Anaprilin (Tablets) Instructions for Use

Instructions
Dosage forms

ATC Code

C07AA05 (Propranolol)

Active Substance

Propranolol (Rec.INN registered by WHO)

Clinical-Pharmacological Group

Dietary supplement – additional source of L-carnitine and magnesium

Pharmacotherapeutic Group

Beta-adrenergic blockers; non-selective beta-adrenergic blockers

Pharmacological Action

Non-selective beta-adrenergic blocker. It has antihypertensive, antianginal, and antiarrhythmic action. Due to the blockade of beta-adrenergic receptors, it reduces catecholamine-stimulated formation of cAMP from ATP, resulting in a decrease in intracellular calcium ion influx and exerts negative chronotropic, dromotropic, bathmotropic, and inotropic effects (reduces heart rate, inhibits conduction and excitability, reduces myocardial contractility).

At the beginning of beta-adrenergic blocker use, total peripheral vascular resistance increases within the first 24 hours (due to reciprocal increase in alpha-adrenergic receptor activity and elimination of stimulation of beta₂-adrenergic receptors of skeletal muscle vessels), but after 1-3 days it returns to the initial level, and with long-term use it decreases.

The hypotensive effect is associated with a decrease in cardiac output, sympathetic stimulation of peripheral vessels, a reduction in the activity of the renin-angiotensin system (important in patients with initial hypersecretion of renin), sensitivity of aortic arch baroreceptors (their activity does not increase in response to decreased blood pressure), and an effect on the central nervous system. The hypotensive effect stabilizes by the end of the 2nd week of course administration.

The antianginal action is due to a reduction in myocardial oxygen demand (due to negative chronotropic and inotropic effects). A decrease in heart rate leads to a prolongation of diastole and improved myocardial perfusion. Due to an increase in end-diastolic pressure in the left ventricle and increased stretching of ventricular muscle fibers, it may increase oxygen demand, especially in patients with chronic heart failure.

The antiarrhythmic effect is due to the elimination of arrhythmogenic factors (tachycardia, increased activity of the sympathetic nervous system, elevated cAMP levels, arterial hypertension), a decrease in the rate of spontaneous excitation of the sinus and ectopic pacemakers, and slowing of AV conduction. Inhibition of impulse conduction is noted mainly in the antegrade and to a lesser extent in the retrograde direction through the AV node and along accessory pathways. It belongs to class II antiarrhythmic agents. Reduction in the severity of myocardial ischemia is due to a decrease in myocardial oxygen demand; post-infarction mortality may also decrease due to the antiarrhythmic action.

The ability to prevent the development of vascular headache is due to a reduction in the severity of cerebral artery dilation resulting from beta-adrenergic blockade of vascular receptors, inhibition of catecholamine-induced platelet aggregation and lipolysis, decreased platelet adhesiveness, prevention of activation of blood clotting factors during adrenaline release, stimulation of oxygen delivery to tissues, and reduced renin secretion.

The reduction in tremor during propranolol use is primarily due to the blockade of peripheral beta₂-adrenergic receptors.

It increases the atherogenic properties of blood. It enhances uterine contractions (spontaneous and those induced by agents stimulating the myometrium). It increases bronchial tone. In high doses, it causes a sedative effect.

Potential mechanisms of propranolol action in infantile hemangioma include the following interrelated therapeutic effects: local hemodynamic effect (vasoconstriction due to beta-adrenergic blockade and reduced blood flow to the hemangioma focus); antiangiogenic effect (reduction in proliferation, neovascularization, and tubulogenesis of endothelial cells due to decreased activity of the key factor of endothelial cell migration – matrix metalloproteinase MMP-9); effect of inducing apoptosis in endothelial cells due to beta-adrenergic receptor blockade.

It is known that stimulation of beta₂-adrenergic receptors can lead to the release of vascular endothelial growth factors VEGF and bFGF and induce endothelial cell proliferation. Propranolol, by blocking beta₂-adrenergic receptors, suppresses the expression of VEGF and bFGF and inhibits angiogenesis. Therapeutic efficacy of propranolol was defined as complete or almost complete involution (regression) of the hemangioma. Data from clinical studies show that the efficacy of propranolol use did not differ significantly in subgroups divided by age (35-90 days/91-150 days), sex, and location of the hemangioma (head/body); positive dynamics after 5 weeks of propranolol treatment were noted in 88% of patients.

Pharmacokinetics

After oral administration, about 90% of the administered dose is absorbed, but bioavailability is low due to first-pass metabolism in the liver. C_max in blood plasma is reached in 1-1.5 hours. Protein binding is 93%. T_1/2 is 3-5 hours. It is excreted by the kidneys mainly in the form of metabolites, less than 1% unchanged.

