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INDERAL LA (PROPRANOLOL HCL) by AKRIMAX PHARMAC

INDERAL LA (PROPRANOLOL HCL) AKRIMAX PHARMAC

Swallow whole. Do not chew or crush.

It is very important that you take or use this exactly as directed. Do not skip doses or discontinue unless directed by your doctor.

May cause dizziness

Some non-prescription drugs may aggravate your condition. Read all labels carefully. If a warning appears, check with your doctor.

WARNING: Do not stop using this drug without first consulting your doctor. Your condition may become worse when the drug is suddenly stopped, especially if you have chest pain (angina) or heart disease (e.g., coronary artery disease, ischemic heart disease, high blood pressure). If your doctor decides you should no longer use this drug, you must gradually decrease your dose according to your doctor's instructions. When gradually stopping this medication, it is recommended that you temporarily limit physical activity to decrease strain on the heart. Seek immediate medical attention if you develop: worsening chest pain, tightness/pressure in the chest, chest pain spreading to the jaw/neck/arm, unusual sweating, trouble breathing, or fast/irregular heartbeat.

INDICATIONS:
Additional Medications for Treating Pheochromocytoma
Overactive Thyroid causing Life-Threatening Symptoms
Essential Tremor
Migraine Prevention
High Blood Pressure
Myocardial Reinfarction Prevention
A Continuous Squeezing Pain in the Chest
Idiopathic Hypertrophic Subaortic Stenosis
Ventricular Rate Control in Atrial Fibrillation
Prevention of Congenital Long QT Syndrome associated Ventricular Arrhythmia
Prevention of Post Cardio-Thoracic Surgery Atrial Fibrillation

CONTRAINDICATIONS:
PROPRANOLOL: Acute Decompensated Heart Failure
PROPRANOLOL: Bronchospastic Pulmonary Disease
PROPRANOLOL: Cardiogenic Shock
PROPRANOLOL: Complete Atrioventricular Block
PROPRANOLOL: Pregnancy
PROPRANOLOL: Second Degree Atrioventricular Heart Block
PROPRANOLOL: Sick Sinus Syndrome
PROPRANOLOL: Sinus Bradycardia
PROPRANOLOL: Chronic Bronchitis
PROPRANOLOL: Myasthenia Gravis
PROPRANOLOL: Pulmonary Emphysema
PROPRANOLOL: Raynaud's Phenomenon
PROPRANOLOL: Severe Chronic Obstructive Pulmonary Disease
PROPRANOLOL: Wolff-Parkinson-White Pattern
PROPRANOLOL: Depression
PROPRANOLOL: Diabetes Mellitus
PROPRANOLOL: Disease of Liver
PROPRANOLOL: Hypoglycemic Disorder
PROPRANOLOL: Myopathy
PROPRANOLOL: Renal Disease
PROPRANOLOL: Tobacco Smoker

MONOGRAPH - PATIENT:
IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

PROPRANOLOL S.R. - ORAL (pro-PRAN-oh-lol)

COMMON BRAND NAME(S): Betachron, Inderal LA

WARNING: Do not stop using this drug without first consulting your doctor. Your condition may become worse when the drug is suddenly stopped, especially if you have chest pain (angina) or heart disease (e.g., coronary artery disease, ischemic heart disease, high blood pressure). If your doctor decides you should no longer use this drug, you must gradually decrease your dose according to your doctor's instructions. When gradually stopping this medication, it is recommended that you temporarily limit physical activity to decrease strain on the heart. Seek immediate medical attention if you develop: worsening chest pain, tightness/pressure in the chest, chest pain spreading to the jaw/neck/arm, unusual sweating, trouble breathing, or fast/irregular heartbeat.

USES: This medication is a beta blocker used to treat high blood pressure, irregular heartbeats, shaking (tremors), and other conditions as determined by your doctor. It is used after a heart attack to improve survival. It is also used to prevent migraine headaches and chest pain (angina). Lowering high blood pressure helps prevent strokes, heart attacks, and kidney problems. Preventing chest pain can help improve your ability to exercise. This drug works by blocking the action of certain natural chemicals in your body (such as epinephrine) that affect the heart and blood vessels. This effect reduces heart rate, blood pressure, and strain on the heart.

