Drug NamePropranolol Drug UsesPropranolol is used for treating certain types of irregular heartbeat. It may also be used for other conditions as determined by your doctor. How to useUse Propranolol as directed by your doctor.
- Take Propranolol by mouth with or without food.
Ask your health care provider any questions you may have about how to use Propranolol. Drug Class and MechanismPropranolol is a beta-blocker. It works by decreasing the action of pacemaker cells and slowing certain impulses in the heart. This helps to control irregular heartbeat. Missed DoseIf you miss a dose of Propranolol and are taking it regularly, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once. Storage Store Propranolol at room temperature, between 68 and 77 degrees F (20 and 25 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Keep in a tight, light-resistant container. Keep Propranolol out of the reach of children and away from pets. Possible Side EffectsCheck with your doctor if any of these most common side effects persist or become bothersome: - constipation; diarrhea; dizziness; drowsiness; fatigue; lightheadedness; mild pain, swelling, or redness at the injection site; nausea; stomach upset or cramping; trouble sleeping; vomiting; weakness.
Seek medical attention right away if any of these severe side effects occur: - severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); chest pain; disorientation; fever with aching and sore throat; hallucinations; memory loss; mental or mood changes; numbness or tingling of the hands; persistent or severe vision changes; red, swollen, blistered or peeling skin; severe dizziness; shortness of breath or wheezing; sudden unusual weight gain; swelling of the hands, ankles, or feet, unusual bruising; unusually slow heartbeat; very cold or blue fingers or toes.
More InformationPropranolol is to be used only by the patient for whom it is prescribed. Do not share it with other people.
If your symptoms do not improve or if they become worse, check with your doctor. Warnings/PrecautionsDo not use Propranolol if: - you are allergic to any ingredient in Propranolol;
- you have moderate to severe heart block, uncontrolled heart failure, shock caused by serious heart problems, very slow heartbeat with heart block, or very low blood pressure after a heart attack;
- you have asthma or Raynaud syndrome;
- the patient is a child with diabetes or heart failure.
- you are taking mibefradil.
Contact your doctor or health care provider right away if any of these apply to you. Important : - Propranolol may cause drowsiness, dizziness, lightheadedness, or vision changes. These effects may be worse if you take it with alcohol or certain medicines. Use Propranolol with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
- Check with your doctor before you drink alcohol while you are taking Propranolol; it may increase the risk of Propranolol 's side effects.
- Do not take more than the recommended dose without checking with your doctor.
- Patients who take medicine for high blood pressure often feel tired or run down for a few weeks after starting treatment. Be sure to take your medicine even if you may not feel "normal." Tell your doctor if you develop any new symptoms.
- If you have a history of any severe allergic reaction, talk with your doctor. You may be at risk for an even more severe allergic reaction if you come into contact with the substance that caused your allergy. Some medicines used to treat severe allergies may also not work as well while you are using Propranolol.
- Propranolol may lower your blood sugar levels. This is most likely to happen in infants and children, or in patients who have diabetes or kidney problems. It may also occur after prolonged physical activity or during fasting. Low blood sugar may make you anxious, sweaty, weak, dizzy, drowsy, or faint. It may also make your heart beat faster; make your vision change; give you a headache, chills, or tremors; or make you more hungry. If this occurs, you should eat or drink a quick source of sugar like table sugar, honey, candy, orange juice, or non-diet soda. This will raise your blood sugar level quickly. Tell your doctor right away if this happens.
- Diabetes patients - Propranolol may hide signs of low blood sugar, such as a rapid heartbeat. Be sure to watch for other signs of low blood sugar. Check blood sugar levels closely. Ask your doctor before you change the dose of your diabetes medicine.
- Propranolol may interfere with certain lab tests, including the glaucoma screening test and dobutamine stress echocardiography. Be sure your doctor and lab personnel know you are using Propranolol.
- Lab tests, including blood pressure and heart function tests, may be performed while you use Propranolol. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
- Pregnancy and breast-feeding: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Propranolol while you are pregnant. Propranolol is found in breast milk. If you are or will be breast-feeding while you use Propranolol, check with your doctor. Discuss any possible risks to your baby.
What is propranolol?
Propranolol is in a group of drugs called beta-blockers. Beta-blockers affect the heart and circulation (blood flow through arteries and veins).
Propranolol is used to treat tremors, angina (chest pain), hypertension (high blood pressure), heart rhythm disorders, and other heart or circulatory conditions. It is also used to treat or prevent heart attack, and to reduce the severity and frequency of migraine headaches.
Propranolol may also be used for other purposes not listed in this medication guide.
