Propranolol (Oral)

Propranolol is a treatment that will artificially lower the blood pressure in patients suffering from hypertension and in doing so will reduce the risk of the occurrence of serious medical conditions.

Overview

Propranolol can either be used in isolation or in conjunction with other medications in the treatment of high blood pressure, which is also known as hypertension.

This condition increases the workload that needs to be carried out by the heart and arteries for normal function. If it is left untreated and is ongoing then the patient will develop problems with the function of the arteries and heart. In time the blood vessels within the heart, arteries, brain and kidney will become damaged and there will be a significantly increased risk of the occurrence of heart attack, heart failure, kidney failure and strokes.

This treatment is not a cure for high blood pressure and will always be prescribed along with advice on how to lower the blood pressure naturally. This will include diet control, weight loss, exercise and other healthier life choices like the cessation of caffeine and tobacco consumption. It is vital that patients with high blood pressure take steps to lower their blood pressure so that they can return to health, reduce the risk of serious medical occurrences and cease use of Propranolol. Once a patient with high blood pressure has started using Propranolol they will need to keep taking it indefinitely unless they are able to lower their blood pressure naturally through taking these steps towards a healthier lifestyle.

Propranolol can also be used in the treatment of severe chest pain, irregularity of the heart, heart tremors, pheochromocytoma, migraine headaches and hypertrophic subaortic stenosis.

Propranolol is also used in the treatment of patients who have recently had heart attacks to reduce the risk of death and the oral solution can be used in the treatment of proliferating infantile hemangioma.

This medication will be administered in significantly different dosages depending on the condition that is being treated. Treatment with this medication requires a prescription from a doctor.

Propranolol works by blocking nerve impulses in the heart and arteries. This makes the heart rate decrease and in doing so reduces the pressure in the blood and the strain placed on the heart and arteries. By lowering the blood pressure, an increased amount of oxygen can be absorbed into the blood and transported to the heart.

This medication is administered as a tablet, an extended-release capsule or as a solution. It is available in the following brands:

  • Propranolol HCl Intensol
  • InnoPran XL
  • Inderal XL
  • Inderal LA
  • Inderal
  • Hemangeol

Conditions treated

  • High blood pressure
  • Hypertension
  • Recent heart attack
  • Irregularity of heartbeat
  • Heart tremors
  • Pheochromocytoma
  • Proliferating infantile hemangioma

Type of medicine

  • Beta-blocker

Side effects

In addition to the desired side effects of treating the condition for which it has been prescribed, Propranolol can also have wider unwanted side effects on the patient. These side effects may not all occur but in cases where they do medical attention may need to be sought. The longer that Propranolol is taken for, the more likely certain side effects are to occur. In some cases, side effects may not require any medical attention and may simply be an annoyance for the patient, but in others, they could potentially threaten the life of the patient.

In cases where the following side effects do occur you should seek immediate medical attention:

  • Abdominal pain and tenderness
  • Black stools with a tarry appearance
  • Bleeding from the rectum
  • Bleeding from the nose
  • Blistering or peeling of skin
  • Blood appearing in the stools
  • Blood appearing during urination
  • Blurring of vision
  • Body aches
  • Body pains
  • Burning or pins and needles feelings on the skin
  • Changed color perception
  • Chest discomfort
  • Chest pains
  • Chills
  • Confusion about oneself, place and/or time
  • Congestion
  • 400;">Constipation
  • Coughing
  • Coughing that produces mucus
  • Cracking of the skin
  • Decreased awareness
  • Decreased responsiveness
  • Decreased volume or frequency of urine output
  • Depersonalization
  • 400;">Diarrhea
  • Difficulty in breathing
  • Difficulty in swallowing
  • Dilation of the neck veins
  • 400;">Dizziness
  • Double vision
  • Dryness of throat
  • Dysphoria
  • Euphoria
  • Extreme fatigue or tiredness
  • Fainting
  • 400;">Feverishness
  • General feeling of discomfort or weakness
  • Hair thinning or loss
  • Halos seen around lights
  • Headaches
  • 400;">Hives
  • Hoarseness
  • Increased strength of menstrual periods
  • Involuntary mimicry of speech or movements
  • Irregularity of breathing
  • Irregularity of heartbeat
  • Irritated eyes with red appearance
  • Itching
  • Joint pain
  • Lightheadedness
  • Lightheadedness experienced when rising suddenly from a lying or sitting position
  • Loosening of the skin
  • Loss of vision
  • Mental depression or extreme sadness
  • Muscle pains
  • Mutism
  • Nausea
  • Negative attitude
  • Night blindness
  • Overbright appearance of lights
  • Overly audible breathing
  • Pale or cold fingertips and toes
  • Paranoia
  • Perceiving things that are not there
  • Puffy or swollen around the eyes, face, lips or tongue
  • Quickness to react or overreacting emotionally
  • Rapid changing of moods
  • Rapid loss of heat from the body
  • Rash that appears like psoriasis
  • Red or purple spots appearing on the skin
  • Red swellings of the skin
  • Reddening of the skin around the ears
  • Runniness of the nose
  • Scaling of the skin
  • Severe sleepiness
  • Short-term memory loss or difficulty with memory retention
  • Shortness of breath without exertion
  • Skin irritations or rash
  • Skin lesions
  • Soreness of the throat
  • Sores or ulcers on the mouth
  • Stomach pain and tenderness
  • Sweating when cool
  • Swelling of glands
  • Swollen eyes, face, fingers, feet or lower legs
  • Tender and swollen glands in the neck
  • Tightness in the chest
  • Tingling or pain in fingers and/or toes when they are exposed to the cold
  • Tunnelling of vision
  • Unusual bleeding
  • Unusual bruising
  • Unusual crying
  • Unusual grimacing
  • Unusual mannerisms
  • Unusual movements
  • Unusual postures
  • Unusual tiredness
  • Unusual weakness
  • Voice changes
  • Vomiting
  • Weight gain
  • White spots on the mouth or lips

Other side effects that would not normally require the patient to seek medical attention may also occur. These side effects may be mild and do not indicate potentially serious medical conditions. In some cases, they may also abate over time as the body adjusts to the treatment that it is receiving. These side effects can become bothersome and they can be reported to a medical professional if they are ongoing. These side effects include the following which may occur from use:

Occurring more commonly:

  • Anxiousness
  • Dryness of the mouth
  • Hyperventilation
  • Quickness or annoyance or increased irritability
  • Restlessness
  • Shaking or trembling
  • Troubled sleep
  • Unusual dreams
  • Unusual drowsiness
  • Unusual sleepiness

Occurring less commonly:

  • Decreased appetite

Frequency of incidence not known:

  • Dryness of the eyes
  • Feeling of sluggishness
  • 400;">Heartburn
  • Lack of energy
  • Loss of strength
  • Muscle weakness
  • Pain in the upper stomach or throat
  • Pain or discomfort across the chest
  • Stomach cramping
  • Unusual drowsiness
  • Unusual dullness
  • Vivid dreams

Other side effects that have not been listed herein may also occur. If you experience other side effects then you should contact your doctor for advice on how to alleviate them and to see if you need to seek medical attention. If you are worried about your immediate health, however, then you should contact emergency services for immediate treatment.

Dosage

This medication should only be used as directed by your doctor. You should never exceed the dose prescribed and you should not take it more frequently than prescribed. Using this medication incorrectly can expose you to serious health risks whether you are taking it in too great or too small doses. It is important that this treatment is taken on a schedule as set out by your doctor and it is essential that you follow other advice given to you by your doctor too.

Your doctor may need to adjust your dose to find the perfect level of treatment for you.

This medication will be issued with a medication guide that you should read and ensure you understand before use. Make you read this each time you collect a prescription as it may change over time. Consult your doctor if you have any questions about it.

When you are being treated for high blood pressure your doctor will also prescribe a diet, exercise and weight loss plan that you should follow. It is vital that you follow this collective advice closely so that you can improve your health to lower your blood pressure. Propranolol is an artificial treatment to lower the blood pressure in the patient and it will not work effectively unless you control your diet properly and effectively. In order to lower your blood pressure, you must follow these steps. Failure to do so will mean that you will need to keep taking this treatment for the rest of your life and prolonged use can expose you to greater risks of developing side effects. If you cease use of this treatment without lowering your blood pressure naturally then you will be exposed once again to serious risks of heart failure, blood vessel disease, kidney failure and stroke.