HOW TO USE: See also Warning section. Take this medication by mouth usually once daily; or as directed by your doctor. Swallow the capsules whole; do not crush or chew the capsules. The dosage is based on your medical condition and response to treatment. Use this medication regularly to get the most benefit from it. To help you remember, take it at the same time each day. It is important to continue taking this medication even if you feel well. This medication is used to help prevent chest pain or migraines. It should not be used to treat chest pain or migraines when they occur. Use other medications (e.g., nitroglycerin tablets placed under the tongue for chest pain, sumatriptan for migraines) to relieve sudden attacks as directed by your doctor. Consult your doctor or pharmacist for details. It may take 1 to 2 weeks before you get the full benefit of this drug. If you also take certain drugs to lower your cholesterol (bile acid-binding resins such as cholestyramine or colestipol), take propranolol at least 1 hour before or at least 4 hours after these medications. Tell your doctor if your condition worsens (e.g., your routine blood pressure readings increase, your chest pain or migraines occur more often).

SIDE EFFECTS: See also Warning and Precautions sections. Dizziness, lightheadedness, or tiredness may occur as your body adjusts to the medication. Nausea/vomiting, stomach pain, vision changes, trouble sleeping, and unusual dreams may also occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly. This drug may reduce blood flow to your hands and feet, causing them to feel cold. Smoking may worsen this effect. Dress warmly and avoid tobacco use. Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects. Tell your doctor immediately if any of these unlikely but serious side effects occur: shortness of breath, blue fingers/toes, swelling ankles/feet, mental/mood changes (e.g., depression), numbness/tingling of arms/legs, very slow heartbeat, fainting, decreased sexual ability, unexplained/sudden weight gain, increased thirst/urination. Tell your doctor immediately if any of these rare but very serious side effects occur: easy bruising/bleeding, signs of infection (e.g., fever, persistent sore throat), aching/swollen joints. A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing. This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist. In the US - Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

PRECAUTIONS: Before taking propranolol, tell your doctor or pharmacist if you are allergic to it; or if you have had a serious reaction to other beta blockers (e.g., metoprolol); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details. This medication should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist if you have: certain types of heart rhythm problems (sinus bradycardia, second- or third-degree atrioventricular block), severe heart failure, asthma. Before using this medication, tell your doctor or pharmacist your medical history, especially of: other breathing problems (e.g., bronchitis, emphysema), heart failure (treated, stable type), other heart problems (e.g., Wolff-Parkinson-White syndrome), overactive thyroid (hyperthyroidism), kidney disease, liver disease, blood circulation problems (e.g., Raynaud's disease), a certain type of tumor (pheochromocytoma), mental/mood disorders (e.g., depression), certain muscle/nerve disease (myasthenia gravis), severe allergic reactions. Before having surgery, tell your doctor or dentist that you are taking this medication. If you have diabetes, this product may prevent the fast/pounding heartbeat you would usually feel when your blood sugar level falls too low (hypoglycemia). Other symptoms of a low blood sugar level, such as dizziness and sweating, are unaffected by this drug. This product also may make it harder to control your blood sugar levels. Check your blood sugar levels regularly as directed by your doctor. Tell your doctor immediately if you have symptoms of high blood sugar such as increased thirst, hunger, and urination. Your anti-diabetic medication or diet may need to be adjusted. This drug may make you dizzy. Do not drive, use machinery, or do any activity that requires alertness until you are sure you can perform such activities safely. Limit alcoholic beverages. To reduce the risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position. During pregnancy, this medication should be used only when clearly needed. Infants exposed to this medication during pregnancy may have low birth weight, low blood sugar, or slow breathing/heartbeat. Discuss the risks and benefits with your doctor. This drug passes into breast milk. Consult your doctor before breast-feeding.

DRUG INTERACTIONS: See also How to Use section. Your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor or pharmacist first. This drug should not be used with the following medication because very serious interactions may occur: thioridazine. If you are currently using this medication, tell your doctor or pharmacist before starting propranolol. Before using this medication, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use, especially of: alpha blockers (e.g., prazosin), aluminum hydroxide, anticholinergics (e.g., atropine, scopolamine), calcium channel blockers (e.g., diltiazem, verapamil), chlorpromazine, diazepam, drugs to treat diabetes (e.g., insulin, sulfonylureas such as glipizide/glyburide), other drugs to treat high blood pressure (e.g., clonidine, hydralazine, methyldopa, reserpine), epinephrine, haloperidol, other heart medications (e.g., amiodarone, digoxin, disopyramide, propafenone, quinidine), MAO inhibitors (e.g., furazolidone, isocarboxazid, linezolid, moclobemide, phenelzine, procarbazine, rasagiline, selegiline, tranylcypromine), mefloquine, rizatriptan, theophylline, thyroid hormones (e.g., levothyroxine), tricyclic antidepressants (e.g., amitriptyline), warfarin, drugs affecting liver enzymes that remove propranolol from your body (such as cimetidine, St. John's wort, certain SSRI antidepressants including fluoxetine/paroxetine/fluvoxamine, HIV protease inhibitors including ritonavir, rifamycins including rifabutin, certain anti-seizure medicines including carbamazepine). Check the labels on all your medicines (e.g., cough-and-cold products, diet aids, nonsteroidal anti-inflammatory drugs-NSAIDs for pain/fever reduction) because they may contain ingredients that could increase your heart rate or blood pressure. Ask your pharmacist about using those products safely. This medication may interfere with certain laboratory tests (including glaucoma screening test, cardiovascular stress testing using arbutamine), possibly causing false test results. Make sure laboratory personnel and all your doctors know you use this drug. This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist.

