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Propranolol

About propranolol

Propranolol belongs to a group of medicines called beta blockers. It's used to treat heart problems, help with anxiety and prevent migraines.

If you have a heart problem, you can take propranolol to:

  • treat high blood pressure
  • treat conditions that cause an irregular heartbeat (arrhythmia), like atrial fibrillation
  • help prevent future heart disease, heart attacks and strokes
  • help prevent chest pain caused by angina

Propranolol can help reduce your symptoms if you have too much thyroid hormone in your body (thyrotoxicosis). You'll usually take it together with medicines to treat an overactive thyroid.

This medicine is only available on prescription. It comes as tablets, slow release capsules, or as a liquid that you swallow.

Who can and cannot take propranolol

Most adults and children aged 12 and over can take propranolol. But it is not officially approved for treating high blood pressure in children under 12 years old.

Propranolol is not suitable for everyone. To make sure it's safe for you, tell your doctor before starting to take propranolol if you:

  • have ever had an allergic reaction to propranolol or any other medicine
  • have low blood pressure or a slow heart rate
  • have heart failure which is getting worse
  • have diabetes
  • have liver or kidney problems
  • have severe blood circulation problems in your limbs (such as Raynaud's phenomenon), which may make your fingers and toes tingle or turn paler than usual or blue
  • have metabolic acidosis, when there is too much acid in your blood
  • have lung disease or asthma
  • are pregnant, trying to get pregnant or breastfeeding

How and when to take propranolol

Propranolol comes as 2 different types of medicine:

  • standard release – this releases propranolol into your body quickly, so you may need to take it several times a day depending on your dose
  • slow release – this releases the medicine slowly so you do not have to take it as often, once a day is usually enough

If you are taking it once a day, your doctor may advise you to take your first dose before bedtime, because it can make you feel dizzy. After the first dose, if you do not feel dizzy, take propranolol in the morning.

Keep taking propranolol even if you feel well. You will still be getting the benefits of the medicine.

Propranolol tablets come in strengths of 10mg, 40mg, 80mg or 160mg. The slow release capsules are 80mg or 160mg. The liquid comes in strengths of 5mg, 10mg, 40mg or 50mg in 5ml.

How much you take depends on why you need propranolol.

The usual doses for adults and children over the age of 12 are:

  • high blood pressure – the starting dose is usually 80mg, taken twice a day. If this dose is not working well enough to reduce your blood pressure, your doctor may increase it to a maximum of 160mg twice a day
  • migraine or angina (chest pain) – 40mg, taken 2 or 3 times a day. This can be increased to 120mg to 240mg a day. Your doctor or pharmacist will explain how to split the dose over the day
  • irregular heartbeat (arrhythmia) – 10mg to 40mg, taken 3 or 4 times a day
  • anxiety – 40mg taken once a day which can be increased to 40mg taken 3 times a day
  • too much thyroid hormone (thyrotoxicosis) – 10mg to 40mg, taken 3 or 4 times a day

Doses are usually lower for people aged over 65 or people with a kidney or liver problem.

If your child is under 12 years old and they need propranolol, your doctor will usually use your child's weight to work out the right dose.

How to take it

Propranolol does not usually upset your stomach so you can take it with or without food. It's best to do the same each day.

Swallow the tablets whole with a drink of water. If you find the tablets difficult to swallow, some brands have a score line to help you break the tablet in half. Check the information leaflet for your brand to see if you can do this.

If you're taking capsules, swallow them whole with a drink of water. Do not break, chew or crush them.

If you're taking propranolol as a liquid, it will come with a plastic syringe or spoon to help you measure out the right dose. If you do not have one, ask your pharmacist for one. Do not use a kitchen teaspoon as it will not measure the right amount of medicine.

If you forget to take it

If you forget to take a dose of propranolol, take it as soon as you remember, unless it's nearly time for your next dose. In this case, just leave out the missed dose and take your next dose at the usual time.

Never take 2 doses at the same time. Never take an extra dose to make up for a forgotten one.

If you often forget doses, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to help you remember to take your medicine.

If you take too much

An overdose of propranolol can slow down your heart rate and make it difficult to breathe. It can also cause dizziness and trembling.