Indications

Arterial hypertension; exertional angina, unstable angina; sinus tachycardia (including in hyperthyroidism), supraventricular tachycardia, tachyarrhythmic form of atrial fibrillation, supraventricular and ventricular extrasystole, essential tremor, migraine prophylaxis, alcohol withdrawal (agitation and tremor), anxiety, pheochromocytoma (adjunctive treatment), diffuse toxic goiter and thyrotoxic crisis (as an adjunctive agent, including in case of intolerance to thyrostatic drugs), sympathoadrenal crises against the background of diencephalic syndrome.

Proliferating infantile hemangioma requiring systemic therapy: hemangioma posing a threat to life or having a negative impact on the functioning of body systems; ulcerated hemangioma characterized by pain and/or lack of response to previous ulceration treatment measures; hemangioma with a potential risk of permanent scarring or deformities.

ICD codes

Open the list of ICD codes

ICD-10 code	Indication
D18.0	Hemangioma of any site
D35.0	Benign neoplasm of adrenal gland
E05	Thyrotoxicosis [hyperthyroidism]
E23.3	Hypothalamic dysfunction, not elsewhere classified
F10.3	Withdrawal state
F41.0	Panic disorder [episodic paroxysmal anxiety]
F41.9	Anxiety disorder, unspecified
G25.0	Essential tremor
G43	Migraine
I10	Essential [primary] hypertension
I20	Angina pectoris
I20.0	Unstable angina
I47.1	Supraventricular tachycardia
I48	Atrial fibrillation and flutter
I49.4	Other and unspecified premature depolarization

ICD-11 code	Indication
2E81.0Z	Neoplastic hemangioma, unspecified
2F25	Cherry angioma
2F37.Y	Other specified benign neoplasm of endocrine glands
2F37.Z	Benign neoplasm of endocrine glands, unspecified
5A02.Z	Thyrotoxicosis, unspecified
5A61.Y	Other specified diseases and hypofunction of the pituitary gland
6B01	Panic disorder
6B0Z	Anxiety or fear-related disorders, unspecified
6C40.4Z	Alcohol withdrawal syndrome, unspecified
8A04.1	Essential tremor or related tremors
8A80.Z	Migraine, unspecified
8A8Z	Headache disorders, unspecified
BA00.Z	Essential hypertension, unspecified
BA40.0	Unstable angina
BA40.Z	Angina pectoris, unspecified
BC81.0	Ectopic atrial tachycardia
BC81.1	Nodal ectopic tachycardia
BC81.20	CTI [cavotricuspid isthmus]-dependent atrial tachycardia by "macro re-entry" mechanism
BC81.21	Atrial tachycardia by "macro re-entry" mechanism not associated with scar or cavotricuspid isthmus
BC81.2Z	Atrial tachycardia by "macro re-entry" mechanism, unspecified
BC81.5	Sinoatrial reentrant tachycardia
BC81.7Z	Atrioventricular reentrant tachycardia, unspecified
BC81.8	Atrioventricular nodal reentrant tachycardia
BC81.Z	Supraventricular tachyarrhythmia, unspecified
BE2Y	Other specified diseases of the circulatory system
LC52	Combined or complex malformations of vessels involving the skin

Dosage Regimen

The method of application and dosage regimen for a specific drug depend on its form of release and other factors. The optimal dosage regimen is determined by the doctor. It is necessary to strictly adhere to the compliance of the dosage form of a specific drug with the indications for use and dosage regimen.

Tablets

For adults, when taken orally, the initial dose is 20 mg, a single dose is 40-80 mg, the frequency of administration is 2-3 times/day.

IV bolus slowly – initial dose 1 mg; then after 2 min the same dose is repeated. In the absence of effect, repeated administrations are possible.

Maximum doses when taken orally – 320 mg/day; with repeated IV bolus injections, the total dose is 10 mg (under control of blood pressure and ECG).

For children aged from 35 days to 150 days on the day of treatment initiation, intended for oral administration in a special pharmaceutical form. For premature infants, the appropriate age should be determined by subtracting the number of weeks of premature pregnancy from the child’s actual age. The initial dose is 1 mg/kg/day in 2 doses (morning and evening, 0.5 mg/kg each). The recommended therapeutic dose is 3 mg/kg/day in 2 doses (morning and evening, 1.5 mg/kg each). The interval between two doses should be at least 9 hours. Dose titration scheme: 1 mg/kg/day during the 1st week; 2 mg/kg/day during the 2nd week; from the 3rd week – 3 mg/kg/day. When dose titration is completed, the amount of drug administered is adjusted depending on the child’s body weight. Clinical monitoring of the child’s condition and dose adjustment should be performed at least once a month. On the first day of treatment and on the days of dose increase, the child should be in a medical institution under the supervision of the attending physician for 2 hours after drug administration. It is necessary to measure heart rate and assess the general condition of the child at least every 60 minutes during the first 2 hours after drug administration. The duration of treatment is 6 months. Discontinuation of the drug does not require gradual dose reduction. In case of disease recurrence after completion of therapy, treatment can be repeated if there is a satisfactory response.

