Essential tremor
Consider starting treatment at lower doses and increasing gradually, for example starting propranolol 10mg twice daily.
Prescribers should be aware of recent increases in propranolol overdoses and consider patients risk factors before prescribing.
40mg twice a day, increased if necessary; 80-160mg total daily dose is usually required for maintenance; maximum total daily dose 240mg.
40mg twice a day, increased if necessary; 80-160mg total daily dose is usually required for maintenance; maximum total daily dose 240mg.
40mg twice a day, increased if necessary; 80-160mg total daily dose is usually required for maintenance; maximum total daily dose 240mg.
When stable on immediate-release preparation patients can be switched to modified-release.
80mg-160mg once daily; maximum total daily dose 240mg once daily.
When stable on immediate-release preparation patients can be switched to modified-release.
80mg-160mg once daily; maximum total daily dose 240mg once daily.
As dose is increased primidone is given 2-3 times a day. Specialists advise to titrate dose gradually.
Initially 50mg daily, then adjusted according to response to up to 750mg total daily dose, dose to be increased over 2-3 weeks.
Initially 50mg daily, then adjusted according to response to up to 750mg total daily dose, dose to be increased over 2-3 weeks.
Prescribing Notes:
- Primidone is also useful for essential tremor in patients unable to take beta-blockers due to, for example, asthma or peripheral vascular disease.
- Primidone can cause sedation.
History Notes
27/10/2022
East Region Formulary content agreed.