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Usage of propranolol:
-Thyrotoxicosis (unlabeled use): Oral: propranolol 10-40 mg/dose every 6-8 hours; may also consider administering extended or sustained release formulations (Bahn, 2011) -Variceal hemorrhage prophylaxis (unlabeled use) Oral: -Primary prophylaxis: Initial: 20 mg twice daily; adjust to maximal tolerated dose .
Note: Risk factors for hemorrhage include Child-Pugh class B/C or variceal red wale markings propranolol on endoscopy .
-Secondary prophylaxis: Initial: 20 mg propranolol twice daily; adjust to maximal tolerated dose Renal Impairment: Not dialyzable (0% to 5%); supplemental dose is not necessary .
Peritoneal dialysis effects: propranolol Supplemental dose is not necessary .
Hepatic Impairment : Marked slowing of heart rate may occur in chronic liver disease with conventional propranolol doses; low initial dose and regular heart rate monitoring .
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