Propranolol is an active component of Anaprilin. There are also tablets with the same name, which are needed for the treatment of diseases of the cardiovascular system. Anaprilin contains the following auxiliary elements that do not fulfill therapeutic goals:
- milk sugar;
- potato starch;
- calcium stearate.
“Anaprilin” refers to a group of adrenergic receptor blockers located in different parts of the human body: blood vessels, muscles of the heart, bronchi, uterus and prostate gland. The interaction of the drug with sensitive cells prevents the stimulating effect of the nervous system and endocrine glands, which explains the use in idiopathic tremor and endocrinological diseases.
In cardiological practice, the drug is most often prescribed to patients with coronary heart disease. The active substance helps to reduce myocardial oxygen demand and prevents remodeling (remodeling) of the heart muscle. The effectiveness of the drug in reducing mortality when consumed in the first hours after a heart attack has been proven.
The multidirectional effect of the drug on the structure of the body causes widespread use in medical practice. Instructions for use “Anaprilina” identifies the following indications for the appointment of a medication:
- essential (primary, idiopathic) arterial hypertension – a disease accompanied by persistent excess of normative indicators of pressure for no apparent reason;
- coronary heart disease (CHD) – a pathology that characterizes a violation of the blood supply to the myocardium with typical pain behind the sternum during exercise;
- angina pectoris – a chronic form of ischemic heart disease;
- hypertrophic cardiomyopathy – a pathology characterized by proliferation of muscle fibers, which reduces the volume of the heart chambers;
- rhythm disturbances: flutter or atrial fibrillation (atrial fibrillation), supraventricular tachycardia, extrasystoles;
- pheochromocytoma – a tumor of the adrenal tissue that synthesizes catecholamines (adrenaline, norepinephrine);
- essential tremor – “trembling” of the hands or other parts of the body for no apparent reason, family cases are more often recorded;
- alcohol withdrawal – a complex of disorders caused by abstinence in people with alcoholism;
- infantile hemangiomas – benign tumors of the vascular wall (more common in children);
- diffuse toxic goiter and thyrotoxicosis of another etiology (against the background of thyroiditis) – thyroid disease, accompanied by increased synthesis of hormones. Anaprilin is prescribed as a second-line drug.
In addition, the tool is used to prevent migraine attacks, panic attacks and deep anxiety.
The pattern of application of Anaprilin is determined by the age of the person, the disease and the severity of the pathology. Average therapeutic doses and frequency of administration of the drug are presented in the table.
|Disease||Form||Dose (in milligrams)||Multiplicity|
|Arterial hypertension||Tablets, capsules||40||2 times a day (with inefficiency – raise to 4)|
|Angina pectoris, rhythm disturbances||Tablets, capsules||20 – 2 weeks, with subsequent increase to 40||3 times a day|
|Post-infarction condition||Tablets, capsules||80||3 times|
|Paroxysmal arrhythmias, thyrotoxic crises||Solution for intravenous administration||1, after 2 minutes – again||In the absence of effect – enter, up to 10 times under the control of rhythm and pressure level|
|Migraine||Pills||40||3 times a day|
In obstetric practice, Anaprilin is used to stimulate the onset of labor and the prevention of hypotonic bleeding in the postnatal period. The dose of the drug is 20 mg 3 times a day for 3-5 days.
“Anaprilin” (the active substance is propranolol) is a drug that is used for long-term use and emergency care, therefore it is available in various forms for convenience.
|Form of issue||Propranolol Dose|
|Pills||10 and 40 mg|
|0,25% solution for intravenous administration of 1 mg||2,5 mg in ampoule|
|1% solution – 5 ml||5 mg in ampoule|
|Capsules depot of prolonged (long) action, which are used 1 time per day||80 mg|
Propranolol refers to non-selective (no selective effect on the cardiovascular system) beta-blockers without internal sympathomimetic activity, which leads to a wide range of therapeutic effects:
- Decreased heart rate (due to the effect on receptors in the myocardium).
- Reducing the oxygen demand of the heart muscle (this is how the antianginal effect of the drug is realized).
- Decrease in the total peripheral vascular resistance (with prolonged use). In the first 2 weeks there is an increase in the tone of smooth muscle fibers, respectively – indicators of diastolic blood pressure with subsequent stabilization and decrease.
