Figure 4. Simulation (Monte-Carlo, n=200) results elderly patients taking a 10mg oral dose resulting in similar Cmax, maximum plasma concentration, to the young patients taking a 40mg oral dose. The dotted lines illustrate the 10th and 90th percentiles of plasma levels of the elderly population with a 10mg oral administration of propranolol.-The Brain and Propranolol Pharmacokinetics in the Elderly

<p>Thus, the package insert (see 1) recommends clinicians start at the lower end of the dosing<br> range, without further details.<br> Similarly, Pfizer manufactures Inderal&reg; LA (Propranolol HCI), which is the long-acting<br> form of propranolol and their package insert (see 2) states, &ldquo;There is no information available for<br> elderly patients.&rdquo; Though the kinetics for the long-acting formdiffers from the standard form,<br> manufactured by Wyeth, we would suspect a 10mg dose for the elderly would achieve a similar<br> maximum plasma concentration (Cmax) to that of the younger patient cohort.This 10mg, which is<br> 25% of the original 40mg, dosing schedule is based on our simulations at 10mg in the geriatric<br> population.</p>