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July 6, 2020

Propranolol is a type of beta-blocker with many uses. It is mainly prescribed for:

  • Lower high blood pressure or hypertension among patients with heart problems
  • Angina pectoris (Chronic chest pain)
  • Heart valve disorder
  • Controlling abnormal rhythm of the heart or arrhythmias
  • Controlling tremor with no underlying cause
  • Reducing irregular heartbeats and the risk of further heart attacks after having a stroke or heart attack
  • Reducing the physical symptoms of anxiety such as sweating, palpitations and trembling
  • Reducing the symptoms of an overactive thyroid gland such as sweating, trembling, and rapid heartbeat.
  • Preventing migraines in people who get a frequent attack of severe headaches
  • Treatment of pheochromocytoma, a rare tumor that starts in the cells in the adrenal glands
  • Treating gastrointestinal bleeding

Propranolol is an inexpensive medication that’s FDA-approved. It’s a first-choice treatment for heart failure, angina pectoris, heart attack, abnormal heart rhythm, and heart valve disorders.

As a beta-adrenergic blocking agent, Propranolol works by blocking the beta receptors found in the heart. It’s a non-selective beta-blocking agent that works similarly on the heart, lungs, and other areas of the body. Blocking the beta receptors makes the heart beat slower and less forcefully. This reduces the pressure at which the heart has to pump blood around the body. This is especially helpful for patients with chronic heart failure, where the pumping action of the heart is less effective.

Propranolol can also prevent angina pectoris or chest pain because it reduces the energy and oxygen level needed by the heart to pump blood. It helps control irregular heartbeats as it allows the electrical signal in the heart to fire more regularly so the heart can beat properly.

When and How to Use Propranolol

The recommended dose and the duration of treatment depend on the strength of the medicine and your condition.

  • Heart attack: Adult patients should take 40 mg three times a day. Your doctor may increase your dose as needed.
  • Adrenal gland tumor: The dose for an adult is 60mg three times a day given three days before having surgery. The usual recommended dose is 1 tablet of 30mg once a day.
  • Chest pain: The dose for an adult is 80mg a day. The maximum dose must not exceed 320mg a day.
  • High blood pressure: An adult patient must take 80mg of extended-release capsules once a day, or 40mg tablet two times a day.
  • Thickened heart muscle: The dose is 20mg to 40mg three to four times a day given before meals and at bedtime.
  • Migraine: Take 80mg per day in divided doses or as prescribed by your physician.
  • Tremors: Take 40mg two times a day. Your doctor may increase your dose if needed
  • Irregular heartbeat: The dose is 10mg to 30mg three to four times a day before meals and at bedtime.

The onset of action of Propranolol is observed within 1-2 hours after intake while the duration of the effect lasts for 6 to 12 hours. Take propranolol exactly as directed by your doctor. Do not take more or less than what is prescribed or for longer than the prescribed duration of treatment. Do not stop taking this medication without informing your doctor.

What should I know before taking Propranolol?

  • This medicine is not a first-choice medication for high blood pressure except if you are suffering from heart disease like heart failure, heart attack, or stroke.
  • If you are diabetic, this drug can hide the symptoms of low blood sugar.
  • This medication may not be suitable for all patients. Do not use this if you have:
    • Heart failure that is not well-controlled
    • A very slow heartbeat
    • A severe form of angina called Prinzmetal’s angina
    • A poorly function heart due to second and third-degree heart block
    • Chronic obstructive pulmonary disease or COPD
    • Very low blood pressure or hypotension
    • Raised acid levels in the blood
    • A very slow heartbeat
    • Untreated tumor of the adrenal gland
    • Very poor blood circulation in the limbs
  • Patients with the following conditions must use this medicine with care:
    • Diabetes
    • Elderly people
    • History of psoriasis as this can worsen the condition
    • History of allergies
    • First-degree heart blockage
    • Liver or kidney problems
    • Poor blood circulation in the arteries of the extremities
    • Myasthenia gravis

Possible Side Effects of Propranolol

Propranolol may cause unwanted side effects. Contact your doctor if any of the symptoms below do not go away:

The following side effect can be serious and may need immediate medical assistance:

  • Hives
  • Difficulty breathing and swallowing
  • Itching
  • Swelling of the face, tongue, throat or lips
  • Irregular heartbeat
  • Feeling faint
  • Peeling or blistering of the skin

Getting the Best Result from Propranolol

  • Propranolol is good at treating varieties of heart problems and other problems in the body. However, it has more side effects than any other medicine of its kind because it crosses in the central nervous system and brain so you can’t miss a dose. Stopping the medication all of a sudden can cause your blood pressure to suddenly spike increasing your chances of having a stroke and heart attack.
  • If your blood pressure is too high, your doctor may add this medicine on top of the medicine you are currently taking.
  • This medicine is not recommended for pregnant women only if necessary. Your doctor may give you a lower dose but discontinue using 2 to 3 days before delivery. It’s not also intended for use by breastfeeding women unless absolutely necessary.

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