The amount of propranolol that can lead to an overdose varies from person to person.

  • you take more than your prescribed dose of propranolol

Call 111 or go to 111 online

If you need to go to A&E, do not drive yourself. Get someone else to drive you or call for an ambulance.

Take the propranolol packet or leaflet inside it plus any remaining medicine with you.

Side effects

Like all medicines, propranolol can cause side effects in some people, but many people have no side effects or only minor ones.

Side effects often improve as your body gets used to the medicine.

These common side effects happen in more than 1 in 100 people. They're usually mild and short-lived.

Talk to your doctor or pharmacist if the side effects bother you or last more than a few days:

  • headaches
  • feeling tired, dizzy or weak
  • cold fingers or toes
  • feeling or being sick (nausea or vomiting), or diarrhoea
  • stomach pain

Serious side effects

It happens rarely, but some people have serious side effects when taking propranolol.

Tell a doctor or contact 111 straight away if:

  • the whites of your eyes turn yellow, your skin turns yellow although this may be less obvious on brown on black skin, or you have pale poo or dark pee – these can be signs of liver problems
  • you get nosebleeds that last for more than 10 minutes, unexplained bruising, or you bruise more easily than usual – these can be signs of low numbers of platelets in your blood (thrombocytopenia)

Go to 111.nhs.uk or call 111.

  • you have shortness of breath with a cough which gets worse when you exercise (like walking up stairs), swollen ankles or legs, chest pain, or an irregular heartbeat – these are signs of heart problems
  • you have shortness of breath, wheezing and tightening of your chest – these can be signs of lung problems

In rare cases, propranolol may cause a serious allergic reaction (anaphylaxis).

These are not all the side effects of propranolol. For a full list, see the leaflet inside your medicine packet.

How to cope with side effects of propranolol

What to do about:

  • headaches – make sure you rest and drink plenty of fluids. Try not to drink too much alcohol. Ask your pharmacist to recommend a painkiller. Talk to your doctor if the headaches last longer than a week or are severe.
  • feeling tired, dizzy or weak – as your body gets used to propranolol, these side effects should wear off. If propranolol makes you feel dizzy, sit or lie down until you feel better. It's best not to drink alcohol as it will make you feel worse. Do not drive or ride a bike until you feel better.
  • cold fingers or toes – put your hands or feet under warm running water, massage them and wiggle your fingers and toes. Do not smoke or have drinks with caffeine in, as this can make your blood vessels narrower and further restrict blood flow to your hands and feet. Try wearing mittens (they're warmer than gloves) and warm socks. Do not wear tight watches or bracelets.
  • feeling or being sick or diarrhoea – stick to simple meals and do not eat rich or spicy food. It might help to take your propranolol after a meal or snack. Drink lots of fluids, such as water or squash, to avoid dehydration. Take small, frequent sips if you're being sick. Signs of dehydration include peeing less than usual or having dark, strong-smelling pee. Do not take any other medicines to treat diarrhoea and vomiting without speaking to a pharmacist or doctor. If you take contraceptive pills and you're being sick or have severe diarrhoea, your contraception may not protect you from pregnancy. Check the pill packet for advice.
  • stomach pain – try to rest and relax. It can help to eat and drink slowly and have smaller and more frequent meals. Putting a heat pad or covered hot water bottle on your tummy may also help. If you are in a lot of pain, speak to your pharmacist or doctor.

Pregnancy and breastfeeding

Propranolol is not thought to be harmful during pregnancy, but it may affect your baby's growth in later pregnancy. Discuss taking propranolol with your doctor or midwife as you may need extra scans to check your baby's growth.

If you're trying to get pregnant or you're already pregnant, talk to your doctor about the benefits and possible harms of taking propranolol. There may be other medicines that are better to use during pregnancy.

Propranolol and breastfeeding

If your doctor or health visitor says that your baby is healthy, it's OK to take propranolol while breastfeeding.

Propranolol passes into breast milk in tiny amounts. It has not been known to cause any side effects in breastfed babies.

It's important to treat your high blood pressure to keep you well. Breastfeeding will also benefit both you and your baby.

