GENERIC NAME: Propranolol

COMMON BRAND: Inderal

Propranolol is an oral prescription drug that belongs to a class of drugs called non-cardioselective beta-blockers. Propranolol works similarly on the heart, lungs, and other areas of the body. A class of drugs is often used to treat similar conditions.

It is not clear how precisely propranolol works to reduce blood pressure. This drug decreases the workload on the heart and blocks the release of a substance from the kidneys known as renin (renin causes vasoconstriction and increases blood pressure). The beta-blocking properties help to regulate heart rhythm, delay of chest pain, prevent migraines and reduce tremors.

What is Propranolol uses for?

Propranolol is a non-selective beta blocker used for the treatment of high blood pressure, shaking (tremors), irregular heartbeats and other conditions. Lowering high blood pressure prevents the risk of strokes, heart attacks, and kidney problems. This drug is also used for the treatment of angina (chest pain), migraine headaches and increases survival chances in case of a sudden heart attack.

This drug acts by blocking the action of certain natural chemicals in your body like adrenaline (norepinephrine) that affect the heart and blood vessels. This effect reduces heart rate, blood pressure, and strain on the heart.

How to use Propranolol?

See Warning section.

Propranolol is taken orally, as directed by the doctor, usually 2-4 times in a day, before meals or at bedtime if taking 4 times a day. The dosage of this drug depends on your medical condition and response to the treatment. Measure the liquid medicine with a measuring spoon or device (usually comes with the product package). Do not use any household spoon as you may end up measuring an incorrect dose.

Use this medication regularly as instructed by your doctor to get the most benefit from it. To remember, take this drug at the same time each day. It is crucial to continue this drug even if you feel better. Most of the people having hypertension (high blood pressure) do not feel ill.

Propranolol is used for the treatment of chest pain and migraines. Do not use this drug for the treatment of chest pain or migraines headaches when they occur. Use other medications (for example nitroglycerin for chest pain and sumatriptan for migraines) to relieve chest pain as instructed by your doctor.

Take propranolol at least an hour before or at least 4 hours after taking cholesterol-lowering drugs such as bile acid-binding resins like cholestyramine or colestipol.

You may have to wait for 1 to 2 weeks to observe the full benefit of this medicine. Inform your doctor if your medical condition remains unchanged or if it worsens (for example, if your blood pressure remains high or chest pain or migraine headaches occurs more often).

What are the side effects of Propranolol?

Some of the significant side effects that may occur with Propranolol include dizziness, lightheadedness, or tiredness. Other side effects you may experience with this drug include nausea/vomiting, stomach pain, trouble sleeping, vision changes, and unusual. If any of these effects remain or worsen, inform your doctor/pharmacist immediately.

You may experience coldness in your hands and feet as this drug may decrease the blood flow to these parts of the body. Avoid smoking or chewing of tobacco as this may worsen this effect.

Your doctor/physician has prescribed this medication because he or she has found that the benefits to you are more than the side effects. Most of the people using this medication do not experience severe side effects.

Notify your doctor on time if any of these serious side effects occur: blue fingers/toes, mental/mood changes (e.g., depression), very slow heartbeat, fainting, numbness/tingling of arms/legs, increased thirst/urination, new or worsening symptoms of heart failure (such as shortness of breath, swelling ankles/feet, unusual tiredness, unusual/sudden weight gain), low sexual ability.

Seek medical assistance if these rare but serious side effects occur such as bruising/bleeding, aching/swollen joints signs of infection (such as fever, persistent sore throat).

A severe allergic reaction to this drug is very rare. However, a severe allergic reaction that includes rashes, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing may occur. Get medical assistance immediately if you notice any of the above side effects.

This is not a complete list of all possible side effects. Inform your doctor at the earliest, if you notice any of the side effects that are not mentioned in this article.

See also Warning and Precautions sections.

What are the precautions while using Propranolol?

Inform your doctor/pharmacist before taking propranolol, if you are allergic to it; or to any other beta-blockers (for example metoprolol, bisoprolol); or if you have other allergies. Drug formulations (products containing propranolol) may also include some ingredients that can cause allergic reactions or other problems. Talk to your doctor/pharmacist for further information.