- Increased tone of the smooth muscles of the bronchi (bronchospasm) and uterus (stimulation of labor).
- Depressive effect (the drug crosses the blood-brain barrier and has a direct effect on the centers in the brain).
- Slows down the processes of iodine metabolism in the body (inhibitory effect on the thyroid gland).
- Hypoglycemic effect: receptor blockade reduces the contra-effects of adrenaline and contributes to a drop in blood glucose (one of the contraindications of the drug is diabetes mellitus).
“Anaprilin” refers to the group of lipophilic beta-blockers that are rapidly and in high concentrations absorbed from the gastrointestinal tract. In the blood they combine with proteins: 95% of the drug is bound. The drug begins to act after 1 hour (when taking tablets), reaches a maximum concentration within 2 hours.
The duration of the effect of the tablet “Anaprilin” is 4-6 hours, which determines the frequency of administration of the drug.
The processes of metabolism and excretion occur in the liver, therefore, in patients with impaired hepatobiliary system function, lower doses of the drug are recommended due to the risk of accumulation and overdose. Less than 1% of the drug is excreted in the kidneys.
Undesirable consequences of the use of “Anaprilin” are associated with the accumulation of active metabolic products or administration against the background of contraindicated conditions:
- orthostatic hypotension – a drop in blood pressure when changing position from horizontal to vertical;
- bradycardia (slowing the pulse): the frequency reaches 40-50 per minute;
- allergic reactions: itchy rash, swelling;
- visual impairment (due to a decrease in the secretion of the lacrimal glands);
- dry tongue, nausea, vomiting, pain in the upper part and bloating, diarrhea;
- redness of the skin, hair loss, the appearance of psoriasis-like peeling;
- collapse – a decrease in vascular tone in the arteries of the brain with loss of consciousness;
- muscle weakness and numbness of the limbs;
- nasal congestion, bronchus or laryngospasm;
- hypoglycemia (in patients with diabetes, propranolol prolongs and enhances the action of insulin);
- headache, weakness, fatigue;
- sleep disorders (insomnia or pathological daytime sleepiness);
- conduction disorders: atrioventricular blockade.
The main symptoms of poisoning:
- severe bradycardia and a drop in blood pressure;
- loss of consciousness;
- difficulty breathing (noisy exhalation);
- cyanosis of fingers and toes (in children – faces);
- on the electrocardiogram: conduction disturbance in the AV node, frequent ventricular extrasystoles.
Toxic dose – individual for each person, depending on the state of the liver enzyme system and the presence of concomitant diseases. In most cases, symptoms of poisoning develop with the simultaneous use of more than 1 gram of the drug.
According to the instructions for use of the drug, alcohol is not recommended while taking Anaprilin. Toxic effects are due to:
- damage to the enzyme systems of the liver by products of ethanol metabolism, metabolic processes and drug excretion
- additional inhibitory effect on the central nervous system;
- alcohol causes tachycardia, an increase in blood pressure, which neutralizes the effect of “Anaprilin”;
- increased side effects of the drug (headache, weakness, nausea).
The compatibility of the drug with other substances that affect the nervous system is an increase in the depressive effect.
The dosage form for the release of Anaprilin is tablets. The active substance is propranolol, in 1 tablet its content reaches 10 or 40 mg. Auxiliary components: milk sugar, potato starch, calcium stearate, talc.
The composition of the drug includes the active substance propranolol, as well as additional substances: starch, milk sugar, calcium stearate, talc.
The active component propranolol inhibits β-1 and β-2 adrenergic receptors and thereby has a hypotensive, antiarrhythmic and antianginal effect. It also reduces the frequency and strength of heart contractions, cardiac output and reduces the oxygen demand of the heart muscle.
In addition, propranolol increases peripheral vascular resistance and lowers blood pressure. With the help of blockade of β-2 receptors, the tone of the bronchi increases, the contraction of the uterus increases, which has a beneficial effect on postpartum or postoperative bleeding and improves the motor and secretory functions of the digestive system.
This drug quickly enters the bloodstream. The half-life of propranolol is 3-5 hours, and with prolonged use it can reach 12 hours. The kidneys are the responsible authority for the release of propranolol. The substance is excreted in the form of metabolites (about 90%) and about 1% remains in its original form.