When you are taking this treatment it is common to feel well and healthy. This is because the treatment is working and you should not cease use. If you have not lowered your blood pressure then you will quickly deteriorate your condition if you cease use. You should keep all appointments and maintain all dosing as directed by your doctor even when you are feeling well.

The tablets should be swallowed whole without crushing, breaking, dissolving, chewing or in any way damaging them. If they are taken when broken the body will absorb the medication too quickly and this can lead to complications occurring in the patient. Broken tablets should not be taken and you should keep the medication in a safe place away from harm. Moisture may also damage the tablets, so it is important to store them correctly as directed.

Extended-release tablets should be taken just before you go to bed and can be taken with or without food. However you take this medication, it should be taken the same way every time. It should also be taken on a strict schedule as directed. This will help to regulate the levels of medication in your body as well as creating a habit that will reduce the chance of your missing a treatment.

If you are taking the oral solution then this treatment may be mixed with a drink in order to make it taste nicer and make it easier to swallow. You should consume it immediately after mixing and should ensure that all of the medication has been consumed.

Every patient will receive a different dose of this medication depending on the condition being treated, the age of the patient, the weight of the patient and a range of other factors. You should only ever take your prescribed brand of this treatment and should only ever take it as directed by your doctor. Taking too much or too little may have unwanted side effects. The following dosing information is a guideline only and you should always follow the advice of your doctor:

When treating acute heart attack:

When administering treatment as a solution:
Adults:180-240 milligrams daily, taken in divided doses.
Children: The use of and dose of this treatment must be determined by the prescribing doctor in each case. The dose is based on body weight.
When administering treatment as tablets:
Adults:40 milligrams three times daily. Your doctor may increase your dose if needed.
Children: The use of and dose of this treatment must be calculated by the doctor and will vary for each patient.

When treating adrenal gland tumors (pheochromocytoma):

When administering treatment as a solution:
Adults:60 milligrams daily, taken in divided doses for three days previous to surgery. Where surgery may not be performed the usual dosing is 30mg daily, taken in divided doses.
Children: Child use of this treatment must be calculated by the prescribing doctor. In each case the dose is based on body weight.

When administering treatment as tablets:

Adult: 60 milligrams daily, taken in divided doses for three days previous to surgery. Where surgery may not be performed the usual dosing is 30mg daily, taken in divided doses.
Children: The use of and dose of this treatment must be determined by the prescribing doctor in each case.

When treating chest pain (angina):

When administering treatment as long-acting oral capsules:
Adults: 80 milligrams once daily. Your doctor may increase your dose if needed.
Children: The use of and dose of this medication is to be calculated by the doctor.
When administering treatment as a solution:
Adults: 80-320 milligrams daily, taken in divided doses.
Children: The use of and dose of this treatment must be determined by the prescribing doctor in each case. The dose is based on body weight.
When administering treatment as tablets:
Adults: 80-320 milligrams daily, taken in divided doses.
Children: In each case, the use and dose should be given by the doctor.

When treating high blood pressure (hypertension):

When administering treatment as extended-release capsules:
Adults:80 milligrams once daily, taken at bedtime. Your doctor may increase your dose if needed. Dose should not normally exceed 120 mg daily.
Children: The use of and dose of this treatment must be determined by the prescribing doctor in each case.
When administering treatment as long-acting oral capsules:
Adults: 80 milligrams once daily. Your doctor may increase your dose if needed.
When administering treatment as a solution:
Adults: 40 milligrams twice daily. Your doctor may increase your dose if needed.
Children: Use depends on body weight.
When administering treatment as tablets:
Adults:40 milligrams twice daily. Your doctor may increase your dose if needed.
Children: Use is calculated based on body weight by the doctor.

When treating hypertrophic subaortic stenosis (thickened heart muscle):

When administering treatment as long-acting oral capsules:
Adults: 80-160 milligrams once daily.
When administering treatment as a solution:
Adults: 20-40 milligrams 3-4 times daily, taken before meals and at night.
Children: Each case should be determined by the prescribing doctor. The dose is based on body weight.
When administering treatment as tablets:
Adults: 20-40 milligrams 3-4 times daily, taken before meals and at night.
Children: Use or dose of medication must be decided by the doctor.

