Propranolol is a beta-blocker medication. Beta-blockers affect the heart, lungs 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 prescribed off-label for the treatment of performance-only social anxiety disorder. Providers may prescribe propranolol to control some of the more physical signs of performance anxiety. For example, mild shaking or tremor, racing heartbeat and sweating. The more you have these symptoms, the more anxious you may feel.
What are the possible side effects of propranolol?
Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.
Consult your doctor at once if you have any of these less common, but serious, side effects:
- A light-headed feeling, like you might pass out
- Wheezing or trouble breathing
- Shortness of breath (even with mild exertion), swelling, rapid weight gain
- Sudden weakness, vision problems, or loss of coordination
- Depression, confusion, hallucinations
- Liver problems--nausea, upper stomach pain, itching, tired feeling, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes)
- Low blood sugar--headache, hunger, weakness, sweating, confusion, irritability, dizziness, fast heart rate, or feeling jittery
- Severe skin reaction--fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.
Common side effects may include:
- Slow heart rate (may affect 10-20% of those who take this medication)
- Fatigue (10-15%)
- Dizziness (5-10%)
- Low blood pressure (5-10%)
- Nausea (1-5%)
- Diarrhea (1-5%)
- Constripation (1-5%)
- Depression (1-5%)
- Weakness (1-5%)
- Decreased interest in sex (1-5%)
This is not a complete list of side effects and others may occur. Consult your doctor for medical advice about side effects. You may report side effects to the FDA at
www.fda.gov/medwatch or call 1-800-FDA-1088.
What should I discuss with my doctor before taking propranolol?
Do not use Propranolol Hydrochloride if you have a history of:
- Sudden and severe drop in blood pressure and blood flow through the body because the heart is not pumping normally
- Any allergies to the active ingredient Propranolol Hydrochloride, or to any of the inactive ingredients.
- Anaphylactic reaction/Anaphylaxis
- Bradycardia (slow heartbeat), Heart block/heart rhythm disorder, Sick sinus syndrome (type of abnormal heart rhythm), Tachycardia (fast heartbeat)
- Angina (severe chest pain)
- Asthma, COPD, or Bronchospasm
- Recent heart attack
- Glaucoma
- Muscle problems (eg, myopathy, myotonia or myasthenia gravis)
- Wolff-Parkinson-White syndrome (rare heart condition)
- Heart failure
- Tremors due to Parkinson's disease
- Hypotension (low blood pressure)
- Pheochromocytoma (an adrenal problem)
- Diabetes
- Hypoglycemia (low blood sugar)
- Hyperthyroidism (overactive thyroid)
- Kidney disease
- Liver disease
- Lung disease (eg, chronic bronchitis, emphysema, COPD)
- Blood circulation problems (e.g., Raynaud's disease)
What should I tell my healthcare provider before taking Propranolol Hydrochloride?
Before starting Propranolol Hydrochloride, tell your healthcare provider about all of your medical conditions, including if you:
- Have heart failure
- Are scheduled for surgery and will be given anesthetic agents
- Have diabetes and take medicine to control blood sugar
- Have thyroid problems
- Have irregular heartbeats
- Have liver or kidney problems
- Have had allergic reactions to medications or have allergies
- Have asthma or other lung problems (such as bronchitis or emphysema)
- Are pregnant or trying to become pregnant. It is not known if propranolol hydrochloride is safe for your unborn baby
Are breastfeeding or plan to breastfeed. Propranolol hydrochloride passes into your breastmilk.
It is not known whether propranolol will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medicine.
Propranolol can pass into breast milk and may harm a nursing baby. Tell your doctor if you are breast-feeding a baby.
How should I take propranolol?
To get started, review the directions on your prescription label and follow your provider's dosing instructions. Since propranolol affects different people in different ways, it’s a good idea to take a test dose at home before using it in front of an audience.
Do not take this medicine in larger or smaller amounts or for longer than recommended.
Adults may take propranolol with or without food, but take it the same way each time.
If you need surgery, tell the surgeon ahead of time that you are using propranolol. You may need to stop using the medicine for a short time.
This medicine can cause unusual results with certain medical tests. Tell any doctor who treats you that you are using propranolol.
Store at room temperature away from moisture and heat. Do not allow liquid medicine to freeze.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.
Overdose symptoms may include slow or uneven heartbeats, dizziness, weakness, or fainting.
What other drugs will affect propranolol?
Tell your doctor about all medicines you use, and those you start or stop using during your treatment with propranolol, especially:
- Blood thinners--warfarin, Coumadin, Jantoven
- Antidepressants--amitriptyline, clomipramine, desipramine, imipramine, and others
- Drugs to treat high blood pressure or a prostate disorder--doxazosin, prazosin, terazosin
- Heart or blood pressure medicine--amiodarone, diltiazem, propafenone, quinidine, verapamil, and others
- NSAIDs (nonsteroidal anti-inflammatory drugs)--aspirin, ibuprofen (Advil, Motrin), naproxen(Aleve), celecoxib, diclofenac, indomethacin, meloxicam, and others
- Steroid medication--prednisone and others.
This list is not complete. Other drugs may interact with propranolol, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.
REMEMBER, KEEP THIS AND ALL OTHER MEDICINES OUT OF THE REACH OF CHILDREN, NEVER SHARE YOUR MEDICINES WITH OTHERS, AND USE THIS MEDICATION ONLY FOR THE INDICATION PRESCRIBED.