Anaprilin is well tolerated. However, side effects may occur, which include:
- agranulocytosis, leukopenia and thrombocytopenia from the hematopoietic system;
- malaise, dizziness and headache, depression, sleep problems, mental disorders, decrease in the speed of motor and psychomotor reactions from the nervous system;
- deterioration of blood circulation and the development of heart failure, obvious arterial hypotension and sinus bradycardia;
- decreased libido and decreased potency;
- rash, alopecia, itching and increased psoriasis;
- cough, pharyngitis, shortness of breath, laryngospasm and bronchospasm;
- soreness and dryness of the eyes, decreased vision, keratoconjunctivitis;
- dyspeptic symptoms (vomiting, nausea and diarrhea), pain in the epigastric part.
If these and other unwanted symptoms appear, you must immediately stop taking the drug and consult a doctor.
When taking Anaprilin, it is necessary to take into account the peculiarities of its interaction with other drugs.
- So, the effect of Anaprilin is enhanced when it is taken with reserpine, diuretics, antihypertensive ethanol, nifedipine, hydralazine and other antihypertensives.
- Anaprilin enhances the effect of uterotonizing and thyreostatic drugs, and also reduces the effect of antihistamines.
- When taking Anaprilin together with monoamine oxidase inhibitors, an increase in the hypotensive effect may occur, as a result of which their parallel use is contraindicated. The period between the reception of these funds should be at least 2 weeks.
- Anaprilin affects the effectiveness of insulin and oral hypoglycemic drugs, hides signs of the possible development of hypoglycemia (increased blood pressure and tachycardia)
- When taking the alkaloids of ergot and Anaprilin, the likelihood of malfunctions in the peripheral circulation increases.
- Taking the drug at the same time as rizatriptan increases its concentration in the blood, so a dosage reduction is required.
- Anaprilin increases the concentration of phenothiazine antipsychotics in blood plasma and lidocaine, and reduces theophylline clearance.
- When combined with diltiazem, verapamil and amiodarone, the effect of negative foreign, chrono- and dromotropic effects increases.
- Antipsychotic drugs (antipsychotics), tri- and tetracyclic antidepressants, hypnotics and sedatives, and ethanol increase the inhibitory effect of Anaprilin on the central nervous system.
- The antihypertensive effect of the drug weakens the effect of glucocorticoids, non-steroidal anti-inflammatory drugs (decreased synthesis of prostaglandins in the kidneys and sodium retention), estrogen (sodium retention);
- With the intravenous administration of iodine-containing radiopaque drugs, the possibility of developing anaphylactic reactions increases.
- Strengthening or development of bradycardia, heart failure, up to cardiac arrest and atrioventricular block is possible with methyldopa, guanfacin and reserpine along with Anaprilin.
- Means for inhalation anesthesia (derivatives of hydrocarbons) and phenytoin when administered intravenously together with Anaprilin increase the severity of the cardiodepressive effect and the likelihood of lowering blood pressure.
- Sulfasalazine and cimetidine increase the bioavailability of Anaprilin.
- Anaprilin prolongs the effect of the anticoagulant effect of coumarins and non-depolarizing muscle relaxants.
- The possibility of the appearance of such severe systemic reactions as anaphylaxis may increase with the combined use of Anaprilin and the introduction of allergens, which are used for skin tests or immunotherapy.
Anaprilin instructions for use refers to non-selective beta-blockers. It has antihypertensive, antianginal and antiarrhythmic effects. Due to the blockade of beta-adrenergic receptors, it decreases catecholamine-stimulated cAMP production from ATP, as a result of which it reduces the intracellular calcium ions, has a negative chrono-, dromo-, batmo- and inotropic effect (reduces heart rate, inhibits conduction and excitability, reduces myocardial contractility).
At the beginning of the use of beta-blockers, OPSS in the first 24 hours increases (as a result of a reciprocal increase in the activity of alpha-adrenergic receptors and the elimination of stimulation of beta2-adrenergic receptors in the vessels of skeletal muscles), but after 1-3 days it returns to its original state, and decreases with prolonged use.
