A year ago we discussed pronethalol (Alderlin - ICI), the first clinically useful blocking agent for adrenergic beta receptors.1 Pronethalol has two serious drawbacks: therapeutic doses often cause unwanted effects, and prolonged high doses induce tumours in mice. It was therefore advisable to reserve the drug for acute life-endangering conditions, particularly in the management of phaeochrome tumours and the treatment of certain arrhythmias. As we foreshadowed,1 pronethalol has now been replaced by a related drug, propranolol (Inderal - ICI), which is not carcinogenic in mice2 and other experimental animals, and has a much greater therapeutic ratio.
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