What is the most important information I should know about propranolol?
You should not use this medication if you are allergic to propranolol, or if you have asthma or certain heart conditions, especially second or third degree heart block. Do not stop taking propranolol without first talking to your doctor. Stopping suddenly may make your condition worse.
If you need to have any type of surgery, you may need to temporarily stop using propranolol. Be sure the surgeon knows ahead of time that you are using propranolol.
Avoid drinking alcohol. It may increase your blood levels of propranolol.
Propranolol is only part of a complete program of treatment for hypertension that may also include diet, exercise, and weight control. Follow your diet, medication, and exercise routines very closely if you are being treated for hypertension.
Hypertension often has no symptoms, so you may not even feel that you have high blood pressure. Continue using this medicine as directed, even if you feel well. You may need to use blood pressure medication for the rest of your life.
What should I discuss with my healthcare provider before taking propranolol?
You should not use this medication if you are allergic to propranolol, or if you have asthma or certain heart conditions, especially second or third degree heart block.
If you have certain conditions, you may need a dose adjustment or special tests to safely use this medication. Before taking propranolol, tell your doctor if you have:
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bronchitis, emphysema, or other breathing disorders;
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diabetes;
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low blood pressure;
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a heart problem such as heart block, sick sinus syndrome, slow heart rate, or congestive heart failure;
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depression;
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liver or kidney disease;
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a thyroid disorder;
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pheochromocytoma; or
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problems with circulation (such as Raynaud's syndrome).
FDA pregnancy category C. This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. Propranolol can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.
How should I take propranolol?
Take propranolol exactly as it was prescribed for you. Do not take the medication in larger amounts or for longer than recommended by your doctor. Follow the directions on your prescription label.
Take this medication with a full glass of water.
Take propranolol at the same time every day.
Do not crush, chew, break, or open an extended-release capsule. Swallow the pill whole. It is specially made to release medicine slowly in the body. Breaking or opening the pill would cause too much of the drug to be released at one time.
To be sure you get the correct dose, measure the liquid with a marked measuring spoon or medicine cup, not with a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.
Do not skip doses or stop taking propranolol without first talking to your doctor. Stopping suddenly may make your condition worse.
To be sure this medication is helping your condition, your blood pressure will need to be checked on a regular basis. It is important that you not miss any scheduled visits to your doctor.
If you need to have any type of surgery, tell the surgeon that you are using propranolol. You may need to briefly stop using propranolol before having surgery.
Propranolol is only part of a complete program of treatment for hypertension that may also include diet, exercise, and weight control. Follow your diet, medication, and exercise routines very closely if you are being treated for hypertension.
Hypertension often has no symptoms, so you may not even feel that you have high blood pressure. Continue using this medicine as directed, even if you feel well. You may need to use blood pressure medication for the rest of your life.
Store propranolol at room temperature away from moisture and heat.
What happens if I miss a dose?
For regular (short-acting) propranolol: Take the missed dose as soon as you remember. If your next dose is less than 4 hours away, skip the missed dose and take the medicine at the next regularly scheduled time.
For extended-release propranolol (Inderal LA, InnoPran XL and others): Take the missed dose as soon as you remember. If your next dose is less than 8 hours away, skip the missed dose and take the medicine at the next regularly scheduled time.
Do not take extra medicine to make up the missed dose.
What happens if I overdose?
Seek emergency medical attention if you think you have used too much of this medicine.
Overdose symptoms may include slow or uneven heartbeats, dizziness, weakness, or fainting.
What should I avoid while taking propranolol?
Avoid drinking alcohol. It may increase your blood levels of propranolol.
Propranolol side effects
Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have any of these serious side effects:
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fast, slow, or uneven heartbeats;
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feeling light-headed, fainting;
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feeling short of breath, even with mild exertion;
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swelling of your ankles or feet;
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fever, sore throat, and headache with a severe blistering, peeling, and red skin rash;
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nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);
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depression, confusion, hallucinations; or
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cold feeling in your hands and feet.
Less serious side effects may include:
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nausea, vomiting, diarrhea, constipation, stomach cramps;
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decreased sex drive, impotence, or difficulty having an orgasm;
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sleep problems (insomnia); or
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tired feeling.
This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect.
Propranolol Dosing Information
Usual Adult Dose for Hypertension: Initial dose: 40 mg orally twice a day or 80 mg sustained release once a day, whether used alone or added to a diuretic.
