WARNING: CARDIAC ISCHEMIA AFTER ABRUPT DISCONTINUATION
Following abrupt discontinuation of therapy with beta-blockers, exacerbations of angina pectoris and myocardial infarction have occurred.
When discontinuing chronically administered INNOPRAN XL, particularly in patients with ischemic heart disease, gradually reduce the dose over a period of 1-2 weeks and monitor the patients. If angina markedly worsens or acute coronary insufficiency develops, promptly resume therapy, at least temporarily and take other measures appropriate for the management of unstable angina. Warn patients against interruption or discontinuation of therapy without physician’s advice.
Because coronary artery disease is common and may be unrecognized, avoid abrupt discontinuation of INNOPRAN XL therapy even in patient treated only for hypertension. (5.1)
INNOPRAN XL SUMMARY
INNOPRAN XL contains propranolol hydrochloride, a nonselective, beta-adrenergic receptor-blocking agent for oral administration, as an extended- release product. INNOPRAN XL is available as 80 mg and 120 mg capsules which contain sustained-release beads. Each of the beads contains propranolol hydrochloride and is coated with dual membranes. These membranes are designed to retard release of propranolol hydrochloride for several hours after ingestion followed by the sustained release of propranolol.
INNOPRAN XL® is indicated for the treatment of hypertension, to lower blood pressure. Lowering blood pressure reduces the risk of fatal and nonfatal cardiovascular events, primarily strokes and myocardial infarctions. These benefits have been seen in controlled trials of antihypertensive drugs from a wide variety of pharmacologic classes, including beta-blockers.
Control of high blood pressure should be part of comprehensive cardiovascular risk management, including, as appropriate, lipid control, diabetes management, antithrombotic therapy, smoking cessation, exercise, and limited sodium intake. Many patients will require more than one drug to achieve blood pressure goals. For specific advice on goals and management, see published guidelines, such as those of the National High Blood Pressure Education Programs Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC).
Numerous antihypertensive drugs, from a variety of pharmacologic classes and with different mechanisms of action, have been shown in randomized controlled trials to reduce cardiovascular morbidity and mortality, and it can be concluded that it is blood pressure reduction, and not some other pharmacologic property of the drugs, that is largely responsible for those benefits. The largest and most consistent cardiovascular outcome benefit has been a reduction in the risk of stroke, but reductions in myocardial infarction and cardiovascular mortality also have been seen regularly.
Elevated systolic or diastolic pressure causes increased cardiovascular risk, and the absolute risk increase per mm Hg is greater at higher blood pressures, so that even modest reductions of severe hypertension can provide substantial benefit. Relative risk reduction from blood pressure reduction is similar across populations with varying absolute risk, so the absolute benefit is greater in patients who are at higher risk independent of their hypertension (for example, patients with diabetes or hyperlipidemia), and such patients would be expected to benefit from more aggressive treatment to a lower blood pressure goal.
Some antihypertensive drugs have smaller blood pressure effects (as monotherapy) in black patients, and many antihypertensive drugs have additional approved indications and effects (e.g., on angina, heart failure, or diabetic kidney disease). These considerations may guide selection of therapy.
Media Articles Related to Innopran XL (Propranolol)
Pharmacists help patients with hypertension
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If you have hypertension, it pays to include a pharmacist in a medical care team.
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Source: Hypertension News From Medical News Today [2015.07.09]
Plastic food containers and wraps containing phthalates were associated with hypertension and insulin resistance in two new studies investigating the chemicals.
Hypertension, high cholesterol, other heart disease risk factors increasing In Asia
Source: Cholesterol News From Medical News Today [2015.07.07]
Research efforts, data collection vital to improved treatmentThe prevalence of cardiovascular risk factors like hypertension, high cholesterol, and diabetes have been decreasing in the United...
Two new studies on the connection between hypertension and cognitive decline
Source: Hypertension News From Medical News Today [2015.07.03]
With the number of individuals affected by cognitive decline expected to rise over the next few decades, investigating its potential causes is of major public health interest.
Source: MedicineNet Cirrhosis Specialty [2015.05.29]
Title: Portal Hypertension
Category: Diseases and Conditions
Created: 1/31/2005 12:00:00 AM
Last Editorial Review: 5/29/2015 12:00:00 AM
Published Studies Related to Innopran XL (Propranolol)
The study of antiarrhythmic medications in infancy (SAMIS): a multicenter,
randomized controlled trial comparing the efficacy and safety of digoxin versus
propranolol for prophylaxis of supraventricular tachycardia in infants. 
CONCLUSIONS: There was no difference in SVT recurrence in infants treated with
Status of propranolol for treatment of infantile hemangioma and description of a randomized clinical trial. [2011.10]
OBJECTIVES: Our primary objective was to review the current use of propranolol for treatment of infantile hemangioma (IH), specifically regarding 1) the age at initiation of therapy, 2) the method of initiation, 3) the use of other adjuvant therapy, 4) the duration of therapy and relapse rate, 5) the adverse events, and 6) the outcome. Our secondary objective was to describe a randomized, controlled, single-blinded trial comparing propranolol to prednisolone for treatment of IH... CONCLUSIONS: Propranolol is an attractive alternative to other treatments for IH. Despite apparent widespread use of this medication, the data are limited, and prospective studies are lacking for this indication. The relatively high rate of adverse effects supports the need for careful monitoring of patients on this therapy. Fastidious reporting of adverse events and objective evaluation of early and late outcomes are necessary to improve our understanding of the use of propranolol for this indication.