Adverse Reactions

From the nervous system increased fatigue, weakness, dizziness, headache, drowsiness or insomnia, vivid dreams, depression, anxiety, confusion, hallucinations, tremor, nervousness, restlessness.

From the sensory organs decreased secretion of tear fluid (dryness and soreness of the eyes).

From the cardiovascular system sinus bradycardia, AV block (up to the development of complete heart block and cardiac arrest), arrhythmias, development (worsening) of chronic heart failure, decreased blood pressure, orthostatic hypotension, manifestation of angiospasm (worsening of peripheral circulation disorders, cold extremities, Raynaud’s syndrome), chest pain.

From the digestive system: nausea, vomiting, epigastric discomfort, constipation or diarrhea, impaired liver function (dark urine, jaundice of sclera or skin, cholestasis), taste changes, increased activity of hepatic transaminases, LDH.

From the respiratory system nasal congestion, bronchospasm.

From the endocrine system changes in blood glucose concentration (hypo- or hyperglycemia).

From the hematopoietic system thrombocytopenia (unusual bleeding and hemorrhage), leukopenia.

Dermatological reactions increased sweating, psoriasis-like skin reactions, exacerbation of psoriasis symptoms.

Allergic reactions itching, skin rash, urticaria.

Other back pain, arthralgia, decreased potency, withdrawal syndrome (increased angina attacks, myocardial infarction, increased blood pressure).

In newborns and infants

From the nervous system: insomnia, poor sleep quality, hypersomnia, nightmares, agitation, irritability, drowsiness.

From the cardiovascular system AV block, bradycardia, decreased blood pressure, angiospasm, Raynaud’s disease.

From the respiratory system bronchitis, bronchiolitis, bronchospasm.

From the digestive system decreased appetite, diarrhea, vomiting, constipation, abdominal pain.

From the skin and subcutaneous tissues erythema, urticaria, alopecia.

Other cold extremities, decreased plasma glucose concentration, hyperkalemia, agranulocytosis, hypoglycemic convulsions.

Contraindications

AV block of II and III degree, sinoatrial block, severe bradycardia (less than 50 beats/min), arterial hypotension, acute or chronic heart failure in the stage of decompensation, acute myocardial infarction (systolic blood pressure less than 100 mm Hg), cardiogenic shock, pulmonary edema, sick sinus syndrome, Prinzmetal’s angina, cardiomegaly (without signs of heart failure), severe peripheral vascular disorders, metabolic acidosis (including diabetic acidosis), pheochromocytoma (without simultaneous use of alpha-adrenergic blockers), bronchial asthma, chronic obstructive pulmonary disease, tendency to bronchospastic reactions, simultaneous use with antipsychotics and anxiolytics (chlorpromazine, trioxazine and others), MAO inhibitors.

For newborns and infants. Decrease in heart rate below the following limits: in children aged from 0 to 3 months – 100 beats/min, from 3 months to 6 months – 90 beats/min, from 6 months to 12 months – 80 beats/min; decrease in blood pressure below the following limits: in children aged from 0 to 3 months – 65/45 mm Hg, from 3 months to 6 months – 70/50 mm Hg, from 6 months to 12 months – 80/55 mm Hg. Breastfed children, if the mother is taking medications that are not recommended for simultaneous use with propranolol.

Hypersensitivity to propranolol.

Use in Pregnancy and Lactation

The use of propranolol during pregnancy is possible only if the intended benefit to the mother outweighs the potential risk to the fetus. If use during this period is necessary, careful monitoring of the fetus’s condition is required; Propranolol should be discontinued 48-72 hours before delivery.

It should be borne in mind that a negative effect on the fetus is possible: intrauterine growth retardation, hypoglycemia, bradycardia.

Propranolol is excreted in breast milk. If use during lactation is necessary, medical supervision of the child should be established or breastfeeding should be discontinued.

Use in Hepatic Impairment

Use with caution in patients with hepatic insufficiency.

Use in Renal Impairment

Use with caution in patients with renal insufficiency.

Pediatric Use

Use with caution in children (efficacy and safety have not been established).

Geriatric Use

Use with caution in elderly patients.

