Generic Inderal LA (Ciplar-LA tablets) – Product Information
Generic Inderal LA (Ciplar-LA tablets) are used in the treatment of Hypertension, Angina Pectoris Due to Coronary Atherosclerosis, Migraine prophylaxis, Management of Essential Tremor, Relief of situational anxiety and generalised anxiety, particularly those of somatic type, Adjunctive management of thyrotoxicosis, Prophylaxis of upper gastro-intestinal bleeding in patients with portal hypertension and esophageal varices and Hypertrophic subaortic stenosis. Ciplar-LA tablets are manufactured by Cipla Ltd. in the strengths of 40 mg and 80 mg.
Active Ingredient present in Ciplar LA Tablets
The active ingredient present in Ciplar-LA tablets is Propranolol Hydrochloride. Each Ciplar-LA tablet contains 40 mg or 80 mg of Propranolol Hydrochloride.
Uses of Generic Inderal LA (Ciplar-LA by Cipla)
Generic Inderal LA is used to treat tremors, angina (chest pain), hypertension (high blood pressure), heart rhythm disorders, and other heart or circulatory conditions. Ciplar-LA tablets are also used to treat or prevent heart attack and to reduce the severity and frequency of migraine headaches.
Propranolol Mechanism of Action
The mechanism of the antihypertensive effect of Propranolol tablets has not been clearly established. Among the reasons that can be involved in contributing to the antihypertensive action of Ciplar-LA tablets are: (1) decreased cardiac output, (2) inhibition of renin release by the kidneys, and (3) diminution of tonic sympathetic nerve outflow from vasomotor centers in the brain. Despite the fact that total peripheral resistance may increase initially, it readjusts to or below the pretreatment level with chronic use.
Propranolol LA Tablets (Ciplar-LA) – Dosage
Ciplar-LA provides Propranolol HCl in the form of a sustained-release tablet for once daily administration. The dose of Propranolol LA tablets (Ciplar-LA) should be individualized based on response due to the variable bioavailability of Propranolol. Retitration may be necessary in patients switching over from Ciplar tablets so as to maintain effectiveness at the end of the 24-hour dosing interval. The starting adult dosage for the treatment of various indications is given below.
The recommended starting dosage is 80 mg of Propranolol LA tablets (Ciplar-LA) once daily, whether used alone or added to a diuretic. Dosage may be increased gradually to 120 mg once daily or higher until adequate blood pressure control is achieved. The usual maintenance dosage is 120 mg to 160 mg once a day. The time needed for complete hypertensive response to a given dosage is variable and may range from a few days to several weeks.
The recommended total daily dosage of Propranolol LA tablets is 80 mg when administered orally, once a day. The dosage of Ciplar-LA should be gradually increased at three-to seven-day intervals until optimal response is obtained. The average optimal dosage for most patients appears to be 160 mg once daily. If treatment has to be discontinued, the dosage has to be gradually reduced over a period of several weeks.
The recommended starting dose of Propranolol tablets is 80 mg daily once a day. The usual effective dose range is 160 mg to 240 mg once a day. The dosage may be increased gradually to achieve optimum migraine prophylaxis. If a satisfactory response is not obtained within four to six weeks after reaching the maximal dose, treatment with Ciplar-LA tablets should be stopped.
Essential Tremor and Thyrotoxicosis:
The initial dosage of Propranolol LA tablets (Ciplar-LA) is 80 mg once daily, taken either morning or evening. Optimum reduction of essential tremor is usually achieved with a dose of 80 mg once daily. Occasionally, it may be necessary to increase the dose to 160 mg once daily and also may be increased to 240 mg once daily only if required.
Hypertrophic Subaortic Stenosis:
The usual dosage is 20 mg to 40 mg Ciplar three or four times daily before meals and at bedtime.
