VIVALOL ER ( TABLET ) ( 100 mg )

Source : IAP Pediatric Drug Formulary
Oral Children 0.2-0.4 mg/kg/day initially, gradually increase to a maximum of 1 mg/kg/day in two divided doses and adolescents 100-450mg/24hr in 3-4 divided doses. IV 5mg every 2 min for 3 doses.

Source : NFI National Formulary of India
Oral

Heart failure: Initiating dose 12.5 - 25 mgonce a day, Maximum dose: 200 mg oncea day; Hypertension: initially 100 mg daily,increase if required to 200 mg in two divideddoses (max 400 mg daily). Angina: 50 mgdaily, up to 300 mg daily in 2 to 3 divideddoses if necessary.

Intravenous injection

Arrhythmia: up to 5 mg at a rate of 1 to2 mg per min, repeated after 5 min ifnecessary (max dose 10 to 15 mg). Arrythmiadeveloping during anaesthesia: 2 to 4 mgduring induction.

• Supraventricular arrhythmia, angina pectoris, hypertension, myocardial infarction
• Migraine prophylaxis
• Hyperthyroidism, heart failure.

• Asthma, uncontrolled heart failure, Prinzmetal's angina, marked bradycardia, hypotension, sick sinus syndrome, second- or third- degree AV block, cardiogenic shock, metabolic acidosis, severe peripheral arterial disease
• Pheochromocytoma. Beta-blockers, including those considered to be cardioselective, should not be given to patients with a history of asthma or bronchospasm. However, in rare situations where there is no alternative a cardioselective beta-blocker is given to these patients with extreme caution and under specialist supervision.

• Avoid abrupt withdrawal especially in is- chaemic heart disease, first-degree AV block, portal hypertension 
• Diabetes
• History of obstruc- tive airways disease
• Myasthenia gravis
• Symptoms of hypoglycaemia and thyrotoxicosis may be masked
• History of hypersensitivity-may increase sensitivity to allergens and result in more serious hypersensitivity response
• Also may reduce response to adrenaline (epinephrine)
• Reduce dose of oral propranolol in hepatic impairment
• Renal impairment
• Lactation
• Pregnancy

• Gastro-intestinal disturbances
• Bradycardia, heart failure, hypotension, conduction disorders
• Peripheral vasoconstriction 
• Bronchospasm
• Dyspnoea
• Headache
• Fatigue
• Sleep disturbances
• Paraesthesia
• Dizziness
• Vertigo
• Psychosis
• Sexual dysfunction
• Purpura
• Thrombocytopenia
• Visual disturbances
• Exacerbation of psoriasis
• Alopecia
• Rarely, rashes and dry eyes on infusion venous irritation and thrombophlebitis
• Agranulocytosis
• Hyperglycemia
• Myocardial depression.

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