If you notice that your baby is not feeding as well as usual, or seems unusually sleepy, or if you have any other concerns about your baby, then talk to your doctor or health visitor.

Cautions with other medicines

There are some medicines that may affect the way propranolol works.

Tell your doctor if you're taking:

  • other medicines for high blood pressure. The combination with propranolol can sometimes lower your blood pressure too much. This may make you feel dizzy or faint. If this keeps happening to you, your doctor may change your dose
  • other medicines for an irregular heartbeat such as amiodarone or flecainide
  • other medicines which can lower your blood pressure. These include some antidepressants, nitrates (for chest pain), baclofen (a muscle relaxant), medicines for an enlarged prostate gland like tamsulosin, or Parkinson's disease medicines such as levodopa
  • asthma or chronic obstructive pulmonary disease (COPD) medicines
  • diabetes medicines, particularly insulin – propranolol may make it more difficult to recognise the warning signs of low blood sugar. Speak to your doctor if you have low blood sugar levels without getting any of the usual warning signs. Check your blood sugar after exercise, and follow usual advice about checking it before driving, cycling or operating machinery
  • medicines to treat nose or sinus congestion, or other cold remedies (including those you can buy in the pharmacy)
  • medicines for allergies, such as ephedrine, noradrenaline or adrenaline
  • non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, diclofenac or naproxen. These medicines may increase your blood pressure, so it's best to keep them to a minimum

There's very little information about taking herbal remedies and supplements with propranolol. They are not tested in the same way as pharmacy and prescription medicines.

Related links

Angina — Link to Related Condition

Anxiety, fear and panic — Link to Related Condition

Arrhythmia — Link to Related Condition

Heart attack — Link to Related Condition

Heart failure — Link to Related Condition

High blood pressure (hypertension) — Link to Related Condition

Migraine — Link to Related Condition

HealthUnlocked: propranolol forum — Link to Useful Resource

Anxiety UK: charity — Link to Useful Resource

Blood Pressure UK: charity — Link to Useful Resource

Migraine Trust: charity — Link to Useful Resource

Healthtalk: videos of real stories of heart attacks — Link to Useful Resource

NHS Health Check: free health check-up — Link to Useful Resource

HealthUnlocked contains information from NHS Digital, licensed under the current version of the Open Government Licence

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1,464 public posts

Propranolol

Anyone here been put on propranolol for panic anxiety? Care to share your experience.
Anyone here been put on propranolol for panic anxiety? Care to share your experience.
Jsteve36 profile image
Jsteve36
in Anxiety and Depression Support

Can propranolol withdrawal cause a major increase in anxiety?

Back in 2016 when my anxiety about my heart rate began I started taking 3 propranolol (40mg for each single propranolol) to ease myself. I did it for a year until December 2017 where I decided to reduce the amount to 1.
Back in 2016 when my anxiety about my heart rate began I started taking 3 propranolol (40mg for each single propranolol) to ease myself. I did it for a year until December 2017 where I decided to reduce the amount to 1.
Marc0133 profile image
Marc0133
in Anxiety Support

Propranolol

My GP phoned and has put me in 10mg of Propranolol twice a day. Does this help with random irregular heartbeats and are the side effects as bad as Bisoprolol? Thank you for reading x
My GP phoned and has put me in 10mg of Propranolol twice a day. Does this help with random irregular heartbeats and are the side effects as bad as Bisoprolol? Thank you for reading x
MrsAnxious profile image
MrsAnxious
in British Heart Foundation
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Reducing Propranolol dose

I've been taking 40mg Propranolol 3 times per day for about 12 days. At first it was great. I didn't feel any anxiety at all and my heart rate was nice and low, I thought I'd finally found something to help.
I've been taking 40mg Propranolol 3 times per day for about 12 days. At first it was great. I didn't feel any anxiety at all and my heart rate was nice and low, I thought I'd finally found something to help.
mummyofspot profile image
mummyofspot
in Anxiety and Depression Support

How long for the irregular beats to go, after starting propranolol and diltiazem please? Thanks