OVERDOSE: If overdose is suspected, contact your local poison control center or emergency room immediately. US residents can call the US national poison hotline at 1-800-222-1222. Canadian residents should call their local poison control center directly. Symptoms of overdose may include unusually slow heartbeat, severe dizziness, slow or shallow breathing, weakness, or fainting.

NOTES: Do not share this medication with others. Lifestyle changes such as stress reduction programs, exercise and dietary changes may increase the effectiveness of this medicine. Talk to your doctor or pharmacist about lifestyle changes that might benefit you. Have your blood pressure and pulse checked regularly while taking this medication. It may be best to learn how to monitor your own blood pressure and pulse. Discuss this with your doctor.

MISSED DOSE: If you miss a dose, take it as soon as you remember, but not if it is within 8 hours of the next dose. If it is within 8 hours of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.

STORAGE: Store at room temperature between 68-77 degrees F (20-25 degrees C) away from light and moisture. Do not store in the bathroom. Keep all medicines away from children and pets. Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.

MEDICAL ALERT: Your condition can cause complications in a medical emergency. For enrollment information call MedicAlert at 1-800-854-1166 (USA), or 1-800-668-1507 (Canada).

Information last revised May 2010 Copyright(c) 2010 First DataBank, Inc.


MONOGRAPH - FOOD & DRUG:
MONOGRAPH TITLE: Beta-Blockers/Food Interaction

SIGNIFICANCE LEVEL: 2-More Significant; Documented (more clinical data may be needed): Assess risk to patient and take action as needed.

MECHANISM OF ACTION: Food has been shown to increase the peak propranolol concentration and AUC after oral administration.(1) After intravenous propranolol, systemic clearance and AUC was not altered by food. The magnitude of the interaction is patient dependent. In one study the mean increase in availability was 53% and increase in peak serum concentration was 70%.(2) This interaction has been demonstrated with both protein-lipid meals and high carbohydrate meals.(1) Other data suggest that a minimum of 7 gm of protein per meal is required for the interaction and that the magnitude of the interaction correlates with the amount of protein ingested above this threshold.(2) It is theorized that food produces a transient increase in liver blood flow (which is seen with protein but not carbohydrate meals). Food induced changes in serum free fatty acids does not appear to be involved.(3) Food has been reported to increase the systemic bioavailability of other beta blockers including metoprolol(4) and labetalol.(5)

CLINICAL EFFECTS: The bioavailability may be increased by concurrent administration with food.

PATIENT MANAGEMENT: There is no real advantage or disadvantage to this interaction. The consensus is to suggest to patients that the drug should be taken consistently with meals or on an empty stomach rather than random ingestion in order to avoid wide fluctuations in serum drug concentrations.

DISCUSSION: This drug-food interaction is well documented.

REFERENCES:

1.McLean AJ, Isbister C, Bobik A, Dudley FJ. Reduction of first-pass hepatic clearance of propranolol by food. Clin Pharmacol Ther 1981 Jul;30(1):31-4. 2.Walle T, Fagan TC, Walle UK, Oexmann MJ, Conradi EC, Gaffney TE. Food-induced increase in propranolol bioavailability--relationship to protein and effects on metabolites. Clin Pharmacol Ther 1981 Dec; 30(6):790-5. 3.Naranjo CA, Sellers EM, Khouw V. Unaltered serum propranolol binding by meal-induced variations in fatty acids. Br J Clin Pharmacol 1982 Apr; 13(4):575-6. 4.Melander A, Danielson K, Schersten B, Wahlin E. Enhancement of the bioavailability of propranolol and metoprolol by food. Clin Pharmacol Ther 1977 Jul;22(1):108-12. 5.Daneshmend TK, Roberts CJ. The influence of food on the oral and intravenous pharmacokinetics of a high clearance drug: a study with labetalol. Br J Clin Pharmacol 1982 Jul;14(1):73-8. 6.Byrne AJ, McNeil JJ, Harrison PM, Louis W, Tonkin AM, McLean AJ. Stable oral availability of sustained release propranolol when co-administered with hydralazine or food: evidence implicating substrate delivery rate as a determinant of presystemic drug interactions. Br J Clin Pharmacol 1984; 17 Suppl 1:45S-50S. 7.Olanoff LS, Walle T, Cowart TD, Walle UK, Oexmann MJ, Conradi EC. Food effects on propranolol systemic and oral clearance: support for a blood flow hypothesis. Clin Pharmacol Ther 1986 Oct;40(4):408-14. 8.Shand DG, Nuckolls EM, Oates JA. Plasma propranolol levels in adults with observations in four children. Clin Pharmacol Ther 1970 Jan-Feb; 11(1):112-20.

