Propranolol

Propranolol is used to treat a number of different conditions. If you are unsure why you are taking propranolol, speak with your doctor.
Do not stop taking this medicine without speaking to your doctor first as this can cause problems.
The most common side-effects are tiredness, cold fingers or toes, disturbed sleep and stomach upset.

About propranolol

Type of medicine

A beta-adrenoceptor blocking drug (often referred to as a beta-blocker)

Used for

High blood pressure
Angina
Irregular heartbeat
Some symptoms of anxiety
Some thyroid problems
To protect the heart following a heart attack
To help prevent migraines

Also called

Bedranol SR®
Beta Prograne®; Half Beta Prograne®
Inderal-LA®; Half-Inderal LA®
Syprol®

Available as

Tablets, modified-release capsules, and oral liquid

Propranolol is a medicine which is used to treat several different problems. It works on the heart and blood vessels.

High blood pressure: it is not fully understood how propranolol works in hypertension (high blood pressure), but it is known to slow down the activity of the heart. This then reduces high blood pressure.

Angina: by slowing down the activity of the heart, propranolol reduces the heart's need for oxygen. This reduces how hard the heart has to work and makes angina attacks less likely to occur.

Irregular heartbeat: normally the heartbeat is regulated by special tissues which conduct electricity. Some causes of irregular heartbeat result in parts of the heart beating too quickly. Propanolol reduces the overactivity in these conducting tissues.

Anxiety: anxiety can cause physical symptoms such as a fast heartbeat and trembling. Propranolol slows the heart rate to relieve these symptoms. (However it does not relieve the emotional symptoms associated with anxiety, such as stress or fear, so these symptoms should be treated separately.)

Thyroid problems: an overactive thyroid gland causes symptoms such as a fast heartbeat and trembling. Propranolol relieves these symptoms quickly, which allows time for other antithyroid treatments to take effect, which may take several weeks.

To protect the heart: taking propranolol after having a heart attack has been shown to reduce the risk of a second attack in some people.

To prevent migraines: it is not clear how propranolol and other beta-blockers work to prevent migraine, but they are commonly used. Migraine prevention with propranolol may be helpful for people who suffer several migraine attacks each month and also for people who find the treatments for migraine unsuitable. Although propranolol helps prevent migraines from starting, if a migraine attack occurs, other medicines are used to treat it.

Before taking propranolol

Before taking propranolol make sure your doctor or pharmacist knows:

If you are pregnant, trying for a baby or breast-feeding.
If you have liver or kidney problems.
If you have low blood pressure or poor circulation.
If you have asthma or breathing difficulties.
If you have diabetes.
If you have psoriasis (a skin problem).
If you have myasthenia gravis (a condition causing muscle weakness).
If you have heart failure (a condition where the pumping action of the heart is reduced) or heart block (a slow and irregular heartbeat).
If you have been told you have Prinzmetal's angina (chest pain caused by spasms of the heart's blood vessels).
If you have phaeochromocytoma (a tumour on your adrenal gland).
If you are taking other medicines, including those available to buy without a prescription, herbal and complementary medicines.
If you have ever had an allergic reaction to a medicine, or if you have ever had any other severe allergic reaction.

How to take propranolol

Before starting this treatment, read the manufacturer's printed information leaflet from inside the pack.
Take propranolol exactly as your doctor has told you.
If you have been given a long-acting or sustained-release brand of propranolol (if so, the name of your medicine will have 'LA' or 'SR' after it), you should swallow these capsules whole. Do not chew or crush the capsules, as they are made so that the propranolol is released slowly.
Try to take your doses of propranolol at the same times each day to avoid missing any.
If you do forget to take a dose, take it as soon as you remember unless it is nearly time for your next dose, in which case leave out the missed dose. Do not take two doses together to make up for a forgotten dose.

Getting the most from your treatment

Try to keep your regular appointments with your doctor. This is so your progress can be monitored.
It is very important to follow any dietary advice that you may have been given by your doctor.
It is recommended that you avoid drinking alcohol while you are taking propranolol, as it may increase some of its side-effects.
If you have diabetes, check your blood glucose levels regularly, as this medicine can affect the levels of sugar in your blood. It may also block the symptoms of low blood sugar.
If you are having an operation or dental treatment, tell the person carrying out the treatment that you are taking propranolol.
Do not stop taking this medicine unless your doctor tells you to stop. Stopping treatment suddenly can cause problems in some people and your doctor will probably want you to reduce your dose gradually if this is necessary.
If you buy any medicines, check with a pharmacist that they are safe to take with propranolol.

Can propranolol cause problems?

Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. These usually improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following side-effects continue or become troublesome.

Some possible side-effects	What can I do if I experience this?
Light-headedness or fainting (especially when getting up from a sitting or lying down position)	Getting up more slowly may help. If you begin to feel dizzy, lie down so that you do not faint, then sit for a few moments before standing. If this continues, speak with your doctor
Dizziness, tiredness, blurred sight	If this happens, do not drive or use tools or machines
Feeling or being sick, stomach upset	Stick to simple foods, and eat regular small meals
Cold hands or toes, tingling feelings, sexual problems, shortness of breath, disturbed sleep, mood changes, headache	Speak with your doctor if any of these become troublesome

If you experience any other symptoms which you think may be due to this medicine, speak with your doctor or pharmacist.

How to store propranolol

Keep all medicines out of the reach and sight of children.
Store in a cool, dry place, away from direct heat and light.
If you are taking propranolol liquid (Syprol®), you must not use the liquid if the bottle has been open for more than three months.

Important information about all medicines

Never take more than the prescribed dose. If you suspect that someone has taken an overdose of this medicine go to the accident and emergency department of your local hospital at once. Take the container with you, even if it is empty.
This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.
Never keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.
If you have any questions about this medicine ask your pharmacist.

References

Manufacturer's PIL, Propranolol 10 mg, 40 mg and 80 mg Tablets, Goldshield Group Limited, electronic Medicines Compendium. Dated February 2010.
Manufacturer's PIL, Inderal LA® 160 mg and Half-Inderal LA® 80 mg, AstraZeneca UK Limited, electronic Medicines Compendium. Dated November 2010.
Manufacturer's PIL, Syprol® 5 mg/5 ml Oral Solution, Rosemont Pharmaceuticals Limited, electronic Medicines Compendium. Dated August 2009.
British National Formulary; 62nd Edition (Sep 2011) British Medical Association and Royal Pharmaceutical Society of Great Britain, London (link to current BNF)

The pharmacists and clinicians responsible for the production of this document are:

Original Author: Helen Allen
Last Checked: 15 Nov 2011

Current Version: Helen Allen
Document ID: 1480 Version: 24

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