Propranolol
Propranolol Hydrochloride
También conocido como: Inderal LA · InnoPran XL · Syprol · AY-64043 · ICI-45520 · NSC-91523 · propranololi hydrochloridum · Propranolol hydrochloride
Revisado por el equipo veterinario de VetSheetActualizado 5 abr 2026Referencia veterinaria basada en la evidencia
Evidencia posológica v13 auditada
Evidencia estructurada para el cálculoHypertrophic cardiomyopathy (extra-label)
Requiere verificación veterinaria
- q12-24h
NA
Contexto clínico obligatorio (6)
- NOTE: Because of a high first-pass effect after oral dosing, IV dosages are ≈10% of oral dosages. Do not confuse the dosages.
- ■ This medicine can be given with or without food.
- ■ When starting this medicine, your veterinarian may start with a low dose and gradually increase it over time to see how your animal reacts to it. Do not administer more than your veterinarian prescribes.
- ■ Do not suddenly stop giving propranolol to your animal as it can make your animal’s condition worse.
- ■ Your veterinarian will need to monitor your animal closely while it is receiving this medicine. Do not miss these important follow-up visits.
- All propranolol preparations should be stored at room temperature (15°C-30°C [59°F-86°F]) and protected from light. Propranolol solutions will decompose rapidly at alkaline pH.
Las dosis son una referencia clínica para profesionales veterinarios autorizados. Confirme siempre con el prospecto actual y cada paciente individual.
Resumen
El propranolol es un antagonista beta-adrenérgico no selectivo (betabloqueante) utilizado principalmente en medicina veterinaria por sus propiedades antiarrítmicas. Se clasifica como un agente antiarrítmico de Clase II.
- Usos principales: Manejo de taquiarritmias supraventriculares y ventriculares (p. ej., APCs, VPCs, fibrilación auricular), miocardiopatía hipertrófica (HCM) e hipertensión sistémica.
- Usos endocrinos: Se utiliza frecuentemente para controlar los signos cardiovasculares y neuromusculares de la sobreestimulación simpática en el hipertiroidismo felino y el feocromocitoma.
- Usos conductuales: Ocasionalmente se utiliza fuera de indicación (off-label) para la ansiedad situacional o fobias a ruidos fuertes en perros.
Perla clínica: Debido a que el propranolol es no selectivo, bloquea los receptores tanto cardíacos como pulmonares. Debe utilizarse con extrema precaución o evitarse en pacientes con asma felina u otras enfermedades de las vías respiratorias con broncoespasmo.
Mecanismo de acción
Propranolol acts via competitive blockade of both $\beta_1$ and $\beta_2$ adrenergic receptors.
- $\beta_1$ Blockade (Cardiac): $\rightarrow$ Decreases sinus heart rate (negative chronotropy) $\rightarrow$ Depresses AV node conduction (negative dromotropy) $\rightarrow$ Decreases myocardial contractility (negative inotropy) $\rightarrow$ Ultimately reduces cardiac output and myocardial oxygen demand.
- $\beta_2$ Blockade (Pulmonary/Vascular): $\rightarrow$ Can cause bronchoconstriction and peripheral vasoconstriction.
- Additional Effects: Possesses membrane-stabilizing (quinidine-like) effects at higher doses, which alters the cardiac action potential. It lacks intrinsic sympathomimetic activity (ISA) and inhibits glycogenolysis.
Seguridad y advertencias
Contraindicaciones
- Overt heart failure
- Hypersensitivity to beta-blockers
- Greater than 1st degree heart block
- Sinus bradycardia
- Congestive heart failure (unless secondary to a tachyarrhythmia responsive to beta-blockers)
- Bronchospastic lung disease (e.g., feline asthma)
- Bradyarrhythmias
- Acute or decompensated congestive heart failure
- Concurrent administration with alpha-adrenergic agonists (e.g., adrenaline)
Efectos adversos
- Bradycardia
- Lethargy and depression
- Impaired AV conduction
- Congestive heart failure (CHF) or worsening of heart failure
- Hypotension
- Syncope
- Diarrhea
- Hypoglycemia
- Bronchoconstriction
- AV block
- Myocardial depression
- Hypoglycaemia
- Bronchospasm
- Diarrhoea
- Peripheral vasoconstriction
Precauciones
Use with Caution:
- Patients with significant renal or hepatic insufficiency.
- Patients with sinus node dysfunction.
- Labile diabetic patients (can cause or mask clinical signs of hypoglycemia).
- Digitalized or digitalis-intoxicated patients (severe bradycardia may result).
- May mask clinical signs of thyrotoxicosis.
- Withdrawal: If discontinuing the drug after chronic use, gradual withdrawal is recommended to prevent exacerbation of clinical signs.