RELATED DISEASES:
Abnormal ECG
Angina
Aortic Valve Stenosis
Arteriosclerotic Vascular Disease
Atrial Fibrillation
Cardiac Disease
Cardiomyopathy
Chronic Coronary Insufficiency
Conduction Disorder of the Heart
Congenital Heart Disease
Congenital Long QT Syndrome
Coronary Artery Disease
Decreased Cardiac Function
Disease of Cardiovascular System
Disorder of Adrenal Gland
Disorder of Thyroid Gland
Eclampsia of Pregnancy
Frequent Headache Disorder
Heart Failure
High-Renin Essential Hypertension
Hypertension
Hypertension due to Aortic Coarctation
Hypertension due to Arteriovenous Shunt
Hypertensive Emergencies
Hyperthyroidism
Hypertrophic Cardiomyopathy
Idiopathic Hypertrophic Subaortic Stenosis
Increased Cardiovascular Event Risk
Left Main Coronary Artery Disease
Left Ventricular Hypertrophy
Low Cardiac Output
Metabolic Syndrome X
Migraine
Mild Hypertension
Mild Pre-Eclampsia
Moderate Hypertension
Myocardial Infarction
Myocardial Ischemia
Neoplasm
Occlusive Vascular Disease
Organic Cardiac Disease
Pheochromocytoma
Progressive Angina Pectoris
Prolonged QT Interval
Severe Aortic Valve Stenosis
Severe Arteriosclerotic Vascular Disease
Severe Cardiac Disease
Severe Cardiovascular Disease
Severe Pre-Eclampsia
Severe Uncontrolled Hypertension
Structural Disorder of Heart
Supraventricular Arrhythmias
Supraventricular Tachycardia
Surgical or Other Procedure
Tachyarrhythmia
Thoracic Surgery
Thyrotoxicosis
Thyrotoxicosis Crisis
Tremors
Ventricular Tachycardia
Worsening Headache Disorder

