Propranolol

Propranolol for preventing migraine attacks

ParametersDetails
Category of DrugPropranolol for migraine. U.S. Food and Drug Administration (FDA) for preventing migraine attacks.
Mechanism of Action Propranolol is a nonselective β-adrenergic receptor antagonist. Beta-blockers reduce the frequency of migraine attacks in 60 to 80 percent of people (1)
Structure
IndicationsPropranolol for migraine is used as a prophylaxis (of migraine)
Pharmacokinetic properties1. Tmax – 2 hours
2. Vd- 4L/kg
3. Protein binding- Approximately 90% of propranolol is protein-bound in plasma.
4. Metabolism- 17% of a dose undergoes glucuronidation and 42% undergo ring oxidation.
5. Route of elimination- 91% in the urine
6. Half-life- 8 hours.
Well Known
Pharmaceutical Brands
1. CIPLAR- CIPLA
2. BETACAP-TR- SUN
3. INDERAL- ABBOTT
4. PROVANOL- INTAS PHARMA
Available dosage forms1. TABLETS
2. CAPSULES
3. INJECTION

Dose80 mg/day PO divided q6-8hr initially; may be increased by 20-40 mg/day every 3-4 weeks; not to exceed 160-240 mg/day divided q6-8hr (2)
Pharmacokinetic
properties
1. Tmax – 2 hours
2. Vd- 4L/kg
3. Protein binding- Approximately 90% of propranolol is protein-bound in plasma.
4. Metabolism- 17% of a dose undergoes glucuronidation and 42% undergo ring oxidation.
5. Route of elimination- 91% in the urine
6. Half-life- 8 hours.
Contraindications1. Asthma or history of obstructive airway disease
2. Uncontrolled heart failure
3. Prinzmetal angina
4. Marked bradycardia
5. Hypotension
6. Sick sinus syndrome
7. Second- or third-degree
atrioventricular block
8. Cardiogenic shock
9. Metabolic acidosis
10. Severe peripheral arterial
disease
11. Pheochromocytoma 
Precautions1. First-degree atrioventricular block
2. Renal impairment
3. Liver disease
4. Pregnancy 
5. Lactation
6. Portal hypertension
10. Diabetes Mellitus
11. Myasthenia gravis
10. History of hypersensitivity
Adverse Effects1. Bradycardia
2. Heart failure
3. Hypotension
4. Conduction disorders
5. Bronchospasm
6. Peripheral vasoconstriction
7. Exacerbation of intermittent claudication and Raynaud
phenomenon
8. Gastrointestinal disturbances
9. Fatigue
10. Sleep disturbances
Pregnancy Category
National Formulary

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