Interacciones farmacológicas
May reduce oral propranolol absorption; separate doses by at least one hour
Additive myocardial depression may occur
May negate cardiac effects of beta-blockers
Concurrent use should be done with caution due to additive negative inotropic effects, particularly in patients with cardiomyopathy or CHF
May decrease the metabolism of propranolol and increase blood levels
May increase risk for hypotension
Unopposed alpha effects of epinephrine may lead to rapid increases in blood pressure and decrease in heart rate
May decrease propranolol metabolism; complete heart block reported in one human
Propranolol may prolong the hypoglycemic effects of insulin therapy
Clearance may be impaired by propranolol
Propranolol doses may need to be decreased when initiating therapy
May increase the metabolism of propranolol
May increase risk for hypotension
May have additive effects with propranolol
Effects may be enhanced with propranolol therapy
May have their actions blocked by propranolol
Effects of theophylline (bronchodilation) may be blocked by propranolol
May decrease the effects of beta blocking agents
Enhanced hypotensive effect
Enhanced hypotensive effect
Enhanced hypotensive effect
Increased risk of bradycardia, severe hypotension, heart failure, and AV block
Potentiates bradycardia
May necessitate a decrease in propranolol dose when initiating therapy
Reduces propranolol absorption
Enhances the effects of the muscle relaxants
Hepatic enzyme induction increases the rate of metabolism of propranolol
Propranolol may enhance the hypoglycaemic effect of insulin
Concurrent use is contraindicated; risk of severe hypertension and bradycardia
Monitorización
- ECG (Electrocardiogram)
- Signs of toxicity (bradycardia, hypotension, lethargy)
- Blood pressure (especially if administering IV)
- Heart rate and rhythm (ECG)
- Signs of congestive heart failure (e.g., respiratory rate/effort)
- Blood glucose (especially in diabetic patients receiving insulin)
Farmacocinética
Vida media
Absorción
Well absorbed after oral administration, but undergoes a rapid first-pass effect through the liver, reducing systemic bioavailability to approximately 2-27% in dogs. Hyperthyroid cats may have increased bioavailability compared to normal cats.
Distribución
Highly lipid soluble and readily crosses the blood-brain barrier. Apparent volume of distribution is 3.3-11 L/kg in dogs. Crosses the placenta and enters milk at very low levels. Approximately 90% bound to plasma proteins in humans.
Metabolismo
Principally metabolized by the liver. An active metabolite, 4-hydroxypropranolol, has been identified after oral administration.
Eliminación
Less than 1% of a dose is excreted unchanged into the urine.
Sobredosis
Clinical Signs: The most predominant expected signs are hypotension and bradycardia. Other possible effects include CNS depression (ranging from depressed consciousness to seizures), bronchospasm, hypoglycemia, hyperkalemia, respiratory depression, pulmonary edema, AV block, or asystole.
Treatment:
- Decontamination: If recent oral ingestion, consider emptying the gut and administering activated charcoal.
- Monitoring: Monitor ECG, blood glucose, potassium, and blood pressure.
- Cardiovascular Support: Use IV fluids and pressor agents for hypotension. Treat bradycardia with atropine; if atropine fails, cautiously administer isoproterenol. A transvenous pacemaker may be necessary.
- Heart Failure: Treat with digoxin, diuretics, oxygen, and IV aminophylline if necessary.
- Antidotal Therapy: Glucagon (5-10 mg IV; human dose) may increase heart rate and blood pressure, reducing the cardiodepressant effects of propranolol.
- Seizures: Generally respond to IV diazepam.
Productos disponibles
Formulaciones
- Oral Tablets
- Extended/Sustained-Release Capsules
- Injection
- 1 mg/ml injectable solution
- 10 mg tablet
- 40 mg tablet
- 80 mg tablet
- 160 mg tablet
- 5 mg/5 ml oral solution
- 10 mg/5 ml oral solution
- 40 mg/5 ml oral solution
- 50 mg/5 ml oral solution
Etiquetado para humanos
- Propranolol HCl Oral Tablets: 10 mg, 20 mg, 40 mg, 60 mg & 80 mg
- Propranolol HCl Extended/Sustained-Release Capsules: 60 mg, 80 mg, 120 mg & 160 mg (Inderal LA, InnoPran XL)
- Propranolol for Injection: 1 mg/mL in 1 mL amps or vials (Inderal)
- Propranolol Oral Solution: 4 mg/mL & 8 mg/mL in 500 mL
- Syprol oral solution
- Propranolol tablets (10 mg, 40 mg, 80 mg, 160 mg)
- Propranolol injection (1 mg/ml)
Estado regulador
Available as POM (Prescription Only Medicine)
Available as POM-V or POM (human generics like Syprol used under the cascade)
Sin datos reguladores para: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
Almacenamiento y estabilidad
Store all propranolol preparations at room temperature (15-30°C) and protect from light. Propranolol solutions will decompose rapidly at alkaline pH.
Información para el cliente
- La constancia es clave: Para que sea efectivo, su mascota debe recibir todas las dosis exactamente como las prescribió su veterinario. No suspenda este medicamento abruptamente sin consultar a su veterinario, ya que puede causar un peligroso efecto rebote en el corazón.
- Qué observar: Contacte a su veterinario inmediatamente si su mascota se muestra inusualmente letárgica, se cansa fácilmente durante el ejercicio, comienza a jadear o silbar al respirar, desarrolla dificultad para respirar o tos, o muestra un cambio repentino en su comportamiento o actitud.
- Dosis omitidas: Si olvida una dosis, adminístrela tan pronto como lo recuerde, pero nunca administre dos dosis al mismo tiempo.
La referencia de medicamentos de VetSheet está destinada a profesionales veterinarios autorizados como ayuda para la toma de decisiones clínicas, no como sustituto del criterio profesional ni del prospecto actual del fabricante.