Ciplar-40 (Propranolol 40mg)

Ciplar-40 general information

What is Ciplar-40 used for?

Ciplar tablets 40mg are used to treat a variety of heart conditions including control of hypertension (high blood pressure); management of angina pectoris (chest pain) due to coronary atherosclerosis.  Ciplar 40 is also used for reducing situational and generalised anxiety, particularly the physical symptoms of anxiety (somatic), preventing migraine, management of essential tremor and as an adjunctive treatment in the management thyrotoxicosis (overactive thyroid).  Ciplar 40 is also used as prophylaxis to prevent bleeding due to portal hypertension (high blood pressure in the portal veins from the stomach, spleen, pancreas an intestine) and esophageal varices (enlarged veins in the oesophagus); also for hypertrophic subaortic stenosis (thickening of the heart muscle causing obstruction to blood flow).  Ciplar tablets 40mg work through a common mechanism in several different body systems to manage the condition and relieve symptoms by reducing heart rate (pulse), workload on the heart (force needed to pump) and oxygen demand by the heart, which results in increased blood flow and lower blood pressure.   

How does Ciplar-40 work?

Ciplar 40 contains propanolol, which is a nonselective beta-blocker or antagonist that binds to the beta-receptor and acts by blocking the action of chemicals called catecholamines, such as adrenaline (epinephrine), which are released by the adrenal glands in response to nerve stimulation during physical and mental stress.  Adrenaline works via beta-receptors in the heart to stimulate increased heart rate and constriction (narrowing) of blood vessels.  Propanolol in Ciplar tablets 40mg blocks these actions of adrenaline, to slow heart rate, dilate (widen) blood vessels, lower blood pressure, and increase blood flow and oxygen to the heart.  Since beta-receptors are found in many tissues, particularly the heart, kidneys, vascular smooth muscle in blood vessel walls, lung, skeletal muscle and liver, all short-term and long-term symptom relief due to taking Ciplar 40, is based on blocking beta-receptors in the target tissue. 

What does Ciplar-40 contain?

Ciplar 40 contains the active ingredient propranolol 40mg, a beta blocker that blocks the action of adrenaline, to slow heart rate and relax blood vessels, amongst other actions, and is used to treat a variety of conditions.

Treating high blood pressure (hypertension) with Ciplar-40

Ciplar tablets 40mg contain propanolol, a beta-blocker that blocks the action of adrenaline (epinephrine); released by the adrenal glands in response to nerve stimulation (for example due to stress).  Adrenaline stimulates beta-receptors in blood vessel walls, causing blood vessels to constrict (narrow) which reduces blood flow and raises blood pressure.  Ciplar-40 is used to treat high blood pressure (hypertension) by widening blood vessels (vasodilation), reducing heart rate (number of heart beats) and reducing the force of the heart contraction.  These actions lower blood pressure and help the heart to cope better. 

Treating angina with Ciplar-40

Ciplar 40mg tablets contain propanolol, a beta-blocker that blocks the action of adrenaline (epinephrine); released by the adrenal glands in response to nerve stimulation (for example due to stress).  Adrenaline stimulates beta-receptors in the heart muscle, which increases heart rate and the strength of muscular contraction in response to excitement/physical exertion.  Ciplar 40 is used for management of angina by reducing heart rate and force of contraction of the heart, and widening blood vessels.  When the heart does not have to work as hard, it requires less oxygen and the reduced workload relieves symptoms of angina, such as chest pain and breathlessness on exertion.  

What are the side effects of Ciplar-40?

The most commonly reported side effects when taking Ciplar-40 include, nausea, vomiting, diarrhoea, stomach pain, bradycardia (slow heart rate), tiredness, dizziness, hypotension (low heart rate), coldness of the extremities, peripheral vasoconstriction, sleep disturbances or nightmares, hair loss, mood changes or confusion,. 

When should Ciplar-40 not be used?

You should not use Ciplar-40 if you:

• are allergic to propranolol or any ingredients in Ciplar-40
• have a history of bronchial asthma or bronchospasm
• are diabetic and taking hypoglycaemic therapy as propranolol may prolong the hypoglycaemic response to insulin
• have, poor peripheral blood circulation, uncontrolled heart failure, low blood pressure (hypotension), metabolic acidosis (too much acid in your blood) or a certain type of angina called Prinzmetal's angina
• have a phaeochromocytoma (a rare tumour of the adrenal gland) which is not already being treated with other medicines
• have certain other heart problems
• are taking medication that may interact with Ciplar-40, including: other medicines for high blood pressure angina or an irregular heart beat such as calcium channel blockers (disopyramide) digoxin, clonidine, hydralazine, diltiazem, verapamil, and nifedipine; adrenaline for emergencies like anaphylaxis; ergotamine and derivatives for migraine; antiinflammatories like ibuprofen or indomethacin; cimetidine for reflux and ulcers; chlorpromazine for psychiatric disorders.

What medications interact with Ciplar-40?

Several medications interact with Ciplar-40 and should either not be taken while you are taking Ciplar-40 or only after discussion and instruction from your doctor:

• Drugs that cause a serious reaction with Ciplar-40: other medicines for high blood pressure angina or an irregular heart beat such as calcium channel blockers (disopyramide) digoxin, clonidine, hydralazine, diltiazem, verapamil, and nifedipine, ergotamine and derivatives for migraine
• Drugs that affect Ciplar-40: adrenaline for emergencies like anaphylaxis, cimetidine for reflux and ulcers, chlorpromazine for psychiatric disorders, antiinflammatories like ibuprofen or indomethacin
• Drugs that are affected by Ciplar-40: chlorpromazine for psychiatric disorders

How should Ciplar-40 be taken?

You should take your Ciplar-40 tablets with a glass of water, with or without food.  The number of tablets you take each day, how often you take them depends on the condition you are being treated for and your doctor’s recommendations.  You should continue take your Ciplar-40 tablets every day, as instructed and if you are advised to stop taking them, withdrawal should be gradual and treatment should not be discontinued abruptly.  You should continue take your Ciplar-40 tablets for as long as recommended by your doctor, which may be for a few days or weeks, depending on the condition you are being treated for. 

How long should you take Ciplar-40?

You should continue take your Ciplar-40 tablets for as long as recommended by your doctor, which may be for a few days or weeks, depending on the condition you are being treated for. 

Missed dose of Ciplar-40

If you miss a dose of Ciplar-40 take it as soon as you remember, unless it is time to take the next dose, then skip the missed dose.  Do not take a double dose.

How should Ciplar-40 be stored?

You should store your Ciplar-40 below 25°C in a cool dry place.