Propranolol exerts ant arrhythmic effects in concentrations producing beta-adrenergic blockade, which appears to be its principal ant arrhythmic mechanism of action. Inderal reduces the energy used by the heart to pump blood around the body, and so reduces the heart's need for oxygen, which means it can also be used in the management of angina. Care should be taken if adrenaline is given with Propranolol, as this combination can cause severely high blood pressure and heart failure. Propranolol can, in certain patients, be used alone or as an initial agent in patients in whom, in the judgment of the physician, treatment should be started with a beta-blocker rather than a diuretic. Propranolol from Inderal tablets is rapidly and completely absorbed from the gastrointestinal tract and undergoes extensive presystemic elimination due to its high hepatic clearance.
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