RELATED ICD CODES:
Abnormal Electrocardiogram [794.31]
Abnormal Involuntary Movements Not Elsewhere Classified [781.0]
Acute Myocardial Infarction [410]
Acute Myocardial Infarction Initial Episode [410.91]
Acute Myocardial Infarction Not Elsewhere Classified (STEMI) [410.8]
Acute Myocardial Infarction Not Elsewhere Classified Initial Episode (STEMI) [410.81]
Acute Myocardial Infarction Not Elsewhere Classified Subsequent Episode (STEMI) [410.82]
Acute Myocardial Infarction Not Elsewhere Classified Unspecified Episode (STEMI) [410.80]
Acute Myocardial Infarction Not Otherwise Specified [410.9]
Acute Myocardial Infarction of Anterior Wall Not Elsewhere Classified (STEMI) [410.1]
Acute Myocardial Infarction of Anterior Wall Not Elsewhere Classified Initial Episode (STEMI) [410.11]
Acute Myocardial Infarction of Anterior Wall Not Elsewhere Classified Subsequent Episode (STEMI) [410.12]
Acute Myocardial Infarction of Anterior Wall Not Elsewhere Classified Unspecified Episode (STEMI) [410.10]
Acute Myocardial Infarction of Anterolateral Wall (STEMI) [410.0]
Acute Myocardial Infarction of Anterolateral Wall Initial Episode (STEMI) [410.01]
Acute Myocardial Infarction of Anterolateral Wall Subsequent Episode (STEMI) [410.02]
Acute Myocardial Infarction of Anterolateral Wall Unspecified Episode (STEMI) [410.00]
Acute Myocardial Infarction of Inferior Wall Not Elsewhere Classified (STEMI) [410.4]
Acute Myocardial Infarction of Inferior Wall Not Elsewhere Classified Initial Episode (STEMI) [410.41]
Acute Myocardial Infarction of Inferior Wall Not Elsewhere Classified Subsequent Episode (STEMI) [410.42]
Acute Myocardial Infarction of Inferior Wall Not Elsewhere Classified Unspecified Episode (STEMI) [410.40]
Acute Myocardial Infarction of Inferolateral Wall (STEMI) [410.2]
Acute Myocardial Infarction of Inferolateral Wall Initial Episode (STEMI) [410.21]
Acute Myocardial Infarction of Inferolateral Wall Subsequent Episode (STEMI) [410.22]
Acute Myocardial Infarction of Inferolateral Wall Unspecified Episode (STEMI) [410.20]
Acute Myocardial Infarction of Inferoposterior Wall (STEMI) [410.3]
Acute Myocardial Infarction of Inferoposterior Wall Initial Episode (STEMI) [410.31]
Acute Myocardial Infarction of Inferoposterior Wall Subsequent Episode (STEMI) [410.32]
Acute Myocardial Infarction of Inferoposterior Wall Unspecified Episode (STEMI) [410.30]
Acute Myocardial Infarction of Lateral Wall Not Elsewhere Classified (STEMI) [410.5]
Acute Myocardial Infarction of Lateral Wall Not Elsewhere Classified Initial Episode (STEMI) [410.51]
Acute Myocardial Infarction of Lateral Wall Not Elsewhere Classified Subsequent Episode (STEMI) [410.52]
Acute Myocardial Infarction of Lateral Wall Not Elsewhere Classified Unspecified Episode (STEMI) [410.50]
Acute Myocardial Infarction Subsequent Episode [410.92]
Acute Myocardial Infarction Unspecified Episode [410.90]
Angina Decubitus [413.0]
Angina Pectoris [413]
Angina Pectoris Not Elsewhere Classified and Not Otherwise Specified [413.9]
Atrial Fibrillation [427.31]
Atrial Fibrillation and Flutter [427.3]
Benign Essential Hypertension as Antepartum Condition [642.03]
Benign Essential Hypertension Delivered With or Without Antepartum Condition [642.01]
Benign Essential Hypertension Delivered with Postpartum Complication [642.02]
Benign Essential Hypertension of Pregnancy [642.0]
Benign Essential Hypertension of Pregnancy Unspecified [642.00]
Benign Hypertension [401.1]
Benign Hypertensive Chronic Kidney Disease with CKD [403.1]
Benign Hypertensive Chronic Kidney Disease with CKD stage I thru IV, or Unspecified [403.10]
Benign Hypertensive Chronic Kidney Disease with CKD stage V or End Stage Renal Disease [403.11]
Benign Hypertensive Heart and Chronic Kidney Disease with/without Heart Failure and with CKD [404.1]
Benign Hypertensive Heart and CKD with Heart Failure and with CKD Stage I to IV or Unspecified [404.11]
Benign Hypertensive Heart and CKD with Heart Failure and with CKD Stage V or ESRD [404.13]
Benign Hypertensive Heart and CKD without Heart Failure and with CKD Stage I to IV or Unspecified [404.10]
Benign Hypertensive Heart and CKD without Heart Failure and with CKD Stage V or ESRD [404.12]
Benign Hypertensive Heart Disease [402.1]
Benign Hypertensive Heart Disease with Heart Failure [402.11]
Benign Hypertensive Heart Disease Without Heart Failure [402.10]
Benign Neoplasm of Adrenal Gland [227.0]
Benign Neoplasm of Endocrine System Not Otherwise Specified [227.9]
Benign Neoplasm of Other Endocrine System Structures [227]
Benign Renovascular Hypertension [405.11]