Inform your doctor/pharmacist before using propranolol about your medical history, especially if you have any breathing problems (such as asthma, emphysema, bronchitis), heart failure, heart rhythm problems (such as Wolff-Parkinson-White syndrome, sinus bradycardia, second- or third-degree atrioventricular block), liver disease, overactive thyroid (hyperthyroidism), kidney disease, pheochromocytoma (adrenal tumor), blood circulatory problems (such as Raynaud’s disease), mental/mood disorders (such as depression), severe allergic reactions, or myasthenia gravis (muscle/nerve disease).

If you have diabetes, this drug may mask the symptoms of hypoglycemia (sudden fall in blood sugar level) such as fast/pounding heartbeat you would usually feel when you are hypoglycemic. Other symptoms of hypoglycemia such as sweating and dizziness, does not change by this drug. This drug can also make it difficult to control your blood sugar level. Monitor your blood sugar levels regularly share the results with the doctor. Inform your doctor immediately if you have any symptoms of hyperglycemia (high blood sugar level) such as an increase in thirst or urination. Your doctor may recommend you exercises, diet or may adjust your diabetes medication.

Get up slowly from a sitting/lying position, and this may help to reduce the risk of dizziness and lightheadedness.

Before having any surgery, notify your doctor or dentist about all the products you use (such as prescription drugs, nonprescription drugs, and herbal product).

This drug may cause you dizzy. Alcohol or marijuana can make you dizzier. Avoid driving, use of machinery or doing anything that needs sharpness until you can do it safely. Limit alcoholic beverages. Speak to your doctor/physician if you are using any of the above.

This medication should be used only when needed during pregnancy and under doctor’s supervision. It may be harmful to the fetus. Children exposed to this medication during pregnancy may suffer low birth weight, low blood sugar, or slow breathing/heartbeat. This drug can also cross into breast milk. For further information about the risks and benefits discuss with your doctor.

What are the drug interactions of Propranolol?

Drug interactions may alter drug’s action or increase your chance for serious side effects. This section does not contain the full list of all possible drug interactions. Have a list of all the products you use (for example prescription/nonprescription drugs and herbal products) and inform it to your doctor/pharmacist. Do not start, stop, or adjust the dosage of any medicines without your doctor’s advice.

Propranolol may interact with alpha blockers (e.g., prazosin), aluminum hydroxide, anticholinergics (such as scopolamine, atropine), drugs affecting liver enzymes that helps to eliminate propranolol from your body (such as certain SSRI antidepressants including fluoxetine/fluvoxamine/paroxetine, cimetidine, St. John’s wort, HIV protease inhibitors such as ritonavir, rifamycins including rifabutin), other drugs used in the treatment of high blood pressure (such as clonidine, methyldopa, hydralazine), epinephrine, fingolimod, haloperidol, warfarin, other heart medications (such as digoxin, disopyramide, propafenone, quinidine), mefloquine, rizatriptan, theophylline, thioridazine, thyroid hormones (such as levothyroxine).

Some products may contain ingredients that could raise your blood pressure or heart rate. Tell your doctor/pharmacist about products you are using, and ask how to use them safely (particularly cough-and-cold products, NSAIDs such as ibuprofen/naproxen, diet aids).

Propranolol may interfere with specific laboratory test results (for example cardiovascular stress testing using arbutamine, glaucoma screening test), this can lead to incorrect lab test results. Make sure you inform all your health care providers about this drug.

See also How to Use section.

WARNINGS:

Do not suddenly stop this medication without informing your doctor. Some conditions may become dangerous when you suddenly discontinue this drug. Some people who have abruptly discontinued taking similar drugs have had angina (chest pain), heart disease (such as a sudden increase in blood pressure, coronary artery disease, ischemic heart disease). If your doctor recommends you to stop this drug, your doctor may ask you to reduce your dose gradually.

When you are gradually reducing the dose of this drug to discontinue this medication slowly, your doctor may recommend you to limit physical activity to reduce strain on your heart. Get medical assistance immediately if you notice symptoms like chest pain/tightness/pressure, unusual sweating, trouble in breathing, fast/irregular heartbeat, or chest pain spreading to the jaw/neck/arm.

