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Propranolol Controversy

John D. Archer, MD; Mary Ellen Kosman, PhD
JAMA. 1974;227(2):201-202. doi:10.1001/jama.1974.03230150049020.
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To the Editor.—  The letter of Doctor Fisch (226:1009, 1973) requires some comment, although his remarks concerning the labeling of propranolol for use in angina pectoris are now somewhat anachronistic. Almost simultaneously with the Commentary on propranolol by the Department of Drugs, the manufacturer obtained approval from the Food and Drug Administration (FDA) to include the treatment of angina pectoris among the labeled indications for the drug. There actually have been a substantial number of well-controlled studies to support this use, and these surely were taken into consideration by the FDA in its action. We believe, however, that the Department's monograph succeeded better than the government-approved labeling in placing the proper role of the drug in perspective. For example, the physician relying solely on the manufacturer's package insert could be left confused and uncertain about the continuing importance of sublingual nitrates in the management of the disease.All that, however,


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