Cardiology | Antiarrhythmic Drug Guide | Class II | Propranolol

Propranolol

IV Dose 0.02 mg/kg every 5 min to 0.1 mg/kg total dose.
Oral dose 2 mg/kg/day divided q 6 hours to start. Increase routinely to 5 mg/kg/day. May in rare circumstances go to 14 mg/kg/day, watching levels. Inderal LA should be given BID in children
Levels 25-150 nanograms/ml for beta blockade. 150-1000 ng/ml for control of VT.
Kinetics Large first-pass metabolism in liver. Elimination half-life 4-6 hours. (T 1/2 of 4-hydroxy-P 5.2-7.5 hours, active). Peak levels at 2-3 hours after oral dose.
Cautions Contraindicated in asthma, congestive heart failure. Beware hypoglycemia in infants and diabetics
Interactions Levels increased by cimetidine. Contraindicated with verapamil, due to synergistic negative inotropic effect and cardiovascular collapse Increases hepatic lidocaine metabolism.
Preparations Inderal scored tabs: 10, 20, 40, 60, 80, 90 mg. Inderal LA capsules: 60, 80, 120, 160 mg. Inderal injection, 1 mg/1 ml ampules
FDA approval in children yes

Return to Antiarrhythmic Drug Guide page

© 2019 by Washington University in St. Louis
One Brookings Drive, St. Louis, MO 63130