Situational and Generalised Anxiety:
The usual dosage is 80 mg Ciplar-LA once daily which should be enough to provide short-term relief of acute situational anxiety. Generalised anxiety, that requires longer term therapy, usually responds adequately at the same dosage. In individual cases, the dosage may be increased to 160 mg/day. Treatment should be continued as per response of the individual patient.
How to Use Generic Inderal LA (Ciplar-LA tablets)
Take Generic Inderal LA exactly as it was prescribed for you. Do not take the medication in larger amounts or for longer than recommended by your doctor. Hypertension often has no symptoms, so you may not even feel that you have high blood pressure. Continue using this medicine as directed, even if you feel well. You may need to use blood pressure medication for the rest of your life.
Take this medicine with a full glass of water at the same time every day. Do not crush, chew, break, or open an extended-release capsule. Swallow the pill whole. It is specially made to release the medicine slowly in the body. Breaking or opening the pill would cause too much of the drug to be released at one time.
Do not skip any doses or stop taking this medicine without first talking to your doctor. Stopping suddenly may make your condition worse. If you miss a dose, take the missed dose as soon as you remember. If your next dose is less than 8 hours away, skip the missed dose and take the medicine at the next regularly scheduled time. Do not take extra medicine to make up the missed dose.
Your blood pressure will need to be checked on a regular basis to be sure this medicine is helping your condition. It is important that you do not miss any scheduled visits to your doctor.
If you need to have any type of surgery, tell the surgeon that you are using this medicine. You may need to briefly stop using it before having surgery.
This medicine is only part of a complete program of treatment for hypertension that may also include diet, exercise, and weight control. Follow your diet, medication, and exercise routines very closely if you are being treated for hypertension.
Propranolol LA tablets Side effects
The side effects of Propranolol LA tablets (Ciplar-LA) are given below. Get emergency medical help if you have any signs of an allergic reaction including: hives, difficulty breathing, and swelling of your face, lips, tongue, or throat.
Call your doctor at once if you have any of these serious side effects:
• fast, slow, or uneven heartbeats
• feeling light-headed, fainting
• feeling short of breath, even with mild exertion
• swelling of your ankles or feet
• fever, sore throat, and headache with a severe blistering, peeling, and red skin rash;
• nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes)
• depression, confusion, hallucinations
• cold feeling in your hands and feet
Less serious side effects of Propranolol Hydrochloride LA tablets may include:
• nausea, vomiting, diarrhea, constipation, stomach cramps
• decreased sex drive, impotence, or difficulty having an orgasm
• sleep problems (insomnia)
• tired feeling
Overdose symptoms may include slow or uneven heartbeats, dizziness, weakness, or fainting. This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effects.
Propranolol LA Contraindications
The contraindications of Propranolol LA Tablets (Ciplar-LA) are given below.
- Hypersensitivity to Propranolol Hydrochloride or any inactive ingredient present in Ciplar-LA tablets.
- Cardiogenic shock
- Sinus bradycardia and greater than first degree block
- Bronchial asthma or bonchospasm
Warnings & Precautions When Using Generic Inderal LA (Ciplar-LA tablets)
You should not take Generic Inderal LA tablets if you are allergic to propranolol (the active ingredient) or if you have asthma or certain heart conditions, especially second or third degree heart block. You may need a dose adjustment or special tests to safely use this medication if you have certain specific conditions.
Before taking this medicine, tell your doctor if you have:
• bronchitis, emphysema, or other breathing disorders
• low blood pressure
• a heart problem such as heart block, sick sinus syndrome, slow heart rate, or congestive heart failure
• liver or kidney disease
• a thyroid disorder
• problems with circulation (such as Raynaud’s syndrome)
Avoid drinking alcohol. It may increase your blood levels of this medicine.
Propranolol During Pregnancy and Breastfeeding
Propranolol has been classified by the US FDA as pregnancy category C. Propranolol LA tablets may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. It is not known whether this medicine passes into breast milk or if it could harm a nursing baby. Do not use this medicine without telling your doctor if you are breast-feeding a baby.