So, my query is - does anyone have thoughts on how long for propranolol and diltiazem to make him feel better please? Thanks Persevere99
So, my query is - does anyone have thoughts on how long for propranolol and diltiazem to make him feel better please? Thanks Persevere99
Persevere99 profile image
Persevere99
in AF Association

Results confusion 😕

So this is my latest blood results ...they don't seem to have done the t3 which was really high last time ..im currently on 15mg carbimazole and propranolol when required ....what do these results mean ...also attached last t4 results
So this is my latest blood results ...they don't seem to have done the t3 which was really high last time ..im currently on 15mg carbimazole and propranolol when required ....what do these results mean ...also attached last t4 results
andie25 profile image
andie25
in Thyroid UK

Experiences with Propranolol with Hyperthyroidism?

Hey everyone, just curious on peoples good or bad experiences with propranolol when we have Hyperthyroidism or needing to take replacement T4 T3 etc. I heard it can mess up conversion of T4 to T3. All input appreciated as I was just put on 10mg 2x a day of propranolol 🙏
Hey everyone, just curious on peoples good or bad experiences with propranolol when we have Hyperthyroidism or needing to take replacement T4 T3 etc. I heard it can mess up conversion of T4 to T3. All input appreciated as I was just put on 10mg 2x a day of propranolol 🙏
T808 profile image
T808
in Thyroid UK

Propranolol Withdrawal

I've been on Propranolol since the middle of November (just over 2 months). I was taking 10mg twice a day. This was prescribed for anxiety. The side effects are awful. I feel worse than when I started it. I have no appetite, so I am not eating well. My hands are always cold. My chest hurts.
I've been on Propranolol since the middle of November (just over 2 months). I was taking 10mg twice a day. This was prescribed for anxiety. The side effects are awful. I feel worse than when I started it. I have no appetite, so I am not eating well. My hands are always cold. My chest hurts.
MaryH11 profile image
MaryH11
in British Heart Foundation

Flacainide

I am taking propranolol 60ER and started taking flacainide 75mg, 2/day. It is making me dizzy and weak but prevents Afib Is this a common side effect and will it disappear after a short period. But it keeps me in NSR
I am taking propranolol 60ER and started taking flacainide 75mg, 2/day. It is making me dizzy and weak but prevents Afib Is this a common side effect and will it disappear after a short period. But it keeps me in NSR
alfrae13 profile image
alfrae13
in AF Association

Bedranol 80mg SR

Hope I’m not breaking any rules in asking this, but does anyone know of any online doctor facilities which offer propranolol as Bedranol in an 80mg, slow release formula? I have a prescription for the lower dose, short acting version but would like to give a slow release option a go. Thanks!
Hope I’m not breaking any rules in asking this, but does anyone know of any online doctor facilities which offer propranolol as Bedranol in an 80mg, slow release formula? I have a prescription for the lower dose, short acting version but would like to give a slow release option a go. Thanks!
JonnyA profile image
JonnyA
in Anxiety Support

Started back @ work

I must say when I have had bad anxiety the last few days propranolol really takes the edge off. However like I say I would like to try a SSRI to help me long term.
I must say when I have had bad anxiety the last few days propranolol really takes the edge off. However like I say I would like to try a SSRI to help me long term.
Jelley93 profile image
Jelley93
in Thyroid UK

Hyperthyroidism

I was diagnosed with overactive thyroid 2 months ago.I am on carbimazole 10mg daily and propranolol 40mg daily.i have developed forgetfulness,I even forget of whether I have taken the drugs or not.I forget almost everything.This has been worrying me alot and of late I just want to be alone.I am a student
I was diagnosed with overactive thyroid 2 months ago.I am on carbimazole 10mg daily and propranolol 40mg daily.i have developed forgetfulness,I even forget of whether I have taken the drugs or not.I forget almost everything.This has been worrying me alot and of late I just want to be alone.I am a student
Chungi profile image
Chungi
in Thyroid UK

Is Propranolol Safe for Hypos.

