Propranolol

Sounds like 'pro-PRAN-oh-lol'

Propranolol has a number of different uses including preventing migraines, preventing chest pain (angina), reducing the symptoms of tremor or trembling and shakes and to ease the symptoms of anxiety, eg, a fast heartbeat and sweating. Propranolol is also called Drofate or Cardinol LA.

What is propranolol?

Propranolol is used to treat a number of different conditions and related symptoms. It is used:

Propranolol belongs to a group of medicines called beta blockers. Propranolol works by slowing down your heart rate and making it easier for your heart to pump blood around your body.

Dose

Propranolol comes as immediate release tablets or controlled release capsules.

  • The dose of propranolol will be different for different people depending on your medical condition and response to treatment.
  • 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

  • Immediate release tablets 
    • Take these as you have been prescribed (usually between 2 and 4 times a day).
    • Take your doses at the same times each day.
  • Controlled release capsules (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.
    • Don't crush or chew them as 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 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. Don't take double the dose.
  • Don't stop taking propranolol suddenly; talk to your doctor or nurse before stopping.

Things to consider while you are taking propranolol

  • Avoid alcohol while you are taking propranolol, especially when you first start treatment. Alcohol can increase your risk of side effects such as dizziness.
  • Propranolol can interact with other medicines. Tell your doctor or pharmacist about all medicines you are taking including over the counter medicines and herbal and complementary medicines.

If you have diabetes

  • If you have diabetes, propranolol may cause changes in your blood glucose level. This effect usually settles with time.
  • Beta blockers such as propranolol 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're worried about this, talk to your doctor. Don't stop taking your beta blocker without checking with your doctor first. Read more about hypoglycaemia.

If you have asthma

  • If you have asthma, taking a beta blocker such as propranolol may trigger your asthma symptoms or make them worse. However, not everybody with asthma is sensitive to beta blockers.
  • If you're 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.
  • Don't 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.

What are the side effects of propranolol?

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.

Side effects What should I do?
  • Tiredness
  • Headache
  • Disturbed, unsettled, restless sleep 
  • These are quite common when you first start taking propranolol and usually go away with time.
  • Tell your doctor if these side effects bother you.
  • Dizziness
  • Feeling faint when you stand up
  • This is common when you first start taking propranolol.
  • Don't drink alcohol.
  • Be careful when getting up from either lying down or sitting to avoid falls.
  • Cold hands and feet
  • Tell your doctor if these bother you.
  • Depression and low mood
  • Sexual problems
  • Sleep problems
  • Nightmares
  • 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.
Did you know that you can report a side effect from a medicine to CARM (Centre for Adverse Reactions Monitoring)? Report a side effect to a product.

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: 21 Dec 2022