Propranolol

Sounds like 'pro-PRAN-oh-lol'

Easy-to-read medicine information about propranolol – what it is, how to take propranolol safely and possible side effects.

Type of medicine Also called
  • Belongs to a group of medicines called beta-blockers
  • Apo-Propranolol®
  • Inderal®
  • Cardinol LA®

What is propranolol?

Propranolol is used to treat a number of different conditions and related symptoms, such as:

Propranolol belongs to a group of medicines called beta-blockers. Beta-blockers work by blocking some natural chemicals in the body, to slow the heart rate and lower blood pressure.

Dose

  • The dose of propranolol will be different for different people depending your medical condition and response to treatment.
  • Propranolol is available in 2 forms – an immediate release tablet or a controlled release capsule. Check with your pharmacist which version you are taking.
  • Always take your propranolol exactly as your doctor has told you. The pharmacy label on your medicine will tell you how much propranolol to take, how often to take it, and any special instructions.

How to take propranolol

  • If you are prescribed the immediate release tablet 
    • take these as you have been prescribed (usually between 2 to 4 times a day)
    • take your doses at the same times each day.
  • If you are prescribed the controlled release capsule (usually has LA after the name)
    • take these once a day, in the morning – the capsules are designed to release the medication slowly over a few hours
    • swallow the controlled release capsule whole, with a glass of water
    • do not crush or chew them – this will release all the medication at once and increase your chance of side effects.  
  • You can take propranolol with or without food.
  • If you drink alcohol, ask your doctor for advice about taking propranolol and alcohol. Alcohol may increase your chance of side effects such as dizziness.
  • If you forget your dose, take it as soon as you remember that day. But, if it is nearly time for your next dose, just take the next dose at the right time. Do not take double the dose.
  • Do not stop taking propranolol suddenly; speak to your doctor or nurse before stopping.

Precautions – before taking propranolol

  • Do you have asthma?
  • Do you have diabetes?
  • Do you have problems with your kidneys?
  • Do you play a professional sport?
  • Are you pregnant or breastfeeding?
  • Have you ever had an allergic reaction to a medicine?
  • Are you are taking or using any other medicines? This includes any medicines you are using which are available to buy from a pharmacy, supermarket or natural health store without a prescription.

If so, it’s important that you tell your doctor or pharmacist before you start taking propranolol. Sometimes a medicine isn’t suitable for a person with certain conditions, or it can only be used with extra care.

Possible side effects

Like all medicines, propranolol can cause side effects, although not everyone gets them. Often side effects improve as your body gets used to the new medicine.

Diabetes

If you have diabetes you need to take extra care to measure your blood glucose levels regularly.

  • Beta-blockers can cause an increase in blood glucose levels, especially when you first start taking them. This effect usually settles with time.
  • Beta-blockers may reduce the warning signs of a low blood sugar level (hypoglycaemia - often called a hypo). For example, you may not have the feeling of fast, irregular or strong heartbeats (palpitations) or tremor, which can occur when your blood glucose is going too low. If you are worried about this, talk to your doctor. Do not stop taking your beta-blocker without checking with your doctor first. Read more about hypoglycaemia.

Asthma

If you have asthma, taking a beta blocker may trigger your asthma symptoms or make them worse. Not everybody with asthma is sensitive to these medicines. If you are worried about this, talk to your doctor, they may be able to prescribe a different medicine or increase the dose of your asthma preventer medication. Do not suddenly stop taking your beta blocker without talking to your doctor first. This can be dangerous and make you feel unwell. Read more about medicines that may trigger asthma symptoms.

Other side effects

Side effects What should I do?
  • Tiredness
  • Headache
  • Disturbed, unsettled, restless sleep 
  • These are quite common when you first start taking propranolol and usually goes away with time.
  • Tell your doctor if troublesome.
  • Dizziness
  • Feeling faint when you stand up
  • This is common when you first start taking propranolol.
  • Be careful when getting up from either lying down or sitting to avoid falls.
  • Cold hands and feet
  • Tell your doctor if troublesome.
  • Depression and low mood
  • Sexual problems
  • Tell your doctor
  • Problems with breathing such as chest tightness, or wheezing or swelling of the ankles or feet.
  • Tell your doctor immediately or ring HealthLine 0800 611 116 

Interactions

  • Check with a pharmacist before taking over the counter medicines such as:
    • Cold or flu tablets containing phenylephrine (e.g. Sudafed PE), or diphenhydramine (e.g. Benadryl Original)
    • Anti-inflammatories such as diclofenac (e.g. Voltaren Rapid), ibuprofen (e.g. Nurofen), mefenamic acid (e.g. Ponstan), naproxen (e.g. Naprogesic)
  • Propranolol may interact with other medications and herbal supplements, so check with your doctor or pharmacist before starting propranolol or before starting any new medicines.

Learn more

The following links provide further information on propranolol.

Medsafe Consumer Information Sheet: Cardinol LA 
New Zealand Formulary Patient Information: propranolol

References

  1. Propranolol hydrochloride New Zealand Formulary
Credits: Sandra Ponen, Pharmacist. Reviewed By: Angela Lambie, Pharmacist, Auckland Last reviewed: 30 Sep 2018