Medications : Dideral (Dideral)

Dideral contains the active ingredient propranolol, which is a type of medicine called a beta-blocker. (NB. Propranolol is also available without a brand name, ie as the generic medicine.) Beta-blockers work by blocking beta receptors that are found in various parts of the body. Blocking beta receptors prevents the action of two chemicals, called noradrenaline and adrenaline, which are produced naturally by the body. These are often referred to as the 'fight or flight' chemicals, because they are responsible for the body's reaction to stressful situations.

Beta receptors are found in the heart. When they are blocked by propranolol the heart is made to beat more slowly and with less force. This reduces the pressure at which the blood is pumped out of the heart and around the body. This in turn reduces blood pressure, which means that propranolol can be used to treat high blood pressure. It also reduces the energy used by the heart to pump blood around the body, and so reduces the heart's need for oxygen, which means it can also be used in the management of angina.

Angina is chest pain that occurs because the heart does not get enough oxygen to meet demand, such as when doing exercise. Propranolol reduces the workload of the heart and so decreases its demand for oxygen. This helps to prevent attacks of angina.

Propranolol is also prescribed to people who have had a heart attack, because its effects on the heart have been shown to decrease the likelihood of having a further heart attack, and to lower the risk of continued illness and death.

Slowing the heart rate also helps to control abnormal heart beats called arrhythmias. Arrhythmias can seriously undermine the pumping action of the heart and result in inefficient blood circulation around the body. Propranolol corrects the abnormal heart beat and thus can be used to treat arrhythmias.

In addition to these heart related uses, propranolol can also be used to control symptoms that are associated with anxiety or an overactive thyroid gland (thyrotoxicosis), such as a racing pulse, sweating and tremor. This is because it blocks the effects of adrenaline.

Propranolol is also used to prevent migraine, although it is not fully understood how propranolol works in this area.

High blood pressure (hypertension) Angina pectoris Irregular heart beats (arrhythmias)Heart disease characterised by thickening of the internal heart muscle and a blockage inside the heart (hypertrophic obstructive cardiomyopathy)Prevention of further heart attacks following an initial heart attack Management of thyrotoxicosis and thyrotoxic crisis (with other medicines) Anxiety Tremor without underlying cause (essential tremor)Pre-surgical management of adrenal gland tumours (phaeochromocytoma), but only in combination with an alpha-blocking medicinePreventing bleeding from varicose veins in the foodpipe (oesophageal varices) that occur due to high blood pressure in the vein taking bood from the gut to the liver (portal hypertension) - usually a result of liver cirrhosis Prevention of migraines

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