All the Active Ingredient Drugs
Nonselective β-Blocker. Propranolol (HCl) 3.75 mg/mL. GLASS BOTTLE (oral sol.): 120ml. For oral use. It should be admin. directly into the child's mouth using the graduated oral syr., calibr. in mg of propranolol base, suppl. with the oral sol. bottle, during/ right after meal. to avoid the risk of hypoglycaemia. The posology is expressed in propranolol base.
Init. dose is 1 mg/kg/d. which is divided into two separate doses of 0.5 mg/kg. It is recom. to incr. the dose up to the therap. dose under med. supervis. as follows: 1 mg/kg/d for 1 wk., then 2 mg/kg/d for 1 wk. and then 3 mg/kg/d as a mainten. dose.
The therap. dose is 3 mg/kg/d., which is to be admin. into 2 separate doses of 1.5 mg/kg, one in the morn. and one in late afternoon, with a time interv. of at least 9 hrs. betwn. two intakes.
If the child is not eating or is vommit.-skip the dose. In case the child spits up a dose or does not take all of the med., no other dose should be given before the next scheduled dose.
During the titrat. phase, each dose incr. must be manag. and monitor., by a physician in the same condit. as the admin. of the init. dose. After the titrat. phase, the dose will be readjust. by the physician accord. to the changes in the child’s weight.
Clinical monitor. of the child condition, and dose readjust., need to be performed at least mnthly.
Durat. of tmt.: This med. should be admin. for a 6-month period.
Discontinuat. of tmt. does not require a progres. decr. in the dose.
In the minor, of pts. show. a relapse of sympt. after tmt. discont. tmt. may be re-initiat. under the same condit. with a satisfact. response.
The bottle should not be shaken before use.
Tmt. of proliferat. infantile haemangioma requiring system. ther.:
Life- or funct.-threatening haemangioma,
Ulcerated haemangioma with pain and/or lack of response to simple wound car measures, Haemangioma with a risk of permanent scars or disfigurement.
It is to be initiated in infants aged 5 wks.-5 mnths.
C/I: Premature infants, for whom the corrected age of 5 weeks has not been reached (the corrected age being calculated by subtracting the number of weeks of prematurity from the actual age). Breastfed infant., if the mother is treated with meds. contraindic. with propranolol. Hypersens. Asthma/hist. of bronchospasm. 2nd/3rd -degree AV blocks. Dis. of the sinus node (includ. sinoatrial block). Bradycardia below the follow. limits: child(0-3 mnths.) whose heart beat.=100, child(3-6 mnths.) whose heart beat.=90, child(6-12 mnths.) whose heart beat.=80. Low blood press. below the follow. limits: child(0-3 mnths.) whose blood press. (mmhg)=65/40, child(3-6 mnths.) whose blood press. (mmhg)=70/50, child(6-12 mnths.) whose blood press. (mmhg)=80/55.
β Blocker. Propranolol 10 mg, 40 mg. TABS: 50 x 10 mg, 40 mg.
Ang. pect., migraine proph., essent.
tremor: Initial: 40 mg 2-3 x dly, may
incr. grad. acc. pt. response. Usual dose
range for migraine & essent. tremor:
80-160 mg dly, range for tmt. of ang.
120-240 mg dly. Child: Migraine
proph.: Under 12 yrs.: 20 mg 2-3 x dly;
Over 12 yrs.: Adult dose.
HTN: recomm. initial dose 80 mg x 2
dly, may incr. grad. acc. pt. response.
Usual dose range: 160-320 mg dly.
Arrhythm., hypertroph. obstruct.
thyrotox. crises: 10-40 mg 3-4 x dly.
Pheochromocyt: (use only with an
alpha-blocker). Pre-op: 60 mg dly for 3
days; non-op malign: 30 mg dly. Child:
dosage to be individ. determ. 0.25-0.5
mg per kg bdy. Wt. 3-4 x dly, as reqd.
Post - M.I: Start 5-21 days aft. M.I:
Initial: 40 mg 4 x dly for 2-3 days, foll.
by total dly dose: 80 mg 2 x dly.
Elderly: treat with caution. treatment
should start with the lowest dose.
Optimum dose to be individ. determ.
acc. clinic. response.
Also see lit.
Managem. of ang. pect., control of
essent&renal HTN, control of essent. tremor,
control of most forms of cardiac dysrhythm.,
adj. in the managem. of
tachycardias&arrhythmias due to
thyrotoxicosis and thyrotoxic crises,
managem. of hypertroph. obstruct.
cardiomyopathy, managem. of
pheochromocytoma (with an alpha blocker).
Long term proph. after recovery from acute MI (tmt to be initiat. by a hospital physician),
C/I: Hypersens., Pt. or anyone in his family
are suffering/have suffered from: asthma
and/or wheezing, Pt. has suffered from:
uncontroll. heart failure, very slow or
irregular pulse, very low blood pressure,
severe blood circul. disturb., 2nd or 3d
degree heart block, Prinzmetal’s angina.
Cases of: untreated
acidosis, strict diet regimen or after
fasting. Pts. prone to develop
hypoglycemia. Also see lit.