When treating irregular heartbeats:

When administering treatment as a solution:
Adults: 10-30 milligrams 3-4 times daily, taken before meals and at night.
Children: Use is determined by the weight of the patient.
When administering treatment as tablets:
Adults: 10-30 milligrams 3-4 times daily, taken before meals and at night.
Children: The use of and dose of this treatment must be determined by the prescribing doctor in each case.

When treating migraine headaches:

When administering treatment as long-acting oral capsules:
Adults: 80 milligrams once daily. Your doctor may increase your dose if needed.
Children: For determination by the doctor.
When administering treatment as a solution:
Adults: 80 milligrams daily, taken in divided doses. Your doctor may increase your dose if needed.
Children: use and dose is based on weight.
When administering treatment as tablets:
Adults: 80 milligrams daily, taken in divided doses. Your doctor may increase your dose if needed.
Children: The prescribing doctor must determine use.

When treating proliferating infantile hemangioma:

When administering treatment as a solution:
Children ages 5 weeks-5 months: The dose given will be based on the weight of your child and should be determined by the prescribing doctor. The usual dose is 0.6mg/kg taken twice daily with at least 9 hours betwixt doses. Th dose should be given around meal times for the child.
Children aged under 5 weeks: Use is not recommended.

When treating tremors:

When administering treatment as a solution:
Adults: 40 milligrams twice daily. Your doctor may increase your dose if needed.
Children: For determination by the doctor based on body weight.
When administering treatment as tablets:
Adults: 40 milligrams twice daily. Your doctor may increase your dose if needed.
Children: Should only be used under doctor's orders.

If a dose of this treatment is missed then you should take it as soon as possible. If you are close to your next dose, however, then you should skip the missed dose and return your usual schedule. You should record missed doses so you can report them to your doctor. This may affect tests and should be avoided.

Interactions

Medications can interact with one another in the body. In the most extreme cases, they can react violently and cause severe side effects in the body. In other cases, they may stop each other from working or may increase the chance of the occurrence or severity of certain side effects. In some cases, treatments should not be used together at all, while in other cases treatments can be used together but doses and frequency of use may need to be amended so they can safely be used in conjunction with one another.

The use of this medication with the following treatment is not recommended. Your doctor may change one or other medication:

  • Thioridazine

The use of Propranolol in conjunction with the following medications is not recommended in most cases. If you are prescribed both then your doctor may wish to adjust the dose of one or more of the treatments received:

  • Verapamil
  • Simeprevir
  • Rivastigmine
  • Prilocaine
  • Pixantrone
  • Peginterferon Alfa-2b
  • Oxymetazoline
  • Mepivacaine
  • Mefloquine
  • Lidocaine
  • Lacosamide
  • Haloperidol
  • Fluoxetine
  • Fingolimod
  • Fenoldopam
  • Eslicarbazepine Acetate
  • Epinephrine
  • Dronedarone
  • Diltiazem
  • Diatrizoate
  • Darunavir
  • Crizotinib
  • Clozapine
  • Clonidine
  • Bupropion
  • Bupivacaine Liposome
  • Bupivacaine

Use of the following treatments alongside propranolol can increase the risk of occurrence or severity of certain side effects when used with the following. Your doctor can still prescribe both treatments but may need to adjust the dose or frequency of use of one or more treatments:

  • Zileuton
  • Vildagliptin
  • Valdecoxib
  • Urapidil
  • Tubocurarine
  • Trimazosin
  • Tolmetin
  • Tolfenamic Acid
  • Tolbutamide
  • Tolazamide
  • Tiaprofenic Acid
  • Terazosin
  • Tenoxicam
  • Tamsulosin
  • Sulindac
  • St John's Wort
  • Sodium Salicylate
  • Sitagliptin
  • Sertraline
  • Saxagliptin
  • Salsalate
  • Salicylic Acid
  • Rosiglitazone
  • Rofecoxib
  • Rizatriptan
  • Rifapentine
  • Repaglinide
  • Quinidine
  • Proquazone
  • Propyphenazone
  • Propoxyphene
  • Proglumetacin
  • Prazosin
  • Pranoprofen
  • Pramlintide
  • Piroxicam
  • Piperine
  • Pioglitazone
  • Piketoprofen
  • Phenylephrine
  • Phenylbutazone
  • Phentolamine
  • Phenoxybenzamine
  • Parecoxib
  • Oxyphenbutazone
  • Oxaprozin
  • Nimesulide Beta Cyclodextrin
  • Nimesulide
  • Niflumic Acid
  • Nepafenac
  • Nateglinide
  • Naproxen
  • Nabumetone
  • Moxisylyte
  • Morniflumate
  • Miglitol
  • Mibefradil
  • Metildigoxin
  • Metformin
  • Meloxicam
  • Mefenamic Acid
  • Meclofenamate
  • Magaldrate
  • Lumiracoxib
  • Loxoprofen
  • Lornoxicam
  • Lixisenatide
  • Liraglutide
  • Linagliptin
  • Ketorolac
  • Ketoprofen
  • Insulin Lispro, Recombinant
  • Insulin Human Regular
  • Insulin Human Isophane (NPH)
  • Insulin Human Inhaled
  • Insulin Glulisine
  • Insulin Glargine, Recombinant
  • Insulin Detemir
  • Insulin Degludec
  • Insulin Aspart, Recombinant
  • Indomethacin
  • Ibuprofen
  • Guggul
  • Glyburide
  • Glipizide
  • Glimepiride
  • Fluvoxamine
  • Flurbiprofen
  • Flufenamic Acid
  • Floctafenine
  • Flecainide
  • Feprazone
  • Fepradinol
  • Fenoprofen
  • Felbinac
  • Exenatide
  • Etoricoxib
  • Etofenamate
  • Etodolac
  • Ergotamine
  • Empagliflozin
  • Dulaglutide
  • Droxicam
  • Doxazosin
  • Disopyramide
  • Dipyrone
  • Dihydroxyaluminum Sodium Carbonate
  • Dihydroxyaluminum Aminoacetate
  • Dihydroergotamine
  • Digoxin
  • Digitoxin
  • Diflunisal
  • Diclofenac
  • Dexketoprofen
  • Dexibuprofen
  • Deslanoside
  • Dapagliflozin
  • Clonixin
  • Cimetidine
  • Choline Salicylate
  • Cholestyramine
  • Chlorpropamide
  • Chlorpromazine
  • Celecoxib
  • Canagliflozin
  • Calcium Carbonate
  • Bunazosin
  • Bufexamac
  • Bromfenac
  • Aspirin
  • Arbutamine
  • Amtolmetin Guacil
  • Amiodarone
  • Aluminum Phosphate
  • Aluminum Hydroxide
  • Aluminum Carbonate, Basic
  • Alogliptin
  • Alfuzosin
  • Albiglutide
  • Acetyldigoxin
  • Acemetacin
  • Aceclofenac
  • Acarbose

Other drug interactions may occur that have not been listed herein. Before beginning treatment with propranolol, you must inform your doctor of all medications that you are taking. This includes all medications purchased over the counter, all illicit drugs, all vitamin supplements, all prescription medications and all herbal remedies.

The presence of other medical conditions can also affect the use of propranolol. You should inform your doctor of all medical conditions that you suffer from any of your past medical conditions too. This is particularly important in the following cases:

  • Angina
  • 400;">Asthma
  • 400;">Bradycardia
  • 400;">Cardiogenic shock
  • Decompensated heart failure
  • Diabetes
  • com/health/coma/">400;">Glaucoma
  • Heart block
  • History of bronchospasm
  • History of severe anaphylactic reactions
  • 400;">Hyperthyroidism
  • Hypoglycemia
  • Infants below 2kg of weight
  • Kidney disease
  • 400;">Liver disease
  • Lung disease
  • Muscle problems
  • Pheochromocytoma
  • Premature infants aged below 5 weeks (after age correction)
  • Recent heart attack
  • 400;">Sick sinus syndrome
  • 400;">Tachycardia
  • Tremors caused by Parkinson's disease
  • 400;">Wolff-Parkinson-White syndrome

Other medical conditions that have not been listed herein can also have an effect on the use of this medication. Ensure that you inform the prescribing doctor of all treatments that you are receiving.