Maintenance dose: 120 to 240 mg/day or 120 to 160 mg/day of sustained release
Maximum dose: 640 mg/day. Usual Adult Dose for Angina Pectoris: Total daily doses of 80 to 320 mg orally 2 to 4 times a day have been shown to increase exercise tolerance and to reduce ischemic changes in the ECG.
Sustained release: Initial dose: 80 mg orally once a day. Dosage should be gradually increased at 3 to 7 day intervals. The average optimal dosage appears to be 160 mg/day. Usual Adult Dose for Arrhythmias: Oral: 10 to 30 mg 3 to 4 times a day, before meals and at bedtime.
IV: 1 to 3 mg at a rate not exceeding 1 mg/min.
Sufficient time should be allowed for the drug to reach the site of action even when a slow circulation is present. A second dose may be given after 2 minutes. Thereafter, additional drug should not be given in less than 4 hours. Additional propranolol should not be given when the desired alteration in rate and/or rhythm is achieved. Usual Adult Dose for Myocardial Infarction: 180 to 240 mg/day in 3 to 4 divided doses. Usual Adult Dose for Migraine Prophylaxis: Initial dose: 80 mg/day orally in divided doses.
Maintenance dose: 160 to 240 mg/day.
The dosage may be increased gradually to achieve optimum migraine prophylaxis. If a satisfactory response is not obtained within 4 to 6 weeks after reaching the maximum dose, propranolol therapy should be discontinued.
Sustained release: Initial dose: 80 mg orally once a day.
Maintenance dose: 160 to 240 mg once a day. Usual Adult Dose for Benign Essential Tremor: Initial dose: 40 mg orally twice a day.
Maintenance dose: 120 to 320 mg/day.
Optimum reduction of essential tremor is usually achieved with a dose of 120 mg/day.
Occasionally, it may be necessary to administer 240 to 320 mg/day. Usual Adult Dose for Aortic Stenosis: 20 to 40 mg orally 3 to 4 times a day, before meals and at bedtime.
Sustained release: 80 to 160 mg orally once a day. Usual Adult Dose for Pheochromocytoma: Preoperatively: 60 mg/day orally in divided doses for 3 days prior to surgery, concomitantly with an alpha-adrenergic blocking agent.
Management of Inoperable Tumor: 30 mg/day orally in divided doses. Usual Pediatric Dose for not applicable: Neonates
Oral: 0.25 mg/kg/dose every 6 to 8 hours to a maximum of 5 mg/kg/day
Intravenous: 0.01 mg/kg slow IV push over 10 minutes every 6 to 8 hours as needed to a maximum of 0.15 mg/kg/dose every 6 to 8 hours.
Children:
Oral: 0.5 to 1 mg/kg/day in 3 to 4 divided doses. Usual dose is 2 to 4 mg/kg/day (maximum of 16 mg/kg/day or 60 mg/day).
Intravenous: 0.01 to 0.1 mg/kg slow IV over 10 minutes to a maximum of 1 mg (infants); 3 mg (children)
What other drugs will affect propranolol?
Tell your doctor about all other medications you use, especially:
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clonidine (Catapres);
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digitalis (digoxin, Lanoxin);
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dobutamine (Dobutrex);
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haloperidol (Haldol);
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isoproterenol (Isuprel);
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a blood thinner such as warfarin (Coumadin);
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an antidepressant such as amitriptyline (Elavil, Etrafon), clomipramine (Anafranil), desipramine (Norpramin), imipramine (Janimine, Tofranil), and others;
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an MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate);
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aspirin or other NSAIDs (non-steroidal anti-inflammatory drugs) such as ibuprofen (Motrin, Advil), naproxen (Aleve, Naprosyn), diclofenac (Cataflam, Voltaren), etodolac (Lodine), indomethacin (Indocin), ketoprofen (Orudis), and others;
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doxazosin (Cardura), prazosin (Minipress), terazosin (Hytrin);
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a heart medication such as nifedipine (Procardia, Adalat), reserpine (Serpasil), diltiazem (Cartia, Cardizem), or verapamil (Calan, Verelan, Isoptin);
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amiodarone (Cordarone, Pacerone), propafenone (Rythmol), quinidine (Quinaglute, Quinidex, Quin-Release); or
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an ACE inhibitor such as benazepril (Lotensin), captopril (Capoten), fosinopril (Monopril), enalapril (Vasotec), lisinopril (Prinivil, Zestril), moexipril (Univasc), perindopril (Aceon), quinapril (Accupril), ramipril (Altace), or trandolapril (Mavik).
This list is not complete and there may be other drugs that can interact with propranolol. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.
Where can I get more information?
- Your pharmacist can provide more information about propranolol.
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