Prosma
Generic Name
Propranolol
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| prosma 1 mg tablet | ৳ 4.00 | ৳ 40.00 |
Description
Overview of the medicine
Prosma 1 mg Tablet contains Propranolol, a non-selective beta-blocker used to treat various conditions including high blood pressure, angina (chest pain), irregular heartbeats (arrhythmias), migraine prevention, essential tremor, and anxiety.
Uses & Indications
Dosage
Adults
The usual starting dose for Propranolol varies by indication, often beginning with 10-40 mg two to four times daily. A 1 mg tablet may be used for very precise titration, specific pediatric conditions, or in patients requiring extremely low initial doses. Typical maintenance doses can range from 80-320 mg/day depending on the condition.
Elderly
Elderly patients may require lower initial doses and slower titration due to potential increased sensitivity and altered pharmacokinetics. Monitor closely for adverse effects.
Renal_impairment
No significant dose adjustment is usually required for renal impairment, but caution is advised, and monitoring of clinical response is recommended, particularly with severe impairment.
How to Take
Prosma 1 mg Tablet should be taken orally, with or without food. To ensure consistent absorption, it is advisable to take the medicine at the same time each day, preferably with meals. Do not stop taking it abruptly without consulting your doctor.
Mechanism of Action
Propranolol works by blocking both beta-1 and beta-2 adrenergic receptors. This action reduces heart rate, cardiac output, and blood pressure. It also inhibits the release of renin from the kidneys and has antiarrhythmic effects.
Pharmacokinetics
Onset
Oral: 30 minutes to 1 hour.
Excretion
Primarily excreted renally as metabolites; less than 1% as unchanged drug.
Half life
3 to 6 hours for immediate-release formulations.
Absorption
Rapid and complete oral absorption, but undergoes extensive first-pass metabolism, leading to a bioavailability of about 25%.
Metabolism
Extensively metabolized in the liver, primarily via CYP2D6, CYP1A2, and CYP2C19 enzymes.
Side Effects
Contraindications
- Sinus bradycardia (slow heart rate)
- Second or third-degree heart block
- Cardiogenic shock
- Decompensated heart failure
- Bronchial asthma or history of bronchospasm
- Severe chronic obstructive pulmonary disease (COPD)
Drug Interactions
Warfarin
Propranolol can inhibit the metabolism of warfarin, potentially increasing its anticoagulant effect and risk of bleeding.
Insulin and Oral Hypoglycemics
Propranolol may mask the symptoms of hypoglycemia (e.g., tremors, palpitations), and prolong hypoglycemic episodes.
NSAIDs (e.g., Ibuprofen, Indomethacin)
May reduce the antihypertensive effect of propranolol.
CYP2D6 inhibitors (e.g., Fluoxetine, Paroxetine)
Can increase plasma concentrations of propranolol.
Other Antihypertensives (e.g., ACE inhibitors, calcium channel blockers)
May have an additive hypotensive effect, leading to excessive blood pressure reduction.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include severe bradycardia, hypotension, bronchospasm, and acute heart failure. Management involves symptomatic and supportive measures. Treatment may include atropine for bradycardia, glucagon, IV fluids and vasopressors for hypotension, and bronchodilators for bronchospasm.
Pregnancy & Lactation
Pregnancy Category C. Use during pregnancy only if the potential benefit outweighs the potential risk to the fetus. Propranolol is excreted in breast milk; therefore, caution should be exercised when administered to a nursing mother. Consult a doctor.
Side Effects
Contraindications
- Sinus bradycardia (slow heart rate)
- Second or third-degree heart block
- Cardiogenic shock
- Decompensated heart failure
- Bronchial asthma or history of bronchospasm
- Severe chronic obstructive pulmonary disease (COPD)
Drug Interactions
Warfarin
Propranolol can inhibit the metabolism of warfarin, potentially increasing its anticoagulant effect and risk of bleeding.
Insulin and Oral Hypoglycemics
Propranolol may mask the symptoms of hypoglycemia (e.g., tremors, palpitations), and prolong hypoglycemic episodes.
NSAIDs (e.g., Ibuprofen, Indomethacin)
May reduce the antihypertensive effect of propranolol.
CYP2D6 inhibitors (e.g., Fluoxetine, Paroxetine)
Can increase plasma concentrations of propranolol.
Other Antihypertensives (e.g., ACE inhibitors, calcium channel blockers)
May have an additive hypotensive effect, leading to excessive blood pressure reduction.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include severe bradycardia, hypotension, bronchospasm, and acute heart failure. Management involves symptomatic and supportive measures. Treatment may include atropine for bradycardia, glucagon, IV fluids and vasopressors for hypotension, and bronchodilators for bronchospasm.
Pregnancy & Lactation
Pregnancy Category C. Use during pregnancy only if the potential benefit outweighs the potential risk to the fetus. Propranolol is excreted in breast milk; therefore, caution should be exercised when administered to a nursing mother. Consult a doctor.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
2-3 years from manufacturing date
Availability
Available in pharmacies and hospitals
Approval Status
Approved by regulatory authorities (e.g., DGDA)
Patent Status
Patent expired
WHO Essential Medicine
YesClinical Trials
Propranolol has been extensively studied in numerous clinical trials establishing its efficacy and safety for various cardiovascular and neurological conditions over decades.
Lab Monitoring
- Blood pressure and heart rate should be monitored regularly.
- Blood glucose levels should be monitored in diabetic patients, as propranolol can mask hypoglycemia symptoms.
- Liver function tests may be considered in patients with pre-existing liver conditions or during long-term therapy, although severe hepatotoxicity is rare.
Doctor Notes
- Emphasize the importance of gradual withdrawal to patients, especially those with ischemic heart disease.
- Monitor blood pressure and heart rate regularly.
- Counsel diabetic patients about masked hypoglycemia symptoms.
- Assess for history of asthma or COPD before prescribing.
Patient Guidelines
- Take Prosma 1 mg Tablet exactly as prescribed by your doctor.
- Do not stop taking this medicine abruptly without consulting your doctor, as it can worsen your condition.
- Report any unusual or severe side effects to your doctor immediately.
- If you are diabetic, monitor your blood sugar levels closely, as this medicine can mask signs of low blood sugar.
Missed Dose Advice
If you miss a dose, take it as soon as you remember, unless it is almost time for your next dose. In that case, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one.
Driving Precautions
Prosma 1 mg Tablet may cause dizziness, fatigue, or drowsiness. Avoid driving or operating machinery until you know how the medicine affects you.
Lifestyle Advice
- Maintain a healthy lifestyle, including a balanced diet low in sodium and saturated fats.
- Engage in regular physical activity as advised by your doctor.
- Avoid smoking and excessive alcohol consumption.
- Manage stress through relaxation techniques.
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