Warnings

Before beginning treatment with propranolol, you should weight the risks of use against the benefits of beginning treatment. This decision must be taken by you and your doctor and should take into account everything covered herein. For the use of propranolol you should ensure that you have considered the following factors:

Allergies: If you have ever reacted badly to medications then this can possibly limit your ability to use this treatment and your doctor must be informed. This is especially important if you have ever suffered anaphylactic shock from the use of medication. Other allergies to dyes, preservatives, animals, foods and other substances may also occur.

Pediatric: The use of capsules, extended-release capsules and tablets has not been tested in a pediatric population and it is unknown if limitations will occur. The usual method for dosing children is using the oral solution. No pediatric-specific problems have been demonstrated to date in the use of the oral solution in children. Safety of use for the treatment of proliferating infantile hemangioma has been demonstrated between the ages of 5 weeks 5 months. Use outside this bracket has not been tested, however, and results are unknown.

Geriatric: There are no known additional problems that are caused by use in the geriatric population. However, elderly patients are more likely to suffer from illnesses or conditions that may limit safe and effective use.

Pregnancy: There is a demonstrable risk to the fetus in pregnant women. You should inform your doctor before use if you are pregnant or if you may get pregnant during use. If you get pregnant or wish to get pregnant once you have started treatment you should contact your doctor straight away.

Breastfeeding: The risks of breastfeeding while taking this medication are unknown. You should discuss this with your doctor to reach an informed decision.

You will need to visit your doctor regularly during use of this treatment for tests and examinations. You will be tested for unwanted effects during these visits and dosages may be amended multiple times to find the right level of treatment.

It is vital that you are honest about your behaviour and habits when you visit your doctor. This will allow them to treat you properly and get the best possible results. Lying about your diet or exercise will only make it harder to give you the correct treatment.

Propranolol can cause heart failure in patients. You should be alert to the symptoms of this and know how to react if they occur when you are taking this treatment.

This medication can cause changes in your blood sugar levels. In doing so it may cover up signs of other conditions and it may impact treatment in diabetic patients. Diabetic patients will need to monitor levels closely in the first weeks of treatment.

Any medical professionals treating you for any conditions must be informed that you are taking this treatment. Use of this medication may change test results and prohibit certain treatments or procedures from taking place.

This medication may make you less alert. Ensure that you are safe to drive and to operate machinery before you do so. It is your legal responsibility to ensure you are safe to drive.

Anaphylaxis may occur from the use of this treatment. You should be alert to the symptoms of this and know how to react before you begin treatment.

This medication can make central nervous system depressants more potent when taken. This group of substances includes alcohol, sleeping tablets, narcotics, sedatives and antihistamines amongst others. You should discuss your use of all of these with your doctor before use. Patients taking this treatment should not drink in excess.

The chance of suffering a stroke may increase in patients who also suffer from PHACE. Discuss this increased risk with your doctor before beginning use.

Storage

This medication should be stored in a sealed container at room temperature. Keep this treatment away from moisture, away from heat and away from direct light. Prevent from freezing.

Keep this medication out of the reach of children at all times.

Dispose of all outdated and unwanted medication safely as directed by your doctor and ensure it remains out of reach of children during disposal.

Hemangeol that has been opened should be discarded as instructed after 2 months from opening.

Summary

Propranolol is a beta-blocker that artificially lowers the blood pressure in the body by relaxing blood vessels. It can be used in the treatment of a wide range of medical conditions.

Commonly it is used in conjunction with a healthy diet and exercise in patients suffering from high blood pressure. In this case, it is essential that you follow your doctor's advice on healthy eating and exercise in order that you may be able to lower your blood pressure naturally. This treatment will not cure your high blood pressure; it will merely lower it to reduce the risk of serious medical conditions occurring. Patients who do not lower their blood pressure naturally will have to take this treatment for the rest of their lifetime. Doing so can also expose the patient to greater risks of side effects occurring and to greater severity of side effects. Patients should seek to lower their blood pressure naturally to reduce the risk of serious health problems occurring.

This medication has a wide range of side effects and a wide range of interactions with other medications too. Patients should understand the risks of use before beginning treatment with this medication and should discuss any concerns with their doctor before use. Patients should be particularly clear to discuss the risks of prolonged use with their doctor and the benefits of exercising.

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Last Reviewed:
January 31, 2018
Last Updated:
April 16, 2018