MIND THE MILLIGRAMS

Keep an eye on this odd dosing situation.

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1. Counselling Conundrum: a real question from a patient

2. Concise Conclusion: a straight-forward patient-friendly answer 

3. Quick Wrap-up 

Clearly, there are nuances that may not be captured in this format. The goal here is to provide you with helpful counselling tips which often draw from multiple sources or those which are not commonly accessed by busy healthcare providers serving the community.

Counselling Conundrum: "My pharmacy recently switched me from a long-acting version of my propranolol to a type I have to take twice a day, but it's not the same number of milligrams per day. Is that right?"

Concise Conclusion: Great question! This happened because the short-acting version is more readily absorbed, so the dose has to be reduced by around 50% to get around the same effect as the long-acting version.

Quick Wrap-up: This is also a good opportunity to review whether propranolol remains an appropriate beta-blocker for your patient. For example, non-selective beta-blockers may interfere with reliever efficacy in asthma, and are not preferred agents for mortality and hospitalization benefit in heart failure.

Dive Deeper

1) Drug Shortages and Discontinuations | medSask

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