Benign Secondary Hypertension [405.1]
Benign Secondary Hypertension Not Elsewhere Classified [405.19]
Chronic Ischemic Heart Disease Not Elsewhere Classified [414.8]
Chronic Ischemic Heart Disease Not Otherwise Specified [414.9]
Chronic Migraine Without Aura [346.7]
Chronic Migraine Without Aura with Intractable Migraine Stated without mention of Status Migrainosus [346.71]
Chronic Migraine without Aura with Intractable Migraine, so Stated, with Status Migrainosus [346.73]
Chronic Migraine Without Aura without Mention of Intractable Migraine or Status Migrainous [346.70]
Chronic Migraine without Aura, without Mention of Intractable Migraine with Status Migrainosus [346.72]
Chronic Total Occlusion of Coronary Artery [414.2]
Classical Migraine [346.0]
Complication of Hypertension [997.91]
Coronary Atherosclerosis [414.0]
Coronary Atherosclerosis of Unspecified Vessel, Native or Graft [414.00]
Eclampsia [642.6]
Eclampsia as Antepartum Condition [642.63]
Eclampsia Delivered With or Without Antepartum Condition [642.61]
Eclampsia Delivered with Postpartum Condition [642.62]
Eclampsia Unspecified [642.60]
Elevated Blood Pressure Without Hypertension [796.2]
Essential Hypertension [401]
Hemiplegic Migraine [346.3]
Hemiplegic Migraine, with Intractable Migraine, so Stated, with Status Migrainosus [346.33]
Hemiplegic Migraine, with Intractable Migraine, so Stated, without Mention of Status Migrainosus [346.31]
Hemiplegic Migraine, without Mention of Intractable Migraine with Status Migrainosus [346.32]
Hemiplegic Migraine, without Mention of Intractable Migraine without Mention of Status Migrainosus [346.30]
Hypertension Complicating Pregnancy Not Otherwise Specified [642.9]
Hypertension Complicating Pregnancy Not Otherwise Specified as Antepartum Condition [642.93]
Hypertension Complicating Pregnancy Not Otherwise Specified as Postpartum Condition [642.94]
Hypertension Complicating Pregnancy Not Otherwise Specified Delivered W or W/O Antepartum Condition [642.91]
Hypertension Complicating Pregnancy Not Otherwise Specified Delivered W Postpartum Condition [642.92]
Hypertension Complicating Pregnancy, Childbirth, and the Puerperium [642]
Hypertension Not Otherwise Specified [401.9]
Hypertensive Chronic Kidney Disease [403]
Hypertensive Encephalopathy [437.2]
Hypertensive Heart and Chronic Kidney Disease [404]
Hypertensive Heart Disease [402]
Hypertensive Heart Disease Not Otherwise Specified [402.9]
Hypertensive Heart Disease Not Otherwise Specified with Heart Failure [402.91]
Hypertensive Heart Disease Not Otherwise Specified Without Heart Failure [402.90]
Hypertrophic Cardiomyopathies [425.1]
Long QT Syndrome [426.82]
Long-Term (Current) Use of Antiplatelet/Antithrombotics [V58.63]
Long-Term (Current) Use of Aspirin [V58.66]
Malignant Hypertension [401.0]
Malignant Hypertensive Chronic Kidney Disease with CKD [403.0]
Malignant Hypertensive Chronic Kidney Disease with CKD stage I thru IV, or Unspecified [403.00]
Malignant Hypertensive Chronic Kidney Disease with CKD stage V or End Stage Renal Disease [403.01]
Malignant Hypertensive Heart and Chronic Kidney Disease with/without Heart Failure and with CKD [404.0]
Malignant Hypertensive Heart and CKD with Heart Failure and with CKD Stage I thru IV or Unspecified [404.01]
Malignant Hypertensive Heart and CKD with Heart Failure and with CKD Stage V or ESRD [404.03]
Malignant Hypertensive Heart and CKD without Heart Failure and with CKD Stage I to IV or Unspecified [404.00]
Malignant Hypertensive Heart and CKD without Heart Failure and with CKD Stage V or ESRD [404.02]
Malignant Hypertensive Heart Disease [402.0]
Malignant Hypertensive Heart Disease with Heart Failure [402.01]
Malignant Hypertensive Heart Disease Without Heart Failure [402.00]
Malignant Renovascular Hypertension [405.01]
Malignant Secondary Hypertension [405.0]
Malignant Secondary Hypertension Not Elsewhere Classified [405.09]
Maternal Hypertension Affecting Fetus or Newborn [760.0]
Medulloadrenal Hyperfunction [255.6]
Megakaryocytic Leukemia in Relapse [207.22]
Menstrual Migraine [346.4]
Menstrual Migraine, with Intractable migraine, so Stated, with Status Migrainosus [346.43]
Menstrual Migraine, with Intractable Migraine, so Stated, without Mention of Status Migrainosus [346.41]
Menstrual Migraine, without Mention of Intractable Migraine with Status Migrainosus [346.42]
Menstrual Migraine, without Mention of Intractable Migraine without Mention of Status Migrainosus [346.40]
Migraine [346]
Migraine with Aura and with Intractable Migraine so stated, Without Mention of Status Migrainosus [346.01]
