Generic drug of the therapeutic class: Cardiology and angiology
active ingredients: Propranolol
Box of 90
- Prophylaxis of stress angina attacks;
- long-term treatment after myocardial infarction;
- Treatment of certain rhythm disorders: supraventricular (tachycardias, flutters and atrial fibrillations, junctional tachycardias) or ventricular (ventricular extrasystoles, ventricular tachycardias);
- Cardiovascular manifestations of hyperthyroidism and intolerance to replacement therapy for hypothyroidism;
Functional signs of obstructive cardiomyopathy;
- Background treatment of migraine;
- Prevention of gastrointestinal bleeding by rupture of oesophageal varices (primary prevention) and their recurrence (secondary prevention) in patients with cirrhosis: the prevention of a first rupture of oesophageal varices is limited to patients with portal hypertension, among whom endoscopic examination reveals oesophageal varices of intermediate or large size (stage II or III).
Dosage AVLOCARDYL LP 160 mg Prolonged-release capsule Box of 90
- Hypertension, prophylaxis of effort angina attacks, obstructive cardiomyopathy:
One capsule a day, preferably taken in the morning, whatever the indication (for myocardial infarction, migraine and digestive hemorrhages of the cirrhotic: see below).
However, in some patients it may be necessary to increase the dosage up to two capsules per day. In some hypertensives, it may be possible to combine another antihypertensive or a diuretic.
- Long-term treatment after myocardial infarction:
. Initial treatment : it should be instituted between the 5th and the 21st day after the acute episode of infarction; 1 40 mg tablet 4 times daily for 2 to 3 days.
. Maintenance treatment : 1 LP capsule, or 160 mg per day.
- Migraines, rhythm disorders, hyperthyroidism:
Since active doses may vary from one patient to another, and doses below 160 mg are most often effective, treatment with the conventional release form should be started.
- Primary and secondary prevention of gastrointestinal bleeding by rupture of oesophageal varices in cirrhotic patients:
The treatment will generally be instituted at the dose of 160 mg per day: a hard capsule extended release 160 mg in the morning.
The dosage will then be adapted to each patient using, if appropriate, the 40 mg tablet: the heart rate, the decrease of which should be about 25%, is particularly important.
- Hypersensitivity to propranolol,
- chronic obstructive pulmonary disease and asthma: non-selective beta-blockers are formally contraindicated in asthmatics (even if the asthma is old and not currently symptomatic, whatever the dosage),
- heart failure not controlled by treatment,
- cardiogenic shock,
- atrioventricular blocks of the second and third degrees not paired,
- angina of Prinzmetal,
- sinus disease (including sinoatrial block),
- bradycardia (<45-50 beats per minute),
- Raynaud's phenomenon and peripheral arterial disorders,
- untreated pheochromocytoma,
- low blood pressure,
- history of anaphylactic reaction,
- combination with floctafenine, sultopride (see interactions),
- in the context of the primary and secondary prevention of digestive hemorrhages in cirrhotic patients: advanced hepatic insufficiency with hyperbilirubinemia, massive ascites, hepatic encephalopathy,
- predisposition to hypoglycaemia (such as after fasting or abnormal response to hypoglycaemia).
NOT RECOMMENDED :
- This drug is generally not recommended when breastfeeding: beta-blockers are excreted in the milk. The occurrence of hypoglycemia and bradycardia has been described for some beta-blockers with low plasma protein binding. As a result, breastfeeding is not recommended if treatment is needed.
- The combination of propranolol with calcium antagonists (diltiazem, verapamil, bepridil) is not recommended (see interactions).
Adverse effects Avlocardyl LP
The following adverse reactions, presented by frequency and organ class were reported:
- Frequent (1 - 9.9%):
. General : asthenia.
. Cardiovascular disorders : bradycardia, extremity cooling, Raynaud's syndrome.
. Central nervous system disorders : insomnia, nightmares.
- Uncommon (0.1 - 0.9%):
Digestive disorders : gastralgia, nausea, vomiting, diarrhea.
- Rare (0.01 - 0.09%):
. General : dizzying sensations.
. Hematopoietic system : thrombocytopenia.
. Cardiovascular disorders : Heart failure, atrioventricular conduction slowing or intensification of an existing atrioventricular block, orthostatic hypotension may be associated with syncope, worsening of existing intermittent claudication.
. Central nervous system disorders : hallucinations, psychoses, mood changes, confusion, impotence.
. Cutaneous system : purpura, alopecia, psoriasiform eruptions, exacerbation of psoriasis, skin rash.
. Neurological disorders : paresthesia.
. Vision : dry eye, disturbed vision.
. Respiratory system : Bronchospasm may occur in patients with asthma or a history of asthma, sometimes with a fatal outcome.
- Very rare (<0.01%):
. Endocrine system : hypoglycaemia in subjects at risk (see section on warnings and precautions for use).
. At the biological level : it has been observed in rare cases, the appearance of antinuclear antibodies accompanied only exceptionally with clinical manifestations type of lupus syndrome and giving way to the cessation of treatment.
. Nervous system : isolated cases of myasthenia gravis or exacerbation have been reported.