SSRI'S are sometimes prescribed for PPPD, but my GP suggested propranolol. At a low dose. I'm very wary as I have asthma and its not good for asthma sufferers and I seen it used for hyperthyroidism and I'm concerned about the effect on my hypothyroidism. I believe it reduces FT3.
SSRI'S are sometimes prescribed for PPPD, but my GP suggested propranolol. At a low dose. I'm very wary as I have asthma and its not good for asthma sufferers and I seen it used for hyperthyroidism and I'm concerned about the effect on my hypothyroidism. I believe it reduces FT3.
Sparklingsunshine profile image
Sparklingsunshine
in Thyroid UK

Graves relapse

Weaned to a low dose of Carbimazole and contracted covid again in March 2022, symptoms crept back slowly and I’m back where I started last year On 40 mg Carbimazole 3 x 40 mg propranolol. I feel this will never leave me.
Weaned to a low dose of Carbimazole and contracted covid again in March 2022, symptoms crept back slowly and I’m back where I started last year On 40 mg Carbimazole 3 x 40 mg propranolol. I feel this will never leave me.
Michellear profile image
Michellear
in Graves Disease Support

Propranolol and low HR/ Light headedness

I started on Propranolol 40mg for 2 weeks and am now on 80mg slow release and have been for nearly a month. I have felt light headed a few times while standing and happened to notice my heart rate has dropped into the 40's which has scared me a bit. Is this normal?
I started on Propranolol 40mg for 2 weeks and am now on 80mg slow release and have been for nearly a month. I have felt light headed a few times while standing and happened to notice my heart rate has dropped into the 40's which has scared me a bit. Is this normal?
Bbtb321 profile image
Bbtb321
in Migraine Support

Need some guidance, Possibly been suffering for years. Physical health condition has now brought it to the forefront

I have been on propranolol now for nearly five years for the anxiety which flares up randomly. At the moment I am suffering quite bad mentally and physically. I feel dizziness all the time due to the anxiety/ possible PPPD. Propranolol helps with the anxiety but I want to try a SSRI.
I have been on propranolol now for nearly five years for the anxiety which flares up randomly. At the moment I am suffering quite bad mentally and physically. I feel dizziness all the time due to the anxiety/ possible PPPD. Propranolol helps with the anxiety but I want to try a SSRI.
Jelley93 profile image
Jelley93
in Anxiety and Depression Support

Propranolol with low heart rate?

Propranolol with a low resting heart rate? Hi all, I have been having some bad experiences with anxiety so the doctor prescribed me with 10mg of propranolol to be taking 2-3 times per day. He recommend me taking one to start off with in the evening as this is when my anxiety is at its worst.
Propranolol with a low resting heart rate? Hi all, I have been having some bad experiences with anxiety so the doctor prescribed me with 10mg of propranolol to be taking 2-3 times per day. He recommend me taking one to start off with in the evening as this is when my anxiety is at its worst.
healthanxietydoone profile image
healthanxietydoone
in Anxiety Support

Any experience of Propranolol 10mg?

I was described this by an A&E doctor in August. I believe his opinion was that I had an anxiety but I believe my high heart rate, palpitations and dizziness was caused by 2nd vaccine. About a month before I ended up in A&E I started having palpitations with high heart rate accompanied with dizziness
I was described this by an A&E doctor in August. I believe his opinion was that I had an anxiety but I believe my high heart rate, palpitations and dizziness was caused by 2nd vaccine. About a month before I ended up in A&E I started having palpitations with high heart rate accompanied with dizziness
BlueSkyGrey profile image
BlueSkyGrey
in British Heart Foundation

Propranolol and Buspar

Do you think the Propranolol could replace the Klonopin? I will be asking this to my meds dr tomorrow, but I just wanted to know if anyone had suggestions.
Do you think the Propranolol could replace the Klonopin? I will be asking this to my meds dr tomorrow, but I just wanted to know if anyone had suggestions.
Hope4me1 profile image
Hope4me1
in Anxiety Support

Propranolol acid reflux

Does propranolol make acid reflux worse? As GP upped my dose for blood pressure and I seem to have worse acid reflux and cough. Happy new year to everyone hope someone can help as they keep changing my meds.
Does propranolol make acid reflux worse? As GP upped my dose for blood pressure and I seem to have worse acid reflux and cough. Happy new year to everyone hope someone can help as they keep changing my meds.
Robann profile image
Robann
in British Heart Foundation
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