A Guide to Propranolol
Written by: Hussain Abdeh MPharm: 2211840
Published on: 04/05/2021
Updated on: 04/05/2021
Propranolol is one of the most prescribed medicines for a range of conditions, including high blood pressure, heart problems and anxiety.
This prescription-only medicine is available either as a tablet, capsule, or liquid.
In this article, we will be taking a closer look at what propranolol is, how it works, what it can be used for and the side effects that can occur in some users. We will also be looking into who should not take it.
What is Propranolol?
Propranolol belongs to a group of medicines known as beta blockers. Beta blockers are only available to buy on prescription and work to lower blood pressure, protect against recurrent heart attacks and control anxiety. They can also be taken to help people who suffer from heart failure to live longer lives. To understand more about what they are and what they treat, you can read our what are beta blockers guide.
Propranolol works to help the heart beat slower and at a steadier rate. This effect helps to improve and control a number of serious health conditions.
Statistics show that propranolol is the third-most-popular beta blocker sold in the United Kingdom.
What does propranolol do?
Propranolol works to block the beta-adrenergic receptor, which releases the body’s natural stress hormone, adrenaline. This hormone makes your heart beat faster, so when it is blocked your heart rate is slowed down, which means that blood is pumped around your body with less force. This makes it a lot easier for your heart to pump blood around your body without stress.
By lowering how fast your heart beats, your blood pressure is lowered and your heart needs to contract less with each beat. As a result, it does not need to work as hard. Although doctors will not usually prescribe propranolol for high blood pressure as a first line treatment, it is still commonly used for this reason, particularly for complicated high blood pressure.
An increased heart rate is one of the main symptoms of anxiety, so by taking a beta blocker such as propranolol, anxiety sufferers should find that they feel more at ease and less anxious. This medicine will not act as a cure for any underlying psychological triggers of anxiety, but it can be taken to provide short-term relief. Taking propranolol for anxiety can be beneficial in situations that require you to be calm and level-headed, such as before a job interview or a presentation.
The dosage for this medicine differs depending on your age and what you have been prescribed propranolol as a treatment for.
Who can take propranolol?
While propranolol is safe to be taken by both adults and children, it has not been approved for treating children under 12 who suffer from high blood pressure.
You should also make sure that your doctor is aware if any of the following apply to you, before you are prescribed propranolol:
- You have ever had an allergic reaction to propranolol or any other medication in the past
- You suffer from asthma or lung disease
- You suffer from heart failure that is getting worse
- You have low blood pressure or a slow heart rate
- You have a condition called metabolic acidosis, where there is an excessive amount of acid in your blood
- You have any severe blood circulation problems in the limbs, such as Raynaud’s phenomenon
- You are currently pregnant, think you might be pregnant, or are trying to get pregnant
- You are breastfeeding
- You are on a strict fasting diet
- You have high blood pressure due to a tumour near your kidneys (untreated pheochromocytoma)
- You suffer from diabetes
- You have any liver or kidney problems
- You have thyrotoxicosis
You should always read the patient information leaflet, which will come with your medicine. In this leaflet, you will find comprehensive lists of why this medication may not be suitable for you to take.
Please talk to your doctor or pharmacist if you have any doubts about your suitability for this medicine.
All medicines come with the risk of side effects, and propranolol is no exception. Fortunately, most people who suffer side effects will only experience minor ones; the majority of people who take propranolol do not get any side effects at all.
Common side effects
The side effects listed below are relatively common, occurring in more than 1 in 100 people:
- Feeling sick
- Sleeping difficulties and/or nightmares
- Feeling dizzy, light-headed, tired (these may be symptoms of a slow heart rate)
- Cold fingers or toes (propranolol may affect the blood supply to your hands and feet)
Please talk to your doctor or pharmacist if any of these side effects bother you or do not go away.
Serious side effects
Although they only occur rarely, you should talk to your doctor as soon as possible if you get any of the following serious side effects:
- Yellow skin or whites of the eyes (these could be symptoms of a liver problem)
- Wheezing, feeling short of breath or a tightness in the chest (these could be symptoms of lung problems)
- Shortness of breath with a cough that gets worse while exercising, swollen legs or ankles, chest pain or an irregular heartbeat (these could be symptoms of a heart problem)
Serious allergic reaction
If you get any of the following symptoms, you may be having an allergic reaction that may require hospital treatment.
You should call 999 or go to your nearest A&E straight away if:
- You are wheezing
- You develop a skin rash that may include red, itchy or swollen skin
- Your skin starts to peel or blister
- You have any breathing problems
- Your chest or throat feels tight
- Your mouth, face, lips, throat or tongue starts to swell
This list may not be exhaustive. You should always read the patient information leaflet for a complete list of side effects. In this leaflet, you will also find details on what you should do if you do get any side effects. If you experience any side effects, it is advisable to keep a record of them.
If you develop any side effects that are not listed here or in the patient information leaflet, you can report these to the Medicines and Healthcare products Regulatory Agency (MHRA) using their yellow card safety scheme.
Alternatives to Propranolol
If you have previously been prescribed propranolol 10mg or 40mg tablets, it is likely that your doctor or prescriber will be able to prescribe an alternative medicine if they deem it necessary.
If propranolol causes you to suffer persistent or serious side effects, you may be prescribed an alternative medication. Thankfully, Medicine Direct online pharmacy stocks other beta blocker medications which work just as effectively.
Bisoprolol is another beta blocker medicine that is available to buy from our online pharmacy. This medicine contains the active ingredient bisoprolol fumarate, which also works to slow down your heart rate so that blood can be pumped around your body more efficiently. This is also a prescription-only medicine, so you will still need to complete our online consultation questionnaire before you can order it.
Atenolol is also a commonly prescribed beta blocker, although unlike propranolol, it's primary use is to treat heart related conditions such as high blood pressure, angina and arrythmia.
However, one of our registered prescribers will review your answers and prescribe this medicine if it is safe for you. If you place your order by 2pm, you will receive your medication the very next day.
What painkillers can I take with propranolol?
It is safe to take propranolol alongside paracetamol. However, you are advised against taking propranolol at the same time as any medicines that belong to a class of drugs called nonsteroidal anti-inflammatory drugs (NSAIDs). These medicines include over the counter painkillers like ibuprofen and naproxen. NSAIDs such as these may counteract the effect that propranolol has at lowering blood pressure, particularly if you take them regularly while using propranolol long-term.
What happens if you stop taking propranolol suddenly?
You should always talk to your doctor if you wish to discontinue your course of medication. If you stop taking this medicine suddenly, your health problem may become worse. Stopping your course of treatment suddenly after taking propranolol for a long time may cause your body to react badly.
If you wish to stop taking propranolol because you are being bothered by side effects, you should still speak to your doctor first. They may be able to prescribe an alternative form of treatment. It will take approximately 1 to 2 days for the medicine to leave your system completely if you do stop taking it. However, side effects may continue for up to a week afterwards. Please talk to your doctor if you are still suffering from side effects after one week.
Propranolol is a relatively low risk medicine that does not present many serious side effects. However, in some circumstances, individuals may experience side effects particularly if you suffer from any of the interacting conditions listed above. Always let your doctor know about any other medicines you are currently taking or any other conditions that you have or have previously suffered from.