Migraine with Aura Without Mention of Intractable Migraine or Status Migrainosus [346.00]
Migraine with Aura, with Intractable Migraine, so Stated, with Status Migrainosus [346.03]
Migraine with Aura, without mention of Intractable Migraine with Status Migrainosus [346.02]
Migraine without Aura [346.1]
Migraine without Aura and with Intractable Migraine so stated, Without Mention of Status Migrainosus [346.11]
Migraine without Aura, with Intractable Migraine, so Stated, with Status Migrainosus [346.13]
Migraine without Aura, Without Mention of Intractable Migraine or Status Migrainosus [346.10]
Migraine without Aura, without Mention of Intractable Migraine with Status Migrainosus [346.12]
Mild or Unspecified Postpartum Pre-Eclampsia [642.44]
Mild or Unspecified Pre-Eclampsia [642.4]
Mild or Unspecified Pre-Eclampsia as Antepartum Condition [642.43]
Mild or Unspecified Pre-Eclampsia Delivered With or Without Antepartum Condition [642.41]
Mild or Unspecified Pre-Eclampsia Delivered with Postpartum Condition [642.42]
Mild or Unspecified Pre-Eclampsia Unspecified Episode of Care [642.40]
Multiple Endocrine Neoplasia [MEN] Type IIA [258.02]
Multiple Endocrine Neoplasia [MEN] Type IIB [258.03]
Neonatal Thyrotoxicosis [775.3]
Neoplasms of Unspecified Nature [239]
Old Myocardial Infarction [412]
Other Chronic Ischemic Heart Disease [414]
Other Forms of Migraine [346.8]
Other Forms of Migraine With Intractable Migraine so Stated, without Mention of Status Migrainosus [346.81]
Other Forms of Migraine Without Mention of Intractable Migraine or Status Migrainosus [346.80]
Other Forms of Migraine, with Intractable Migraine, so Stated, with Status Migrainosus [346.83]
Other Forms of Migraine, without Mention of Intractable Migraine with Status Migrainosus [346.82]
Other Migraine Variants With Intractable Migraine so Stated, Without Mention of Status Migrainosus [346.21]
Other Migraine Variants Without Mention of Intractable Migraine or Status Migrainosus [346.20]
Other Pre-Existing Hypertension of Pregnancy [642.2]
Other Pre-Existing Hypertension of Pregnancy as Antepartum Condition [642.23]
Other Pre-Existing Hypertension of Pregnancy Delivered With or Without Antepartum Condition [642.21]
Other Pre-Existing Hypertension of Pregnancy Delivered with Postpartum Condition [642.22]
Other Pre-Existing Hypertension of Pregnancy Unspecified [642.20]
Other Variants of Migraine [346.2]
Other Variants of Migraine with Intractable Migraine, so stated, with Status Migrainosus [346.23]
Other Variants of Migraine, without Mention of Intractable Migraine with Status Migrainosus [346.22]
Paroxysmal Ventricular Tachycardia [427.1]
Persistent Aura with Cerebral Infarction [346.6]
Persistent Aura with Cerebral Infarction and Status Migrainosus without Mention of Intractable [346.62]
Persistent Aura with Cerebral Infarction and with Intractable Migraine and Status Migrainous [346.63]
Persistent Aura with Cerebral Infarction with Intractable Migraine Stated, without Mention of Status [346.61]
Persistent Aura with Cerebral Infarction without Mention of Intractable or Status Migrainous [346.60]
Persistent Aura without Cerebral Infarction with Intract Migraine Stated, without Mention of Status [346.51]
Persistent Aura without Cerebral Infarction with Intractable Migraine and Status Migrainosus [346.53]
Persistent Aura without Cerebral Infarction with Status Migrainosus without Mention of Intractable [346.52]
Persistent Aura without Cerebral Infarction, without Mention of Intractable or Status Migrainous [346.50]
Persistent Migraine Aura without Cerebral Infarction [346.5]
Polyglandular Activity in Multiple Endocrine Adenomatosis [258.0]
Polyglandular Dysfunction [258]
Postpartum Benign Essential Hypertension [642.04]
Postpartum Eclampsia [642.64]
Postpartum Pre-Existing Hypertension of Pregnancy Not Elsewhere Classified [642.24]
Postpartum Renal Hypertension [642.14]
Postpartum Transient Hypertension of Pregnancy [642.34]
Pre-Eclampsia or Eclampsia with Pre-Existing Hypertension as Antepartum Condition [642.73]
Pre-Eclampsia or Eclampsia with Pre-Existing Hypertension as Postpartum Condition [642.74]
Pre-Eclampsia or Eclampsia with Pre-Existing Hypertension Delivered W or W/O Antepartum Condition [642.71]
Pre-Eclampsia or Eclampsia with Pre-Existing Hypertension Delivered with Postpartum Condition [642.72]
Pre-Eclampsia or Eclampsia with Pre-Existing Hypertension in Pregnancy [642.7]
Pre-Eclampsia or Eclampsia with Pre-Existing Hypertension in Pregnancy Unspecified [642.70]
Prinzmetal Angina [413.1]