The hypotensive effect is associated with a decrease in minute blood volume, sympathetic stimulation of peripheral vessels, a decrease in the activity of the renin-angiotensin system (important in patients with initial hypersecretion of the renin), the sensitivity of the aortic arch baroreceptors (there is no increase in their activity in response to a decrease in blood pressure) and the effect on CNS
The antihypertensive effect is stabilized by the end of the 2nd week of course appointment. The antianginal effect is due to a decrease in myocardial oxygen demand (due to the negative chronotropic and inotropic effect). A decrease in heart rate leads to an increase in diastole and an improvement in myocardial perfusion.
By increasing the final diastolic pressure in the left ventricle and increasing the stretching of the muscle fibers of the ventricles, it can increase the need for oxygen, especially in patients with chronic heart failure.
The antiarrhythmic effect is due to the elimination of arrhythmogenic factors (tachycardia, increased activity of the sympathetic nervous system, increased content of cAMP, arterial hypertension), a decrease in the rate of spontaneous excitation of sinus and ectopic pacemakers, and a slowdown in AV conduction.
Inhibition of impulse conduction is noted mainly in the antegrade and to a lesser extent in retrograde directions through the AV node and along additional paths. Belongs to the 2nd class of antiarrhythmic drugs. Reducing the severity of myocardial ischemia – due to a decrease in myocardial oxygen demand, post-infarction mortality can also be reduced due to antiarrhythmic action.
The ability to prevent the development of headaches of vascular genesis is due to a decrease in the severity of cerebral artery expansion due to beta-adrenoblock of vascular receptors, inhibition of platelet aggregation and lipolysis caused by catecholamines, decrease in platelet adhesion, prevention of blood coagulation factors during release of oxygen adrenaline and stimulation of tissue renin.
The decrease in tremor with the use of propranolol (the active substance of the drug Anaprilin) is mainly due to blockade of peripheral beta2-adrenergic receptors.
Increases atherogenic properties of blood. Enhances uterine contractions (spontaneous and caused by stimulants of the myometrium). Increases the tone of the bronchi. In high doses, it causes a sedative effect.
- chest pain;
- epigastric discomfort;
- nasal congestion;
- constipation or diarrhea;
- change in blood glucose concentration (hypo- or hyperglycemia);
- taste changes;
- skin rash;
- exacerbation of psoriasis symptoms;
- orthostatic hypotension;
- the manifestation of angiospasm (increased impairment of peripheral circulation, cooling of the lower extremities, Raynaud’s syndrome);
- psoriasis-like skin reactions;
- development (aggravation) of chronic heart failure;
- withdrawal syndrome (increased angina attacks, myocardial infarction, increased blood pressure);
- sinus bradycardia, AV block (up to the development of a complete transverse blockade and cardiac arrest);
- a decrease in blood pressure;
- reduced potency;
- sleepiness or insomnia;
- nausea, vomiting;
- thrombocytopenia (unusual bleeding and hemorrhage), leukopenia;
- decreased secretion of lacrimal fluid (dryness and soreness of the eyes);
- increased sweating.
Due to the possible sharp decrease in blood pressure, it is not recommended to take ethanol-containing agents during treatment. Anaprilin should not be taken together with tranquilizers and antipsychotics (antipsychotic drugs).
The antihypertensive effect of the drug is enhanced while taking reserpine, hydrochlorothiazide, hydralazine and other antihypertensive drugs, it is weakened when taking estrogens, non-steroidal anti-inflammatory drugs, MAO inhibitors (the interval between taking propranolol and monoamine oxidase inhibitors should not be less than 14 days).
Pharmacological group: Beta-blockers. It has hypotensive, antiarrhythmic and antianginal effects.
Bradycardia, atrioventricular block, bronchio spasm, development of Raynaud’s syndrome, heart failure, vomiting, muscle weakness, epigastric pain, vomiting, diarrhea, pruritus, depression, hypoglycemia in patients with insulin-dependent and an increase in blood glucose in patients with diabetes mellitus are noted. diabetes insulin-independent type, impaired vision, decreased potency.
Anaprilin mutually enhances the negative effect of diltiazem and verpamil on the myocardium, inhibits the excretion of lidocaine, and prolongs the duration of action of non-polarizing muscle relaxants. The antihypertensive effect is weakened while taking with glucocorticosteroids, estrogens, NSAIDs. The antihypertensive effect is enhanced by the use of nitrates.