Special Precautions

Use with caution in patients with bronchial asthma, COPD, bronchitis, decompensated heart failure, diabetes mellitus, renal and/or hepatic insufficiency, hyperthyroidism, depression, myasthenia gravis, psoriasis, occlusive peripheral vascular diseases, during pregnancy, during lactation, in elderly patients, in children (efficacy and safety have not been established).

Use with caution in newborns and infants: cardiovascular diseases, heart failure; diabetes mellitus; respiratory diseases; psoriasis; PHACE syndrome; hyperkalemia; history of allergic reactions.

During treatment, exacerbation of psoriasis is possible.

In pheochromocytoma, Propranolol can be used only after taking an alpha-adrenergic blocker.

After a long course of treatment, Propranolol should be discontinued gradually, under medical supervision.

During treatment with propranolol, IV administration of verapamil, diltiazem should be avoided. Several days before anesthesia, it is necessary to stop taking propranolol or select an anesthetic agent with minimal negative inotropic effect.

Effect on ability to drive vehicles and machinery

In patients whose activities require increased attention, the issue of outpatient use of propranolol should be decided only after assessing the individual patient’s response.

Drug Interactions

With simultaneous use with hypoglycemic agents, there is a risk of hypoglycemia due to the enhancement of the action of hypoglycemic agents.

With simultaneous use with MAO inhibitors, there is a possibility of undesirable manifestations of drug interaction.

Cases of severe bradycardia have been described with the use of propranolol for arrhythmia caused by digitalis preparations.

With simultaneous use with agents for inhalation anesthesia, the risk of myocardial function depression and development of arterial hypotension increases.

With simultaneous use with amiodarone, arterial hypotension, bradycardia, ventricular fibrillation, asystole are possible.

With simultaneous use with verapamil, arterial hypotension, bradycardia, dyspnea are possible. C_max in blood plasma increases, AUC increases, and the clearance of propranolol decreases due to inhibition of its metabolism in the liver under the influence of verapamil.

Propranolol does not affect the pharmacokinetics of verapamil.

A case of severe arterial hypotension and cardiac arrest has been described with simultaneous use with haloperidol.

With simultaneous use with hydralazine, C_max in blood plasma and AUC of propranolol increase. It is believed that hydralazine may reduce hepatic blood flow or inhibit the activity of hepatic enzymes, which leads to a slowdown in propranolol metabolism.

With simultaneous use, Propranolol may inhibit the effects of glibenclamide, glyburide, chlorpropamide, tolbutamide, because non-selective beta₂-adrenergic blockers are able to block beta₂-adrenergic receptors of the pancreas associated with insulin secretion.

The insulin release from the pancreas caused by sulfonylurea derivatives is inhibited by beta-blockers, which to some extent prevents the development of the hypoglycemic effect.

When used concomitantly with diltiazem, the plasma concentration of propranolol increases due to inhibition of its metabolism under the influence of diltiazem. An additive inhibitory effect on heart activity is observed due to the slowing of impulse conduction through the AV node caused by diltiazem. There is a risk of severe bradycardia, and stroke volume and minute volume are significantly reduced.

Cases of increased plasma concentrations of warfarin and phenindione have been described with concomitant use.

Experimental studies have shown increased cardiotoxicity with concomitant use with doxorubicin.

When used concomitantly, Propranolol prevents the development of the bronchodilatory effect of isoprenaline, salbutamol, and terbutaline.

Cases of increased plasma concentration of imipramine have been described with concomitant use.

When used concomitantly with indomethacin, naproxen, piroxicam, or acetylsalicylic acid, a decrease in the antihypertensive effect of propranolol is possible.

An additive hypotensive effect may develop with concomitant use with ketanserin.

The antihypertensive effect is enhanced with concomitant use with clonidine.

In patients receiving Propranolol, abrupt withdrawal of clonidine may lead to severe arterial hypertension. It is believed that this is due to an increase in the content of catecholamines in the circulating blood and an enhancement of their vasoconstrictor action.

The effectiveness of propranolol may decrease with concomitant use with caffeine.

The effects of lidocaine and bupivacaine (including toxic ones) may be enhanced with concomitant use, apparently due to the slowing of the metabolism of local anesthetics in the liver.

A case of bradycardia development has been described with concomitant use with lithium carbonate.

A case of enhanced side effects of maprotiline has been described with concomitant use, which is apparently due to a slowdown of its metabolism in the liver and accumulation in the body.

With concomitant use with mefloquine, the QT interval increases, a case of cardiac arrest has been described; with morphine – the inhibitory effect on the central nervous system caused by morphine is enhanced; with sodium amidotrizoate – cases of severe arterial hypotension have been described.

With concomitant use with nisoldipine, an increase in C_max and AUC of propranolol and nisoldipine in plasma is possible, leading to severe arterial hypotension. There is a report of enhanced beta-blocking action.

