifampicin
May decrease propranolol plasma levels.
NSAIDs (e.g., Ibuprofen, Indomethacin)
May reduce the antihypertensive effects of propranolol.
Calcium Channel Blockers (e.g., Verapamil, Diltiazem)
Increased risk of bradycardia, hypotension, and AV block.
Storage
Store in a cool, dry place below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include severe bradycardia, hypotension, cardiac failure, bronchospasm, and hypoglycemia. Treatment is symptomatic and supportive, including atropine for bradycardia, glucagon for severe hypotension/bradycardia, vasopressors, and bronchodilators.
Pregnancy & Lactation
Pregnancy Category C. Propranolol should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is excreted in human breast milk; therefore, caution should be exercised when administered to a nursing mother.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2 to 3 years from the date of manufacture.
Availability
Available in pharmacies worldwide
Approval Status
Approved by major regulatory bodies globally (e.g., FDA, DGDA)
Patent Status
Off-patent
WHO Essential Medicine
YesClinical Trials
Propranolol has undergone extensive clinical trials since its discovery, establishing its efficacy and safety profile across various indications. Ongoing research continues to explore its potential new uses and long-term effects.
Lab Monitoring
- Blood pressure and heart rate monitoring
- ECG monitoring (especially at initiation or dose changes)
- Blood glucose monitoring (in diabetic patients)
- Renal and hepatic function tests (if clinically indicated)
Doctor Notes
- Emphasize gradual withdrawal to prevent rebound effects, especially in patients with IHD.
- Monitor heart rate and blood pressure regularly.
- Caution in patients with diabetes (can mask hypoglycemia symptoms) and respiratory conditions.
- Consider hepatic impairment for dose adjustment.
- Educate patients on potential side effects and when to seek medical attention.
Patient Guidelines
- Take this medicine regularly as prescribed by your doctor, even if you feel well.
- Do not stop taking Presnor suddenly without consulting your doctor, as it can worsen your condition.
- Report any unusual side effects, especially difficulty breathing, very slow heart rate, or swelling.
- Avoid alcohol while on this medication as it may increase side effects.
- If you are diabetic, monitor your blood sugar closely as Presnor may mask symptoms of low blood sugar.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not double the dose to make up for a missed one.
Driving Precautions
Presnor may cause dizziness, lightheadedness, or fatigue, especially at the start of treatment or when the dose is increased. Avoid driving or operating machinery until you know how this medicine affects you.
Lifestyle Advice
- Maintain a healthy diet low in salt and saturated fats.
- Engage in regular physical activity as advised by your doctor.
- Avoid smoking and limit alcohol consumption.
- Manage stress through relaxation techniques.
- Regularly monitor blood pressure at home if advised.
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Global Brand Names
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