HOWARD F. MORRELLI, M.D., F.A.C.P.
In the 5 years since propranolol was introduced in the United States, the indications for its use stated in the package insert have remained virtually unchanged. During this period no studies have appeared that rigorously establish the relative role of propranolol for these indications by comparing it with other forms of therapy. In addition, at least 34 other uses for propranolol therapy have been reported; of these, there is substantial evidence for efficacy only in the management of hypertension, angina pectoris, and thyrotoxicosis. The package insert does not list these new uses or other "uses" for propranolol that have appeared in the medical literature. The physician in practice may experiment with an approved drug for an unapproved use, but the patient should give informed consent to the experiment, and the experiment should be reported to the FDA. The current package insert for propranolol is not adequate as the sole source of drug information for optimal drug selection.
MORRELLI HF. Propranolol. Ann Intern Med. ;78:913–917. doi: 10.7326/0003-4819-78-6-913
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Published: Ann Intern Med. 1973;78(6):913-917.
Cardiology, Coronary Risk Factors, Hypertension, Nephrology, Rhythm Disorders and Devices.
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