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CARDIOVASCULAR SYSTEM › BETA BLOCKING AGENTS › BETA BLOCKING AGENTS, OTHER COMBINATIONS › Beta blocking agents, other combinations
propranolol and other combinations
C07FX01
Forms & Strengths
- Propranolol HCl / Hydrochlorothiazide: 40/25 mg, 80/25 mg tablets
Adult Dosing
- Hypertension: Initial 40/25 mg to 80/25 mg orally once or twice daily; titrate based on blood pressure response up to maximum recommended daily doses.
Pediatric Dosing
- Safety and efficacy in pediatric patients not established; fixed-dose combinations generally not recommended for children.
Indications
- Management of essential hypertension
Mechanism of Action
- Combines the non-selective beta-adrenergic receptor blocking action of propranolol (decreases heart rate, myocardial contractility, and renin release) with the diuretic action of thiazides (inhibits sodium chloride reabsorption in the distal convoluted tubule, decreasing plasma volume and peripheral vascular resistance).
Contraindications
- Cardiogenic shock
- Sinus bradycardia and greater than first-degree heart block
- Bronchial asthma or severe chronic obstructive pulmonary disease
- Overt cardiac failure
- Anuria or hypersensitivity to sulfonamide-derived drugs
Adverse Reactions
- Fatigue, lethargy, and dizziness
- Bradycardia and hypotension
- Cold extremities and Raynaud's phenomenon
- Bronchospasm
- Electrolyte disturbances (hypokalemia, hyponatremia, hyperuricemia via thiazide component)
- Masking of hypoglycemia symptoms in diabetics
Drug Interactions
- Calcium channel blockers (verapamil, diltiazem): Increased risk of bradycardia and AV block
- CYP2D6 inhibitors (fluoxetine, paroxetine): May increase propranolol plasma concentrations
- NSAIDs: May decrease the antihypertensive and diuretic effects
- Lithium: Reduced renal clearance of lithium, increasing toxicity risk
- Antidiabetic agents: Beta-blockers may mask symptoms of hypoglycemia and alter insulin requirements
Curated Content: Needs Vetting Before Put to Clinical Use