Cases of increased C_max and AUC of propranolol, arterial hypotension, and decreased heart rate have been described with concomitant use with nicardipine.

With concomitant use with nifedipine in patients with coronary artery disease, the development of severe arterial hypotension, an increased risk of heart failure and myocardial infarction is possible, which may be due to an enhancement of the negative inotropic effect of nifedipine.

In patients receiving Propranolol, there is a risk of developing severe arterial hypotension after the first dose of prazosin.

The QT interval increases with concomitant use with prenylamine.

With concomitant use with propafenone, the plasma concentration of propranolol increases and toxic effects develop. It is believed that propafenone inhibits the metabolism of propranolol in the liver, reducing its clearance and increasing serum concentrations.

With concomitant use of reserpine and other antihypertensive agents, the risk of arterial hypotension and bradycardia increases.

With concomitant use, the C_max and AUC of rizatriptan increase; with rifampicin – the plasma concentration of propranolol decreases; with suxamethonium chloride, tubocurarine chloride – a change in the action of muscle relaxants is possible.

The clearance of theophylline decreases with concomitant use due to the slowing of its metabolism in the liver. There is a risk of bronchospasm in patients with bronchial asthma or COPD. Beta-blockers may block the inotropic effect of theophylline.

Cases of some increased bleeding without changes in blood coagulation parameters have been described with concomitant use with phenindione.

An additive cardiodepressant effect is possible with concomitant use with flecainide.

Fluoxetine inhibits the CYP2D6 isoenzyme, leading to inhibition of propranolol metabolism and its accumulation, and may enhance the cardiodepressant effect (including bradycardia). Fluoxetine and, mainly, its metabolites are characterized by a long T_1/2, so the likelihood of drug interaction persists even several days after discontinuation of fluoxetine.

Quinidine inhibits the CYP2D6 isoenzyme, leading to inhibition of propranolol metabolism, thereby reducing its clearance. Enhancement of the beta-adrenergic blocking action and orthostatic hypotension are possible.

With concomitant use, plasma concentrations of propranolol, chlorpromazine, and thioridazine increase. A sharp decrease in blood pressure is possible.

Cimetidine inhibits the activity of liver microsomal enzymes (including the CYP2D6 isoenzyme), this leads to inhibition of propranolol metabolism and its accumulation: an enhancement of the negative inotropic effect and the development of a cardiodepressant effect are observed.

With concomitant use, the hypertensive effect of epinephrine is enhanced, and there is a risk of developing severe, life-threatening hypertensive reactions and bradycardia. The bronchodilatory effect of sympathomimetics (epinephrine, ephedrine) is reduced.

Cases of decreased effectiveness of ergotamine have been described with concomitant use.

There are reports of changes in the hemodynamic effects of propranolol with concomitant use with ethanol.

Storage Conditions

Store at 2°C (36°F) to 25°C (77°F). Keep in original packaging, protected from light. Keep out of reach of children.

Dispensing Status

Rx Only

Important Safety Information

This information is for educational purposes only and does not replace professional medical advice. Always consult your doctor before use. Dosage and side effects may vary. Use only as prescribed.

Medical Disclaimer

Brand (or Active Substance), Marketing Authorisation Holder, Dosage Form

Anaprilin [Atoll LLC (Russia)]
Tablets 10 mg: 10, 20, 25, 30, 40, 50, 60, 70, 75, 80, 90, 100, 120, 125, 150, 175, 180, 200, 210, 225, 240, 250, 270, 300, 350, 400, 450 or 500 pcs.

Marketing Authorization Holder

Atoll LLC (Russia)

Manufactured By

Ozon, LLC (Russia)

Dosage Form

Anaprilin

Tablets 10 mg: 10, 20, 25, 30, 40, 50, 60, 70, 75, 80, 90, 100, 120, 125, 150, 175, 180, 200, 210, 225, 240, 250, 270, 300, 350, 400, 450 or 500 pcs.

Dosage Form, Packaging, and Composition

Tablets white or almost white, round, flat-cylindrical, with a score on one side and a bevel.

	1 tab.
Propranolol hydrochloride	10 mg

Excipients: lactose monohydrate (milk sugar) – 64 mg, corn starch – 20 mg, gelatin – 2.5 mg, sodium carboxymethyl starch – 2.5 mg, magnesium stearate – 1 mg.

