Propranolol

Description

Propranolol is a medicine is used to treat hypertension (high blood pressure), arrhythmia (irregular heart rhythms). It is also used to prevent angina (chest pain that radiates to arms, neck, and back), and also to improve survival after a heart attack. It works by relaxing blood vessels and slowing heart rate to improve blood flow. Thus it helps to control high blood pressure. Propranolol is also used to treat phaeochromocytoma (tumour of a small gland near the kidneys), tremors (uncontrolled trembling or shaking movements in one or more parts of your body), and hypertrophic subaortic stenosis (a heart condition caused due to abnormal thickening of heart muscle) and migraine (severe, one-sided headaches). Propranolol is available on prescription as tablets, capsules, sustained-release tablets/capsules, extended-release capsules, and injections. Propranolol shows side effects like tiredness, unusual weakness, nausea, vomiting, and diarrhoea. Most of these side effects are temporary and subside with time. If any of these side effects persist or worsen, consult your doctor. Propranolol oral forms should be taken on an empty stomach. Your doctor will determine the dose and duration of treatment based on your clinical condition. Avoid the discontinuation of Propranolol without consulting your doctor, as it may worsen your condition. Propranolol injection will be administered by a qualified healthcare professional in a hospital/clinical setting. Propranolol is not recommended for use if you are allergic to it. This medicine should be used with caution if you have diabetes, or liver, heart, or kidney problems. Inform your doctor about all your current medicines including any herbs or supplements. Consult your doctor if you are pregnant, or are breastfeeding.

Side effects

Major & minor side effects for Propranolol

  • Dizziness
  • Diarrhoea
  • Swelling of face, lips, eyelids, tongue, hands and feet
  • Irregular heartbeat
  • Hypotension
  • Chest pain and discomfort
  • Tiredness
  • Sleep disturbances
  • Cold hands and feet

Uses of Propranolol

What is it prescribed for?

  • Hypertension
  • Angina pectoris
  • Migraine
  • Heart Attack
  • Phaeochromocytoma
  • Arrhythmias
  • Tremors
Read More
Concerns

Commonly asked questions

  • Onset of action
    For oral forms, the effect of Propranolol can be observed within 1-2 hours. For injections, the effect will be seen within 5 minutes after administration.
  • Duration of effect
    The effect of a conventional tablet lasts for 6-12 hours after intake. The effect of an extended-release form may last for 24 hours. The time duration for which Propranolol injection remains effective in your body is not known.
  • Safe with alcohol?
    Do not consume alcohol if you are on treatment with Propranolol. Alcohol consumption may show additive effects in lowering your blood pressure. You may experience symptoms like headaches, dizziness, lightheadedness, fainting, and/or changes in heart rate.
  • Is it habit forming?
    No habit-forming tendencies were reported for Propranolol.
  • Usage in pregnancy?
    Propranolol is not recommended during pregnancy as it may harm your foetus. Your doctor may recommend a safer alternative with the same medicinal effect based on your clinical condition.
  • Usage while breast-feeding?
    Propranolol is not recommended if you are breastfeeding as this medicine may pass into the breast milk and harm your baby. Your doctor may recommend a safer alternative with the same medicinal effect based on your clinical condition.

Allergy

Propranolol is not recommended for use if you are allergic to it. Seek immediate medical attention you experience symptoms such as skin rashes, swelling (especially of the face, lips, tongue, etc.), breathing difficulty, etc.

Congestive Heart Failure

Congestive Heart Failure is a condition in which the heart muscle does not pump blood properly. Propranolol is not recommended if you have this condition as it may increase the risk of complete loss of heart function.

Cardiogenic shock

Cardiogenic shock is a condition in which your heart suddenly stops pumping enough oxygen-rich blood to the brain, kidneys, and other vital organs. Propranolol is not recommended for use if you have a cardiogenic shock as it may further worsen your condition.

Severe bradycardia

Bradycardia is a heart condition in which the heartbeat becomes very low than normal. Propranolol may further decrease your heartbeat, this will increase the risk of heart attack or stroke (decreased blood supply to your brain). Hence, this medicine is not recommended for use if you have a slow heart rate.
Warnings for special population

Pregnancy

Propranolol is not recommended during pregnancy as it may harm your foetus. Your doctor may recommend a safer alternative with the same medicinal effect based on your clinical condition.

Breast-feeding

Propranolol is not recommended if you are breastfeeding as this medicine may pass into the breast milk and harm your baby. Your doctor may recommend a safer alternative with the same medicinal effect based on your clinical condition.
General warnings

Hyperthyroidism

Hyperthyroidism is a condition where the thyroid gland (a butterfly-shaped gland in the neck) produces excess thyroid hormones. A dose adjustment of Propranolol may be required if you have a hyperactive thyroid gland because the clearance of Propranolol is increased from your body in such conditions. Inform your doctor if you have hyperthyroidism.

Sports

Avoid indulging in certain sports such as archery, racing, shooting, darts, golf, etc. during treatment with Propranolol. Sportspersons should refer to the list of medicines published by the World Anti-Doping Agency that should not be taken while participating in specific sports events.

Other medicines

Propranolol may react with other medicines and cause undesired effects. Hence, inform your doctor if you are taking any other medicines including supplements and herbs.

Paediatric use

The extended-release form of Propranolol is not recommended for use in children below 18 years of age due to a lack of safety and efficacy data.

