Propranolol at a glance
Medicine class
Non-selective beta blocker.
Main roles
Heart and circulation disorders, migraine prevention, essential tremor, physical anxiety symptoms and thyrotoxicosis symptoms.
Taking with food
It can usually be taken with or without food, but use the same approach consistently.
Stopping treatment
Do not stop propranolol suddenly without prescriber guidance.
What is Propranolol used for?
Selected UK products are licensed for:
High blood pressure, angina and many heart rhythm disorders.
Long-term protection after recovery from a heart attack.
Migraine prevention and essential tremor.
Situational or generalised anxiety symptoms, particularly physical symptoms.
Additional treatment for thyrotoxicosis or thyrotoxic crisis.
Hypertrophic obstructive cardiomyopathy.
Prevention of upper gastrointestinal bleeding associated with portal hypertension and oesophageal varices.
Peri-operative management of phaeochromocytoma alongside alpha-blockade.
How does Propranolol work?
Propranolol blocks beta-1 and beta-2 adrenoceptors, reducing the effects of adrenaline and related stress hormones. This slows the heart, reduces its workload and dampens symptoms such as palpitations, shaking and sweating.
Propranolol preparations and strengths
Capsule
Route: Oral
Strengths: 80 mg, 160 mg
Dispersible tablet
Route: Oral
Strengths: 10 mg, 40 mg
How to take Propranolol
Follow the label and instructions for the specific product. Do not stop treatment abruptly unless urgently directed by a clinician.
Swallow conventional tablets with water. Check the leaflet before splitting because score lines on selected tablets are not intended for division.
Measure oral solution with the supplied oral syringe or medicine spoon, not a kitchen teaspoon.
Place Xytencorg orodispersible tablets on the tongue, allow them to disperse and then swallow, with or without water.
It can generally be taken with or without food, but be consistent.
Propranolol side effects
Common or expected effects
- Tiredness, weakness or dizziness.
- Cold fingers or toes, sometimes with Raynaud-type symptoms.
- Sleep disturbance or nightmares.
- Headache.
- A slower heart rate.
- Nausea, vomiting or diarrhoea.
Get urgent medical advice
- New wheezing, marked breathlessness or difficulty breathing.
- Fainting, a very slow heartbeat, a new rhythm disturbance or worsening heart failure symptoms.
- Severe allergic-reaction symptoms, including swelling or difficulty swallowing or breathing.
- Significant hypoglycaemia symptoms, particularly confusion, unusual drowsiness, sweating, shaking or seizure.
- Unexpected or unusually easy bruising, which can indicate a low platelet count.
Propranolol in pregnancy
Propranolol may be used during pregnancy when recommended by a doctor. Existing treatment should be reviewed early rather than stopped without advice. Additional fetal-growth scans may be offered, and late-pregnancy exposure can occasionally cause temporary neonatal effects such as low blood glucose or a slow heart rate.
Propranolol while breastfeeding
Propranolol passes into breast milk in very small amounts and is a preferred beta blocker when breastfeeding a healthy, full-term infant. As a precaution, monitor feeding, weight gain, alertness, pallor, sweating, shaking and breathing. Seek specialist advice for premature or unwell infants.
Propranolol interactions
This is not an exhaustive list. Check all prescribed, pharmacy and herbal products with a clinician or pharmacist.
Verapamil or diltiazem
The combination can markedly slow the heart or cause low blood pressure, conduction block or heart failure.
Amiodarone, flecainide, disopyramide or digoxin
Additive effects on heart rate, conduction and cardiac function may require avoidance or close monitoring.
Insulin and other glucose-lowering medicines
Propranolol can prolong hypoglycaemia and mask warning signs such as a fast heartbeat.
Common questions about Propranolol
Answers are fully visible for fast scanning and source review.
Is propranolol the same medicine as propranolol hydrochloride?
Yes. Propranolol hydrochloride is the salt form used as the active ingredient in these products.
Does propranolol treat anxious thoughts?
It mainly reduces physical symptoms such as shaking, sweating and a racing heartbeat. It does not directly address underlying thoughts or causes of anxiety.
Can someone with asthma take propranolol?
A history of asthma, wheezing or bronchospasm is a contraindication in the selected products because propranolol can narrow the airways.
Can propranolol hide low blood sugar?
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.