10 pcs. – contour cell packaging (1) – cardboard packs.
10 pcs. – contour cell packaging (2) – cardboard packs.
10 pcs. – contour cell packaging (3) – cardboard packs.
10 pcs. – contour cell packaging (4) – cardboard packs.
10 pcs. – contour cell packaging (5) – cardboard packs.
10 pcs. – contour cell packaging (6) – cardboard packs.
10 pcs. – contour cell packaging (7) – cardboard packs.
10 pcs. – contour cell packaging (8) – cardboard packs.
10 pcs. – contour cell packaging (9) – cardboard packs.
10 pcs. – contour cell packaging (10) – cardboard packs.
25 pcs. – contour cell packaging (1) – cardboard packs.
25 pcs. – contour cell packaging (2) – cardboard packs.
25 pcs. – contour cell packaging (3) – cardboard packs.
25 pcs. – contour cell packaging (4) – cardboard packs.
25 pcs. – contour cell packaging (5) – cardboard packs.
25 pcs. – contour cell packaging (6) – cardboard packs.
25 pcs. – contour cell packaging (7) – cardboard packs.
25 pcs. – contour cell packaging (8) – cardboard packs.
25 pcs. – contour cell packaging (9) – cardboard packs.
25 pcs. – contour cell packaging (10) – cardboard packs.
30 pcs. – contour cell packaging (1) – cardboard packs.
30 pcs. – contour cell packaging (2) – cardboard packs.
30 pcs. – contour cell packaging (3) – cardboard packs.
30 pcs. – contour cell packaging (4) – cardboard packs.
30 pcs. – contour cell packaging (5) – cardboard packs.
30 pcs. – contour cell packaging (6) – cardboard packs.
30 pcs. – contour cell packaging (7) – cardboard packs.
30 pcs. – contour cell packaging (8) – cardboard packs.
30 pcs. – contour cell packaging (9) – cardboard packs.
30 pcs. – contour cell packaging (10) – cardboard packs.
50 pcs. – contour cell packaging (1) – cardboard packs.
50 pcs. – contour cell packaging (2) – cardboard packs.
50 pcs. – contour cell packaging (3) – cardboard packs.
50 pcs. – contour cell packaging (4) – cardboard packs.
50 pcs. – contour cell packaging (5) – cardboard packs.
50 pcs. – contour cell packaging (6) – cardboard packs.
50 pcs. – contour cell packaging (7) – cardboard packs.
50 pcs. – contour cell packaging (8) – cardboard packs.
50 pcs. – contour cell packaging (9) – cardboard packs.
50 pcs. – contour cell packaging (10) – cardboard packs.
10 pcs. – jars (1) – cardboard packs.
20 pcs. – jars (1) – cardboard packs.
30 pcs. – jars (1) – cardboard packs.
50 pcs. – jars (1) – cardboard packs.
60 pcs. – jars (1) – cardboard packs.
100 pcs. – jars (1) – cardboard packs.

Anaprilin [Atoll LLC (Russia)]
Tablets 40 mg: 10, 20, 25, 30, 40, 50, 60, 70, 75, 80, 90, 100, 120, 125, 150, 175, 180, 200, 210, 225, 240, 250, 270, 300, 350, 400, 450 or 500 pcs.

Marketing Authorization Holder

Atoll LLC (Russia)

Manufactured By

Ozon, LLC (Russia)

Dosage Form

Anaprilin

Tablets 40 mg: 10, 20, 25, 30, 40, 50, 60, 70, 75, 80, 90, 100, 120, 125, 150, 175, 180, 200, 210, 225, 240, 250, 270, 300, 350, 400, 450 or 500 pcs.

Dosage Form, Packaging, and Composition

Tablets white or almost white, round, flat-cylindrical, with a score on one side and a bevel.

	1 tab.
Propranolol hydrochloride	40 mg

Excipients: lactose monohydrate (milk sugar) – 256 mg, corn starch – 80 mg, gelatin – 10 mg, sodium carboxymethyl starch – 10 mg, magnesium stearate – 4 mg.

Anaprilin [Biosintez, PJSC (Russia)]
Tablets 10 mg: 50 or 100 pcs.

Marketing Authorization Holder

Biosintez, PJSC (Russia)

Dosage Form

Anaprilin

Tablets 10 mg: 50 or 100 pcs.

Dosage Form, Packaging, and Composition

Tablets	1 tab.
Propranolol hydrochloride	10 mg

10 pcs. – contour cell packaging (5) – cardboard packs.
10 pcs. – contour cell packaging (10) – cardboard packs.
20 pcs. – contour cell packaging (5) – cardboard packs.
100 pcs. – dark glass jars (1) – cardboard packs.

Anaprilin [Irbit Chemical Pharmaceutical Plant, JSC (Russia)]
Tablets 10 mg: 50 pcs.

Marketing Authorization Holder

Irbit Chemical Pharmaceutical Plant, JSC (Russia)

Manufactured By

Irbit Chemical Pharmaceutical Plant, JSC (Russia)

Dosage Form

Anaprilin

Tablets 10 mg: 50 pcs.

