(ii) Angina, essential tremor, thyrotoxicosis, and the prophylaxis of migraine The usual dose is 80mg daily, taken orally in the morning or evening, may be sufficient to give adequate control to most patients. A further reduction in blood pressure may be achieved by combining Bedranol* SR with other anti-hypertensive agents or a diuretic. If necessary it can be increased in 80 mg increments until the desired response is achieved (up to a maximum of 320 mg daily). An adequate response is seen by most patients at this dosage. Adults (i) Hypertension The initial dose is usually 160mg daily taken orally in the morning or evening. g) Prophylaxis of upper gastro-intestinal bleeding in patients with portal hypertension and oesophageal varices. The dose may be increased to 160mg, and then if necessary further increased to 240mg per day. Following are various diagnostic tests and treatments that moms with thyroid problems might encounter. The information summarized below is only a general overview. Tests may include: (1) “Most studies indicate that minimal levels of maternal thyroid are transferred into human milk, and further, that the amount secreted in extremely low and insufficient to protect a hypothyroid infant even when nursing… For detailed information, please review the references listed below with your health care provider. it is generally recognized that some thyroxine will transfer but the amount will be extremely low… 649-50) (2) “From these studies it is apparent that only exceedingly low levels of T3 are secreted into human milk and are insufficient to protect an infant from hypothyroidism. 657-58) (1) “Carbimazole is a prodrug and is rapidly converted to methimazole.” (Hale 2014, p. 723-24) (2) Levels of methimazole in milk depend on the maternal dose but appear too low to produce clinical effects.” (Hale 2014, p. 723-24) (3) “Only small amounts are secreted into breastmilk. Reports thus far suggest that levels absorbed by infant are too low to produce side effects… PTU is the best of antithyroid medications for use in lactating mothers. Monitor infant thyroid function (T4, TSH) carefully during therapy.” (Hale 2014, p.
While once a first-line treatment for hypertension, the role for beta blockers was downgraded in June 2006 in the United Kingdom to fourth-line, as they do not perform as well as other drugs, particularly in the elderly, and evidence is increasing that the most frequently used beta blockers at usual doses carry an unacceptable risk of provoking type 2 diabetes. Propranolol is not recommended for the treatment of hypertension by the Eighth Joint National Committee (JNC 8) because a higher rate of the primary composite outcome of cardiovascular death, myocardial infarction, or stroke compared to an angiotensin receptor blocker was noted in one study. Propranolol works to inhibit the actions of norepinephrine, a neurotransmitter that enhances memory consolidation. In one small study individuals given propranolol immediately after trauma experienced fewer stress-related symptoms and lower rates of PTSD than respective control groups who did not receive the drug. Due to the fact that memories and their emotional content are reconsolidated in the hours after they are recalled/re-experienced, propranolol can also diminish the emotional impact of already formed memories; for this reason, it is also being studied in the treatment of specific phobias, such as arachnophobia, dental fear, and social phobia. Ethical and legal questions have been raised surrounding the use of propranolol-based medications for use as a "memory damper", including: altering memory-recalled evidence during an investigation, modifying behavioral response to past (albeit traumatic) experiences, the regulation of these drugs, and others. However, Hall and Carter have argued that many such objections are "based on wildly exaggerated and unrealistic scenarios that ignore the limited action of propranolol in affecting memory, underplay the debilitating impact that PTSD has on those who suffer from it, and fail to acknowledge the extent to which drugs like alcohol are already used for this purpose." Propranolol may be used to treat severe infantile hemangiomas (IHs). The NICE British National Formulary (BNF) and British National Formulary for Children (BNFc) sites are only available to users in the UK, Crown Dependencies and British Overseas Territories. If you believe you are seeing this page in error please contact us.
Certain ?-adrenergic antagonists not including atenolol or acebutolol, such as propranolol, can be safely used as adjunctive therapy during breastfeeding. Propranolol answers are found in the Davis's Drug Guide powered by Unbound Medicine. Available for iPhone, iPad, Android, and Web.