Driving or operating machines

Propranolol may occasionally make you feel dizzy or tired. Hence, avoid performing activities such as driving vehicles or operating machines if you experience any of these symptoms during treatment with this medicine.

Missed Dose

Oral forms: If you forget to take a dose of Propranolol at the given time, take it as soon as you remember. If it is time for your next dose, skip the missed dose. Do not double your dose to make up for the missed dose. Injection: Since injections are usually administered by healthcare professionals, the chances of missing a dose are very unlikely.

Overdose

Oral forms: Never take more than the prescribed dose of Propranolol. Seek immediate medical attention in case of an overdose. Injection: As Propranolol injection is administered by a healthcare professional, the likelihood of an overdose is very less. However, emergency medical treatment will be initiated by your doctor if an overdose is suspected.
All drugs interact differently for person to person. You should check all the possible interactions with your doctor before starting any medicine.
Interaction with Alcohol

Description

N/A

Instructions

Do not consume alcohol if you are on treatment with Propranolol. Alcohol consumption may show additive effects in lowering your blood pressure. You may experience symptoms like headaches, dizziness, lightheadedness, fainting, and/or changes in heart rate.
Interaction with Medicine

Amlodipine

Diltiazem

Lidocaine

Aminophylline

Formoterol

Epinephrine

Disease interactions

Asthma

Asthma is a condition in which your airways become narrow and produce more mucous leading to breathing difficulty. Propranolol is not recommended for use if you have bronchial asthma or chronic obstructive pulmonary disease (a lung condition that causes blockage of airflow leading to breathing-related problems) as it may increase the risk of airway constriction which will further worsen your condition.

Diabetes

Propranolol may mask the symptoms of hypoglycemia (low blood sugar levels) such as high pulse rate, blood pressure changes, etc. Hence, this medicine should be used with caution if you have diabetes. Monitor your blood sugar levels regularly during treatment with this medicine.

Glaucoma

Glaucoma is an eye condition characterized by an increase in the pressure inside your eyes which can lead to ocular (eye) nerve damage. If you are taking medicines for the treatment of glaucoma, Propranolol may further decrease your eye pressure and lead to other complications. Hence, your doctor may recommend a dose adjustment based on your clinical condition.

Liver Disease

Propranolol is broken down in your liver and excreted through urine. If you have problems with your liver functioning this medicine can further worsen it. Hence, Propranolol should be used with caution if you have liver problems.

Kidney Disease

Propranolol should be used with caution if you have kidney problems. This medicine is excreted through urine. Using this medicine while you have kidney problems will lead to its accumulation in your body. This can cause permanent damage to your kidneys and worsen your condition.
Food interactions
Taking Propranolol with multivitamins should be avoided as it may decrease the effects of the medicine. A time gap of at least two hours should be maintained between the administration of multivitamins with minerals and this medicine to avoid their interaction.
Lab interactions
Information not available.
Tablet or Capsules: Take Propranolol exactly as advised by your doctor. Avoid taking more or less than the prescribed dose. Do not stop taking this medicine abruptly as it may worsen your condition. Consult your doctor if you experience side effects that remain for a long time or become worse. Injection: Propranolol injection is normally administered by qualified healthcare professionals in a clinic or hospital. You might feel some pain at the site of injection that usually lasts for a short while.
Miscelleneous

Usage does not depend on food timings

To be taken as instructed by doctor

Effect on sleep is not established

How it works
Propranolol works by relaxing blood vessels and slowing heart rate to improve blood flow and decrease blood pressure.
Legal Status

Approved

Approved

Approved

Approved

Classification

Category

Group II antiarrhythmics, Non-cardioselective beta blockers

Schedule

Schedule H

Dailymed.nlm.nih.gov. 2021. DailyMed - PROPRANOLOL HCL ER capsule, extended releasePROPRANOLOL HYDROCHLORIDE ER capsule, extended releasePROPRANOLOL HCL ER capsule, extended release. [online] Available at: < [Accessed 8 July 2021].

https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=5c370417-eff0-7280-e053-2a91aa0a1446>

Accessdata.fda.gov. 2021. [online] Available at: < [Accessed 8 July 2021].

https://www.accessdata.fda.gov/drugsatfda_docs/label/2011/018553s037lbl.pdf>

Drugs, H., 2021. Propranolol (Cardiovascular): MedlinePlus Drug Information. [online] Medlineplus.gov. Available at: < [Accessed 8 July 2021].

https://medlineplus.gov/druginfo/meds/a682607.html>

Medicines.org.uk. 2021. Propranolol 40mg Film-coated tablets - Summary of Product Characteristics (SmPC) - (emc). [online] Available at: < [Accessed 8 July 2021].

https://www.medicines.org.uk/emc/product/11812>

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Information on this page was last updated on 18 Nov 2021

Disclaimer

We’ve made all possible efforts to ensure that the information provided here is accurate, up-to-date and complete, however, it should not be treated as a substitute for professional medical advice, diagnosis or treatment. Practo only provides reference source for common information on medicines and does not guarantee its accuracy or exhaustiveness. The absence of a warning for any drug or combination thereof, should not be assumed to indicate that the drug or combination is safe, effective, or appropriate for any given patient. Practo does not assume any responsibility for any aspect of healthcare administered with the aid of information provided above. If you have any doubts about your medication then we strongly recommend that you consult with your doctor, nurse or healthcare provider. See detailed T&C here.