Pharmacodynamics and pharmacokinetics
The main, active substance is propranolol. Anaprilin is a non-selective adrenergic blocker, it reduces the sympathetic effect on the beta-adrenergic receptors of the heart, reduces the frequency and strength of the heart contractions, reduces the contractile function of the myocardium, regulates the cardiac output, reduces the positive inotropic and chronotropic effect of catecholamines, reduces the heart’s oxygen demand, reduces arterial pressure.
When taken orally, the drug is rapidly absorbed and excreted from the body. The maximum peak content of the active substance in the blood plasma is recorded after 1 -1.5 hours. The drug crosses the fetoplacental barrier.
Instructions for use
Indications for the use of Anaprilin are: arterial hypertension, sinus tachycardia, angina pectoris, supraventricular tachycardia, unstable angina pectoris, atrial fibrillation (tachysystolic form), prevention of migraine attacks, sympathoadrenal crises, NDC. With arterial hypertension, the drug is effective in the initial stages of the disease, and therefore is used more often in young people (up to 40 years old).
A decrease in systolic pressure is accompanied by a decrease in heart rate, a decrease in the volume of cardiac output and stroke volume of the heart. With coronary heart disease, taking the drug reduces the number of angina attacks, increases resistance to physical activity. It is especially effective for concomitant arterial hypertension, arrhythmias.
Anaprilin is not prescribed for arterial hypotension, intolerance to components, heart failure, atrioventricular block, sinus bradycardia, sinoatrial block, diabetes mellitus, acute myocardial infarction, bronchial asthma, obliterating vascular diseases, metabolic acidosis, tendency to bronchospasm, rhinitis, vasom feeding.
The initial dosage for arterial hypertension is 40 mg, twice a day. A day no more than 320 mg.
In case of cardiac arrhythmias, angina pectoris: 20 mg three times a day with a gradual increase in dose to 120 mg for 2-3 doses.
How to take for the prevention of migraine and with essential tremor? First, 20 mg of the drug is prescribed 2-3 times a day, then the dose can be adjusted to 160 mg.
According to the instructions for the use of Anaprilin in the pathology of the renal system, dosage adjustment is not required.
With an overdose of the drug, the following manifestations are possible: convulsions, arrhythmia, dizziness, bradycardia, bronchospasm, heart failure, acrocyanosis, shortness of breath. Gastric lavage and the use of absorbent substances are required.
An overdose of the drug together with the use of alcohol may result in death.
Anaprilin is taken 10-30 minutes before a meal, washed down with a sufficient amount of liquid. Doses and frequency of administration are established depending on the underlying and concomitant diseases, the age of the patient. The duration of the course of treatment is also determined by the doctor. On average, the duration of treatment of cardiovascular pathologies is 3-4 weeks.
According to indications, the course can be repeated. The interval between therapeutic courses should be 1-2 months. Below are the average recommended dosages of Anaprilin for adults according to the instructions for use of the drug.
With arrhythmias, 10-30 mg are prescribed 3-4 times a day.
With arterial hypertension, the initial dose of the drug is 160 mg (80 mg twice a day). If necessary, the dose can gradually be increased to 320 mg per day.
With migraine, the daily dosage of Anaprilin is from 80 mg to 160 mg.
With angina pectoris, the first three days, the drug is taken at 20 mg four times a day, in the next three days the dose is increased to 40 mg three times a day and 20 mg in the fourth dose. From the seventh day, the drug is taken at 40 mg four times a day. If necessary, increase the dose to 200 – 240 mg per day (40 mg 5-6 times a day).
After myocardial infarction, Anaprilin is taken at 160 mg per day (40 mg 4 times a day).
- acute heart failure;
- lactation period;
- AV blockade 2 and 3 degree;
- cardiogenic shock;
- hypersensitivity to propranolol and other components of the drug Anaprilin, from which tablets can cause side effects;
- chronic heart failure 2B-3 stage;
- sinoatrial blockade;
- arterial hypotension (systolic blood pressure less than 90 mm Hg, especially with myocardial infarction);
- sick sinus syndrome;
- age up to 18 years (safety and efficacy of the drug for this age group have not been established);
- bradycardia (heart rate less than 55 beats/min).