Dosage Form, Packaging, and Composition

Tablets	1 tab.
Propranolol hydrochloride	10 mg

10 pcs. – contour cell packaging (5) – cardboard packs.
50 pcs. – polyethylene jars (1) – cardboard packs.

Anaprilin [Irbit Chemical Pharmaceutical Plant, JSC (Russia)]
Tablets 40 mg: 50 pcs.

Marketing Authorization Holder

Irbit Chemical Pharmaceutical Plant, JSC (Russia)

Manufactured By

Irbit Chemical Pharmaceutical Plant, JSC (Russia)

Dosage Form

Anaprilin

Tablets 40 mg: 50 pcs.

Dosage Form, Packaging, and Composition

Tablets	1 tab.
Propranolol hydrochloride	40 mg

10 pcs. – contour cell packaging (5) – cardboard packs.

Anaprilin [Sintez PJSC (Russia)]
Tablets 10 mg: 50 or 100 pcs.

Marketing Authorization Holder

Sintez PJSC (Russia)

Dosage Form

Anaprilin

Tablets 10 mg: 50 or 100 pcs.

Dosage Form, Packaging, and Composition

Tablets	1 tab.
Propranolol	10 mg

10 pcs. – contour cell packaging (5) – cardboard packs.
50 pcs. – jars (1) – cardboard packs.
100 pcs. – jars (1) – cardboard packs.

Anaprilin [Sintez PJSC (Russia)]
Tablets 40 mg: 50 or 100 pcs.

Marketing Authorization Holder

Sintez PJSC (Russia)

Dosage Form

Anaprilin

Tablets 40 mg: 50 or 100 pcs.

Dosage Form, Packaging, and Composition

Tablets	1 tab.
Propranolol	40 mg

10 pcs. – contour cell packaging (5) – cardboard packs.
50 pcs. – jars (1) – cardboard packs.
100 pcs. – jars (1) – cardboard packs.

Anaprilin [Tatkhimpharmpreparaty, JSC (Russia)]
Tablets 10 mg: 50 pcs.

Marketing Authorization Holder

Tatkhimpharmpreparaty, JSC (Russia)

Dosage Form

Anaprilin

Tablets 10 mg: 50 pcs.

Dosage Form, Packaging, and Composition

Tablets	1 tab.
Propranolol hydrochloride	10 mg

10 pcs. – contour cell packaging (5) – cardboard packs.
25 pcs. – contour cell packaging (2) – cardboard packs.
50 pcs. – dark glass jars (1) – cardboard packs.

Anaprilin [Tatkhimpharmpreparaty, JSC (Russia)]
Tablets 40 mg: 50 pcs.

Marketing Authorization Holder

Tatkhimpharmpreparaty, JSC (Russia)

Dosage Form

Anaprilin

Tablets 40 mg: 50 pcs.

Dosage Form, Packaging, and Composition

Tablets	1 tab.
Propranolol hydrochloride	40 mg

10 pcs. – contour cell packaging (5) – cardboard packs.
25 pcs. – contour cell packaging (2) – cardboard packs.
50 pcs. – dark glass jars (1) – cardboard packs.

Anaprilin [Uralbiopharm, JSC (Russia)]
Tablets 40 mg: 10, 20, 30, 40, 50, 60 or 100 pcs.

Marketing Authorization Holder

Uralbiopharm, JSC (Russia)

Dosage Form

Anaprilin

Tablets 40 mg: 10, 20, 30, 40, 50, 60 or 100 pcs.

Dosage Form, Packaging, and Composition

Tablets	1 tab.
Propranolol hydrochloride	40 mg

10 pcs. – contour cell packaging (1) – cardboard packs.
10 pcs. – polymer jars (1) – cardboard packs.
100 pcs. – polymer jars (1) – cardboard packs.
20 pcs. – polymer jars (1) – cardboard packs.
30 pcs. – polymer jars (1) – cardboard packs.
40 pcs. – polymer jars (1) – cardboard packs.
50 pcs. – polymer jars (1) – cardboard packs.
60 pcs. – polymer jars (1) – cardboard packs.

Anaprilin [Pharmaceutical Company Zdorovye, LLC (Ukraine)]
Tablets 10 mg: 50 pcs.

Marketing Authorization Holder

Pharmaceutical Company Zdorovye, LLC (Ukraine)

Dosage Form

Anaprilin

Tablets 10 mg: 50 pcs.

Dosage Form, Packaging, and Composition

Tablets	1 tab.
Propranolol	10 mg

10 pcs. – contour plastic packaging (5) – cardboard packs.
50 pcs. – contour plastic packaging (1) – cardboard packs.
50 pcs. – plastic containers (1) – cardboard packs.
50 pcs. – dark glass jars (1) – cardboard packs.