A randomized controlled trial of propranolol for infantile hemangiomas. [2011.08]
OBJECTIVE: Propranolol hydrochloride is a safe and effective medication for treating infantile hemangiomas (IHs), with decreases in IH volume, color, and elevation... CONCLUSION: Propranolol hydrochloride administered orally at 2 mg/kg per day reduced the volume, color, and elevation of focal and segmental IH in infants younger than 6 months and children up to 5 years of age.
Endoscopic variceal band ligation compared with propranolol for prophylaxis of first variceal bleeding. [2011.04]
Administration of nonselective beta-blockers in prophylaxis of first variceal bleeding is not suitable for all patients. Thus, we evaluated endoscopic variceal band ligation (EVBL) in primary prevention of bleeding in patients with cirrhosis and large esophageal varices... In conclusion, EVBL was an effective and safe alternative to propranolol in primary prophylaxis of bleeding in patients with large esophageal varices.
Effect of propranolol on word fluency in autism. [2011.03]
OBJECTIVE AND BACKGROUND: Autism is characterized by repetitive behaviors and impaired socialization and communication. Preliminary evidence showed possible language benefits in autism from the beta-adrenergic antagonist propranolol. Earlier studies in other populations suggested propranolol might benefit performance on tasks involving a search of semantic and associative networks under certain conditions. Therefore, we wished to determine whether this benefit of propranolol includes an effect on semantic fluency in autism... CONCLUSIONS: Results are consistent with a selective beneficial effect of propranolol on flexibility of access to semantic and associative networks in autism, with no observed effect on phonological networks. Further study will be necessary to understand potential clinical implications of this finding.
Clinical Trials Related to Innopran XL (Propranolol)
Corticosteroids With Placebo Versus Corticosteroids With Propranolol Treatment of Infantile Hemangiomas (IH) [Recruiting]
This is a prospective randomized, double-blind study to compare the clinical efficacy of
infantile hemangioma treatment using propranolol with corticosteroids as compared to therapy
with corticosteroids and placebo. We hypothesize that a two-month treatment period with
propranolol plus corticosteroids is more effective at reducing infantile hemangioma size and
vascularity when compared to corticosteroids used without propranolol for the same time
TRAUMA HELP: Healing and Analgesia With Propranolol [Recruiting]
The purpose of this study is to determine whether propranolol can decrease pain symptoms in
a common subset of patients admitted to a trauma center after injury.
Study of Propranolol as Anti-Adhesive Therapy in Sickle Cell Disease (SCD) [Recruiting]
An open label, prospective, randomized cross-over phase II study in up to 60 sickle cell
patients who are either homozygous for Hb S or have HbSB0 thalassemia. Initially, each
patient will be treated for 6 weeks with placebo or a standard dose of propranolol (40 mg)
every 12 hrs. This will be followed by a 2-week washout period after which, patients will
receive the other treatment modality (placebo or propranolol).
We Hypothesize that propranolol administered in vivo on a daily basis for 6 weeks (1) will
decrease baseline adhesion to endothelial cells and will substantially abrogate
epinephrine-stimulated adhesion to endothelial cells, as measured in vitro; (2) will improve
biomarkers of endothelial activation and dysfunction; and (3) can be safely used in patients
with SCD. Thus, the use of propranolol in SCD may represent a safe and effective means of
anti-adhesive therapy in SCD.
• To establish the safety and efficacy of long-term therapy with propranolol as an
anti-adhesive therapy for SCD.
• To evaluate changes in soluble markers of endothelial activation and dysfunction.
Correlative Science Objective:
• To determine whether response to propranolol therapy is associated with polymorphisms in
genes encoding the proteins involved in the upregulation of SS RBC adhesion by epinephrine.
Burn Healing and Analgesia With Propranolol [Recruiting]
The purpose of this study is to determine whether propranolol can decrease pain symptoms in
a common subset of patients admitted to a burn center after thermal burn.
Oral Propranolol Versus Placebo for Early Stages of Retinopathy of Prematurity: A Randomized and Prospective Study [Recruiting]
In premature infants, propranolol (Prop) treatment might suppress continuing NV and
decelerate the progression of retinopathy of prematurity (ROP) towards its severe stages
(III-V), thus avoiding the need of interventions (CRYO and/or LASER photo-coagulation of the
ischemic retina and preventing severe ocular sequelae. We therefore plan to prospectively
investigate the influence of prop versus placebo in VLBW infants with ROP stage 1 (zone I),
with stage 2 or higher (any zone) or with Plus disease, along with close follow up regarding
safety of prop administration and its effect on ROP.
Page last updated: 2015-07-31