Indever 40 mg Tablet

Non-selective beta-blocker for:

• Anxiety symptoms (palpitations, tremor, sweating), performance anxiety
• Migraine prevention, essential tremor
• High blood pressure, angina, arrhythmias, after heart attack
• Thyrotoxicosis symptoms
• Portal hypertension (prevention of variceal bleeding in cirrhosis)
• Infantile haemangioma (oral solution, specialist)

Anxiety: 10–40 mg two to three times daily (or 40 mg once daily MR).

Migraine prevention / essential tremor: 40 mg two to three times daily, up to 80–160 mg daily (or 80–160 mg MR once daily).

Hypertension: 40–80 mg twice daily (up to 320 mg/day).

Thyrotoxicosis: 10–40 mg three to four times daily.

Portal hypertension: 40 mg twice daily, adjusted to heart rate (reduce resting pulse by 25%).

• Do not stop suddenly (rebound angina, arrhythmia) — taper over 1–2 weeks.

• Asthma or history of bronchospasm
• Slow heart rate, 2nd/3rd degree heart block, sick sinus syndrome
• Uncontrolled heart failure, cardiogenic shock, severe low blood pressure
• Severe peripheral arterial disease, Prinzmetal's angina
• Untreated phaeochromocytoma, metabolic acidosis
• Prolonged fasting (hypoglycaemia risk)

Common: tiredness, cold hands and feet, slow heartbeat, sleep disturbance, nightmares, nausea, diarrhoea.

Less common: low mood, dizziness, erectile difficulty, shortness of breath.

Serious: bronchospasm/asthma attack, heart block, heart failure, masking of hypoglycaemia (diabetes; low sugar in children/fasting), worsening psoriasis or Raynaud's.

• Diabetes: hides warning signs of low sugar.
• COPD, psoriasis, myasthenia gravis: caution.
• Tell the anaesthetist before surgery.
• Thyrotoxicosis: do not stop suddenly (may precipitate storm).

Use in pregnancy only if needed (monitor baby's growth; newborn slow heart rate and low sugar). Compatible with breastfeeding (monitor baby).

• Verapamil, diltiazem (heart block — avoid)
• Clonidine (rebound hypertension)
• Amiodarone, digoxin (slow pulse)
• Rizatriptan (levels rise — use 5 mg)
• Insulin, sulphonylureas (masked hypoglycaemia)
• Adrenaline (severe hypertension, reduced effect in anaphylaxis)
• NSAIDs (reduced effect); cimetidine, fluvoxamine (raise levels)
• Salbutamol and other bronchodilators (blocked)

Slow heartbeat, low blood pressure, bronchospasm, low blood sugar, seizures, coma. Emergency — dangerous.

Store below 30°C, protected from light and moisture.