What helps Anaprilin from? Acceptance of this drug is necessary for the following diseases and conditions:
- pheochromocytoma (used together with α-blockers);
- violation of the heart rhythm due to rheumatic heart disease (tachyarrhythmia, paroxysmal and sinus tachycardia, arrhythmia);
- thyrotoxicosis (for additional therapy);
- cardiac ischemia;
- cardiac glycoside poisoning, including digitalis preparations;
- angina pectoris.
Anaprilin is prescribed for the prevention of migraine and with prolonged prophylactic treatment after myocardial infarction.
Anaprilin should be taken 10-30 minutes before a meal, drinking plenty of fluids. The dosage of the drug and the duration of administration depend on the disease and the patient’s age. Typically, therapy of cardiovascular pathologies is carried out in 3-4 weeks.
Below are the average dosages of the drug based on the instructions of Anaprilin for an adult patient:
- with migraine – 80-160 mg per day.
- with arrhythmia – 10-30 mg 3-4 times a day.
- with angina pectoris in the first 3 days – 20 mg 4 times a day. In the next 3 days, the dosage can be increased to 40 mg 3 times a day, and the fourth dose can be 20 mg. Starting from the seventh day, the medicine should be taken at 40 mg 4 times a day. If there is such a need, the daily dose can be increased to 200–240 mg (40 mg 5–6 times a day). After myocardial infarction, Anaprilin is taken at 160 g per day, at a dose of 40 mg 4 times.
- with arterial hypertension – 160 mg per day (80 mg 2 times a day). The dosage may be gradually increased to 320 mg per day.
The drug is prescribed for children over 3 years of age with a dose of 0,25-0,5 mg per 1 kg of weight according to the doctor’s clear instructions. You need to take the drug 3-4 times a day.
Anaprilin is contraindicated in the following cases:
- cardiogenic shock;
- impaired peripheral circulation;
- intolerance to the components of the drug;
- tendency to bronchospasm and asthmatic disease;
- hay fever;
- complete or incomplete atrioventricular block;
- sinus bradycardia;
- acute myocardial infarction;
- uncontrolled heart failure;
- acidosis, including sugar ketoacidosis;
- spastic colitis;
- chronic liver disease.
Reception during pregnancy and lactation
The drug is contraindicated in pregnancy and lactation.
The drug is prescribed only if the intended benefit for the woman exceeds the potential risk to the fetus. During the use of Anaprilin, strict monitoring of the fetus is required. 3 days before the birth, the drug must be canceled.
Possible negative effects on the fetus: bradycardia, hypoglycemia, intrauterine growth retardation. Also, the drug can cause fetal death or premature birth.
The active substance is absorbed into breast milk, therefore, lactating women during treatment need to cancel breastfeeding.
- Anaprilin is prescribed for pregnant women if the benefit to the woman is higher than the possible risk to the fetus.
- When taking the drug, it is necessary to constantly monitor the condition of the child.
- 3 days before birth, funds should be stopped.
- Against the background of taking the drug by the mother, the child may experience hypoglycemia, intrauterine growth retardation and bradycardia. In addition, there is a risk of premature birth or even fetal death.
The active component of the drug enters the body of the child during lactation. Women should not take Anaprilin when breastfeeding.
Cost and terms of leave from pharmacies
In a dark, dry place inaccessible to children.
The price of 50 tablets of Anaprilin 10 mg each – from 17 rubles.
A prescription for the purchase of this drug is not needed.
There are contraindications. Specialist consultation required
The average price of Anaprilin (tablets 40 mg No. 50) in Moscow is 22 rubles. In Kiev, you can buy medicine for 38 hryvnias, in Kazakhstan – for 110 tenge. In Minsk, pharmacies offer medicine for 0,5 bel. rubles. Available from pharmacies with a prescription.
According to the action of the active component, the following analogues of Anaprilin can be distinguished
Detonic – a unique medicine that helps fight hypertension at all stages of its development.
The complex effect of plant components of the drug Detonic on the walls of blood vessels and the autonomic nervous system contribute to a rapid decrease in blood pressure. In addition, this drug prevents the development of atherosclerosis, thanks to the unique components that are involved in the synthesis of lecithin, an amino acid that regulates cholesterol metabolism and prevents the formation of atherosclerotic plaques.
Detonic not addictive and withdrawal syndrome, since all components of the product are natural.
Detailed information about Detonic is located on the manufacturer’s page.