Calcium antogonists (includ verapramil, diltiazem, nefedipine) digoxin ( increased risk of bradycardia) catecholamine depleting agents Antiarrhytmic agents, amiodarone, alcohol, CNS depressants, diuretics, clonidine, reserpine,

ACE inhibitors, alpha blockers other antihypertensives Sympathomimetics, isoproternol,dobutamine, ergotamine, quinidine, dihydroergotamine, propafenone, hydralyzine, MAOIs , chlorpromazine,cimetidine, lidocaine, theophylline, antipyrine, ephinephrine warfarin, antispychotics, TCADs , moxisylate, fluvoxamine, erythromycin, Insulin/oral hypoglycemics, antimalarials, local anethestics, May interfere with glaucoma screening tests

Essentional and renal hypertension

Hypotension, bradycardia, CHF , Angina, cold extremities, headaches, dreams, GI disturbances, Pharyngitis, brochospasm,

Peripheral neuritis, paralytic ileus, blood dycrasias, Fatigue, dizziness, depression, agranulocytosis, Hypoglycemia, eye reactions, Cutaneous reactions including Stevens-Johnson syndrome, toxic epidermal necrosis,

Exfoliative dermatitis, erythema multiforme, rash and urticaria, Increased AV block, cardiac arrhythmias, Reynauds phenomenon Sexual dysfunction, dyspnoea, parathesia, peripheral neurpathy, Arthalgia, myopathy, diabetes,

Intrauterine growth retardation, small placentas, and Congenital abnormalities in neonates whose mothers received propranolol during pregnancy Sports events- restricted/banned

Bronchial spasm, COPD, history of bronchospasm 2nd or 3rd degree heart block, Congestive cardiac failure, Acute myocardial infarction, right ventricular hypertrophy

Sick sinus syndrome, severe bradycardia, Shock, hypotension, allergic disorders, Severe periphreal arterial disease, Idiopathic SLE Aortic or mitral stenosis Pregnancy

Special precautions-

Lactation

First degree heart block     Renal or hepatic impairment

Surgery, diabetes, hyperthyroidism Alcoholic cardiomyopathy

. Peripheral arterial circulatory disorder Heart failure Prinzmetal angina Psoriasis Withdraw gradually Elderly

Essential and renal hypertension

Dosage-

Initially 1 tablet 1-2 times daily and gradually increased till optimum response is obtained

Contraindicated for use during pregnancy and laction. Observe caution if use is needed