Anaprilin [Pharmaceutical Company Zdorovye, LLC (Ukraine)]
Tablets 40 mg: 50 pcs.

Marketing Authorization Holder

Pharmaceutical Company Zdorovye, LLC (Ukraine)

Dosage Form

Anaprilin

Tablets 40 mg: 50 pcs.

Dosage Form, Packaging, and Composition

Tablets	1 tab.
Propranolol	40 mg

Anaprilin [Pharmstandard-Lexredstva OJSC (Russia)]
Tablets 40 mg: 10, 15, 20, 30 or 50 pcs.

Marketing Authorization Holder

Pharmstandard-Lexredstva OJSC (Russia)

Dosage Form

Anaprilin

Tablets 40 mg: 10, 15, 20, 30 or 50 pcs.

Dosage Form, Packaging, and Composition

Tablets	1 tab.
Propranolol	40 mg

10 pcs. – contour cell packaging (1) – cardboard packs.
10 pcs. – contour cell packaging (3) – cardboard packs.
10 pcs. – contour cell packaging (5) – cardboard packs.
15 pcs. – contour cell packaging (1) – cardboard packs.
15 pcs. – contour cell packaging (2) – cardboard packs.
20 pcs. – contour cell packaging (1) – cardboard packs.

Anaprilin Medisorb [Medisorb, JSC (Russia)]
Tablets 40 mg: 7, 10, 14, 20, 21, 28, 30, 35, 40, 42, 50, 56, 70, 100, or 140 pcs.

Marketing Authorization Holder

Medisorb, JSC (Russia)

Dosage Form

Anaprilin Medisorb

Tablets 40 mg: 7, 10, 14, 20, 21, 28, 30, 35, 40, 42, 50, 56, 70, 100, or 140 pcs.

Dosage Form, Packaging, and Composition

Tablets white, round, flat-cylindrical, with a bevel on both sides.

	1 tab.
Propranolol hydrochloride	40 mg

Excipients: potato starch, sucrose (sugar), povidone (medium molecular weight polyvinylpyrrolidone), talc, calcium stearate.

7 pcs. – contour cell packaging (1) – cardboard packs.
7 pcs. – contour cell packaging (2) – cardboard packs.
7 pcs. – contour cell packaging (3) – cardboard packs.
7 pcs. – contour cell packaging (4) – cardboard packs.
7 pcs. – contour cell packaging (5) – cardboard packs.
7 pcs. – contour cell packaging (10) – cardboard packs.
10 pcs. – contour cell packaging (1) – cardboard packs.
10 pcs. – contour cell packaging (2) – cardboard packs.
10 pcs. – contour cell packaging (3) – cardboard packs.
10 pcs. – contour cell packaging (4) – cardboard packs.
10 pcs. – contour cell packaging (5) – cardboard packs.
10 pcs. – contour cell packaging (10) – cardboard packs.
14 pcs. – contour cell packaging (1) – cardboard packs.
14 pcs. – contour cell packaging (2) – cardboard packs.
14 pcs. – contour cell packaging (3) – cardboard packs.
14 pcs. – contour cell packaging (4) – cardboard packs.
14 pcs. – contour cell packaging (5) – cardboard packs.
14 pcs. – contour cell packaging (10) – cardboard packs.
50 pcs. – polymer jars (1) – cardboard packs.
100 pcs. – polymer jars (1) – cardboard packs.

Anaprilin Renewal [Obnovlenie Pfc, JSC (Russia)]
Tablets 10 mg: 50, 56, 100, or 112 pcs.
Tablets 40 mg: 50, 56, 100, or 112 pcs.

Marketing Authorization Holder

Obnovlenie Pfc, JSC (Russia)

Dosage Forms

	Anaprilin Renewal	Tablets 10 mg: 50, 56, 100, or 112 pcs.
		Tablets 40 mg: 50, 56, 100, or 112 pcs.

Dosage Form, Packaging, and Composition

Tablets white or almost white, round, flat-cylindrical, with a bevel.

	1 tab.
Propranolol hydrochloride	10 mg

Excipients: sucrose (sugar) – 68 mg, potato starch – 18.5 mg, talc – 2.5 mg, calcium stearate – 1 mg.

10 pcs. – contour cell packaging (5) – cardboard packs.
10 pcs. – contour cell packaging (10) – cardboard packs.
14 pcs. – contour cell packaging (4) – cardboard packs.
14 pcs. – contour cell packaging (8) – cardboard packs.

Tablets white or almost white, round, flat-cylindrical, with a bevel.