Alum Hydrox gel , ethanol reduce propranol absorption Cimetidine inhibits propranolol hepatic clearance Propranolol reduces theophylline clearance

Concurent steroid use may cause hypokalemia Exagerrated hypotension with catecholamine depletors and other antihypertensives

NSAIDs blunt antihypertensive effect

Insulin requirement in diabetes may be altered

Hyperetension

Hypotension, intensification of AV block, bradycardia, paraesthesia, depression, vivid dreams Visual disturbances, fatigue, lethargy, Nausea, epihgastric distress, Constipation, diarrhoea Airway resistence, impotence, alopecia, Agranulocytosis, purpura, fever,

Photosensitivity, Masking of hypoglycemic symptoms Hyperuricemia, pancreatitis may occur Severe hypotension

Cardiogenic shock, sinus bradycardia, & > first degree block, Bronchisal asthma, CHF ( unless the failure is secondary to tacharrhythmias treatable with propranolol Anuria patients, hyperesensitivity to either component and sulfonamide therapy

Special precautions-

Avoid abrupt discontinuation of therapy, diabetes mellitus, Thyrotoxicosis, renal/hepatic impairment, beta blockade may intefere with glaucoma screening test Monitor serum electrolytes periodically

Pregnancy Lactation

Hypertension

Dosage-

Start with 1/2 tablet . Increase gradually as required up to a max of 4 tabs daily

Use during pregnancy and lactation contraindicated. Observe caution if requiredto be used.