What are the forms and strengths of Propranolol?

Generic: Propranolol
Form: Oral tablet
Strengths: 10mg, 20mg, 40mg, 60mg, 80mg

What is the dosage of Propranolol?

For Atrial Fibrillation:

Adult dosage (18 years and older):

The typical dosage is 10–30mg taken 3–4 times per day, before meals and at bedtime.

Children (0–17 years):

Avoid using propranolol in children under the age of 18 years, as the studies have not established yet.

For Hypertension (high blood pressure):

Adult dosage (ages 18 years and older):

Typical starting dosage: 40mg twice daily.

Dosage increases: To increase the dose, your doctor may gradually increase the dose.

Typical maintenance dosage: 120–240mg per day given in 2–3 divided doses. In some cases, dose up to 640mg per day is given.

Notes:

You may have to wait for several days to several weeks to observe the full benefit of this drug. If you are taking a low dose twice a day and your blood pressure does not subside, this your doctor may gradually increase your dose or may recommend you to take three times per day.

Children (0–17 years):

Avoid using propranolol in children under the age of 18 years, as the studies have not established yet.

For Angina (chest pain):

Adult dosage (ages 18 years and older):

Typical dosage: 80–320mg per day, 2-4 times in divided doses (not at once).

Children (0–17 years):

Avoid using propranolol in children under the age of 18 years, as the studies have not established yet.

For Heart Attack:

Adult dosage (ages 18 years and older):

Typical starting dosage: 40mg three times a day.

Dosage increases: To increase the dose, your doctor may gradually increase the dose after 1 month up to 60–80mg three times per day.

Typical maintenance dosage: 180–240mg per day, 2-4 times in divided doses (not at once).

Children (ages 0–17 years):

Avoid using propranolol in children under the age of 18 years, as the studies have not established yet.

For Hypertrophic Subaortic Stenosis:

Adult dosage (18 years and older):

Typical dosage: 20–40mg taken 3–4 times per day, before meals and at bedtime.

Children (0–17 years):

Avoid using propranolol in children under the age of 18 years, as the studies have not established yet.

For Migraine:

Adult dosage (18 years and older):

Typical starting dosage: 80mg per day. 2-3 times in divided doses (not at once).

Typical maintenance dosage: 160–240mg per day.

Note:

If your migraine headaches don’t subside after 4-6 weeks of treatment with propranolol. Your doctor may slowly reduce your dose over a period of several weeks to avoid side effects from stopping too quickly.

Children (0–17 years):

Avoid using propranolol in children under the age of 18 years, as the studies have not established yet.

For Essential Tremor:

Adult dosage (18 years and older):

Typical starting dosage: 40mg twice a day.

Dosage increase: 120mg a day. In a few cases, the dosage is increased to 240–320mg per day.

Children (0–17 years):

Avoid using propranolol in children under the age of 18 years, as the studies have not established yet.

For Pheochromocytoma (a tumor in the adrenal gland):

Adult dosage (18 years and older):

Typical maintenance dosage: 60mg per day taken in divided doses starting 3 days before your surgery.

Notes:

Propranolol is not used alone for the treatment of pheochromocytoma. If the surgery can’t be done for a tumor, the usual dosage of this is 30mg per day in divided doses in combination with other medications.

Children (0–17 years):

Avoid using propranolol in children under the age of 18 years, as the studies have not established yet.

Special Dosage Considerations:

Kidney problems: People suffering from kidney problems can make it more difficult to eliminate this drug from the body. Inform your doctor about your condition. Caution is required when prescribing this drug.

Liver problems: Inform your doctor if you are suffering from any liver problems. Caution is required when prescribing this drug.

Disclaimer

TheMedPharma has made every effort to make sure that all the information is factually correct, comprehensive, and up-to-date. However, this website should not be considered as a substitute for the advice, knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or licensed health care professional before taking any medication. The drug information contained herein is subjected to changes if required. The lack of warnings or other information for a given drug does not mean that the drug or its combination is safe, effective or appropriate for use in all patients.