Renal Hypertension as Antepartum Condition [642.13]
Renal Hypertension of Pregnancy [642.1]
Renal Hypertension of Pregnancy Delivered With or Without Antepartum Condition [642.11]
Renal Hypertension of Pregnancy Delivered with Postpartum Condition [642.12]
Renal Hypertension of Pregnancy Unspecified [642.10]
Renovascular Hypertension [405.91]
Secondary Hypertension [405]
Secondary Hypertension Not Elsewhere Classified [405.99]
Secondary Hypertension Not Otherwise Specified [405.9]
Severe Postpartum Pre-Eclampsia [642.54]
Severe Pre-Eclampsia [642.5]
Severe Pre-Eclampsia as Antepartum Condition [642.53]
Severe Pre-Eclampsia Delivered With or Without Antepartum Condition [642.51]
Severe Pre-Eclampsia Delivered with Postpartum Condition [642.52]
Severe Pre-Eclampsia Unspecified [642.50]
Subendocardial Infarction (NSTEMI) [410.7]
Subendocardial Infarction Initial Episode (NSTEMI) [410.71]
Subendocardial Infarction Subsequent Episode (NSTEMI) [410.72]
Subendocardial Infarction Unspecified Episode (NSTEMI) [410.70]
Thyrotoxicosis [242]
Thyrotoxicosis due to Ectopic Thyroid Nodule [242.4]
Thyrotoxicosis due to Ectopic Thyroid Nodule Without Crisis [242.40]
Thyrotoxicosis Not Otherwise Specified [242.9]
Thyrotoxicosis Not Otherwise Specified with Crisis [242.91]
Thyrotoxicosis Not Otherwise Specified Without Crisis [242.90]
Thyrotoxicosis of Specified Origin Not Elsewhere Classified [242.8]
Thyrotoxicosis of Specified Origin Not Elsewhere Classified with Crisis [242.81]
Thyrotoxicosis of Specified Origin Not Elsewhere Classified Without Crisis [242.80]
Toxic Diffuse Goiter [242.0]
Toxic Diffuse Goiter Without Crisis [242.00]
Toxic Multinodular Goiter [242.2]
Toxic Multinodular Goiter Without Crisis [242.20]
Toxic Nodular Goiter Not Otherwise Specified [242.3]
Toxic Nodular Goiter Without Crisis [242.30]
Toxic Uninodular Goiter [242.1]
Toxic Uninodular Goiter Without Crisis [242.10]
Transient Hypertension of Pregnancy [642.3]
Transient Hypertension of Pregnancy as Antepartum Condition [642.33]
Transient Hypertension of Pregnancy Delivered With or Without Antepartum Condition [642.31]
Transient Hypertension of Pregnancy Delivered with Postpartum Condition [642.32]
Transient Hypertension of Pregnancy Unspecified [642.30]
Tremor Not Elsewhere Classified [333.1]
True Posterior Wall Acute Myocardial Infarction (STEMI) [410.6]
True Posterior Wall Acute Myocardial Infarction Initial Episode (STEMI) [410.61]
True Posterior Wall Acute Myocardial Infarction Subsequent Episode (STEMI) [410.62]
True Posterior Wall Acute Myocardial Infarction Unspecified Episode (STEMI) [410.60]
Unspecified Hypertension Complicating Pregnancy Unspecified Episode of Care [642.90]
Unspecified Hypertensive Chronic Kidney Disease with CKD [403.9]
Unspecified Hypertensive Chronic Kidney Disease with CKD stage I thru IV, or Unspecified [403.90]
Unspecified Hypertensive Chronic Kidney Disease with CKD stage V or End Stage Renal Disease [403.91]
Unspecified Hypertensive Heart and Chronic Kidney Disease with/without Heart Failure and with CKD [404.9]
Unspecified Hypertensive Heart and CKD w/o Heart Failure and with CKD Stage I to IV or Unspecified [404.90]
Unspecified Hypertensive Heart and CKD with Heart Failure and with CKD Stage I to IV or Unspecified [404.91]
Unspecified Hypertensive Heart and CKD with Heart Failure and with CKD Stage V or ESRD [404.93]
Unspecified Hypertensive Heart and CKD without Heart Failure and with CKD Stage V or ESRD [404.92]
Unspecified Migraine [346.9]
Unspecified Migraine With Intractable Migraine so Stated, Without Mention of Status Migrainosus [346.91]
Unspecified Migraine With Intractable Migraine, so Stated, with Status Migrainous [346.93]
Unspecified Migraine Without Intractable Migraine with Status Migrainous [346.92]
Unspecified Migraine Without Mention of Intractable Migraine or Status Migrainosus [346.90]

Indication: Chronic Stable Angina:

take 1 capsule (60 mg) by oral route 2 times per day
take 2 capsules (120 mg) by oral route once daily

Indication: High Blood Pressure:

take 1 capsule (60 mg) by oral route 2 times per day
take 2 capsules (120 mg) by oral route once daily

Indication: Idiopathic Hypertrophic Subaortic Stenosis:

take 1 capsule (60 mg) by oral route 2 times per day
take 2 capsules (120 mg) by oral route once daily

Indication: Migraine Prevention:

take 1 capsule (60 mg) by oral route 2 times per day
take 2 capsules (120 mg) by oral route once daily

For more information:
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Educational resources:
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