Generic name: propranolol [ pro-PRAN-oh-lol ]
Brand names: Hemangeol, Inderal LA, Inderal XL, InnoPran XL, Inderal, Propranolol Hydrochloride ER
Dosage forms: intravenous solution (1 mg/mL); oral capsule, extended release (120 mg; 160 mg; 60 mg; 80 mg); oral liquid (4.28 mg/mL); oral solution (20 mg/5 mL; 40 mg/5 mL); oral tablet (10 mg; 20 mg; 40 mg; 60 mg; 80 mg)
Drug classes: Group II antiarrhythmics , Non-cardioselective beta blockers
What is propranolol?
Propranolol is a beta-blocker. Beta-blockers affect the heart and circulation (blood flow through arteries and veins).
Propranolol is used to treat tremors, angina (chest pain), hypertension (high blood pressure), heart rhythm disorders, and other heart or circulatory conditions. It is also used to treat or prevent heart attack , and to reduce the severity and frequency of migraine headaches.
Hemangeol (propranolol oral liquid 4.28 milligrams) is given to infants 5 weeks to 1 year old to treat a genetic condition called infantile hemangiomas. Hemangiomas are caused by blood vessels grouping together in an abnormal way. These blood vessels form benign (non-cancerous) growths that can develop into ulcers or red marks on the skin. Hemangiomas can also cause more serious complications inside the body (in the liver, brain, or digestive system).
You should not use propranolol if you have asthma, very slow heart beats, or a serious heart condition such as “sick sinus syndrome” or “AV block” (unless you have a pacemaker).
Babies who weigh less than 4.5 pounds should not be given Hemangeol oral liquid.
Before taking this medicine
You should not use propranolol if you are allergic to it, or if you have:
- asthma ;
- history of slow heart beats that have caused you to faint;
- severe heart failure (that required you to be in the hospital); or
- a serious heart condition such as “sick sinus syndrome” or heart block (2nd or 3rd degree, unless you have a pacemaker).
You should not use Hemangeol if you have pheochromocytoma (tumor of the adrenal gland). propranolol also should not be used in babies who weigh less than 4.4 pounds.
To make sure propranolol is safe for you, tell your doctor if you have ever had:
- slow heartbeats, congestive heart failure;
- bronchitis, emphysema , or other breathing disorders;
- diabetes (propranolol can make it harder for you to tell when you have low blood sugar );
- liver or kidney disease;
- a thyroid disorder;
- pheochromocytoma (tumor of the adrenal gland);
- problems with circulation (such as Raynaud’s syndrome ); or
- if you smoke.
Tell your doctor if you are pregnant or breastfeeding.
How should I take propranolol?
Take propranolol exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose.
Adults may take propranolol with or without food, but take it the same way each time.
Hemangeol must be given to an infant during or just after a feeding. Doses should be spaced at least 9 hours apart. Measure Hemangeol with the supplied measuring device (not a kitchen spoon). Do not shake.
Hemangeol can cause low blood sugar ( hypoglycemia ), especially during times of stress , illness, infections, or skipped meals. Make sure your child eats regularly while taking this medicine.
Call your doctor if a child taking Hemangeol is sick with vomiting , has missed a meal, or has signs of hypoglycemia such as severe weakness or seizure.
Doses are based on weight in children. Your child’s dose may change if the child gains or loses weight.
Your heart function and blood pressure will need to be checked often.
Tell your doctor if you have a planned surgery.
Your condition may get worse if you stop using propranolol suddenly. Ask your doctor before stopping the medicine.
This medicine can affect the results of certain medical tests. Tell any doctor who treats you that you are using propranolol.
If you have high blood pressure, keep using this medicine even if you feel well. High blood pressure often has no symptoms.
Store at room temperature away from moisture and heat. Do not freeze Hemangeol. Throw away any unused Hemangeol 2 months after you first opened the bottle.
Detailed Propranolol dosage information
What happens if I miss a dose?
Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.
Overdose symptoms may include feeling light-headed or restless, tremors, fast or slow heartbeats, and trouble breathing.
What should I avoid while taking propranolol?
Avoid drinking alcohol. It may increase your blood levels of propranolol.
Propranolol Propranolol and alcohol (more detail)
Propranolol side effects
Get emergency medical help if you have signs of an allergic reaction to propranolol ( hives , difficult breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat , burning eyes, skin pain, red or purple skin rash with blistering and peeling).
Call your doctor at once if you have:
- slow or uneven heartbeats;
- a light-headed feeling, like you might pass out;
- wheezing or trouble breathing;
- sudden weakness, vision problems, or loss of coordination (especially in a child with hemangioma that affects the face or head);
- cold feeling in your hands and feet;
- depression , confusion, hallucinations;
- heart problems – swelling, rapid weight gain, feeling short of breath;
- low blood sugar – headache , hunger, sweating, irritability, dizziness , fast heart rate , and feeling anxious or shaky; or
- low blood sugar in a baby – pale skin, blue or purple skin, sweating, fussiness, crying, not wanting to eat, feeling cold, drowsiness, weak or shallow breathing (breathing may stop for short periods), seizure (convulsions), or loss of consciousness.
Common propranolol side effects may include:
- dizziness, tiredness;
- nausea , vomiting, diarrhea , constipation , stomach cramps;
- sleep problems ( insomnia ); or
- runny or stuffy nose, cough, sore throat, hoarse voice.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
Propranolol side effects (more detail)
What other drugs will affect propranolol?
Sometimes it is not safe to use certain medicines at the same time. Some drugs can affect your blood levels of other drugs you use, which may increase side effects or make the medicines less effective.
Tell your doctor about all your current medicines. Many drugs can affect propranolol, especially:
- cholestyramine or colestipol ;
- warfarin ( Coumadin , Jantoven );
- an antidepressant;
- heart or blood pressure medicine;
- medicine to treat an infection;
- medicine to treat a prostate disorder;
- steroid medicine; or
- NSAIDs (nonsteroidal anti-inflammatory drugs) – aspirin , ibuprofen ( Advil , Motrin ), naproxen ( Aleve ), celecoxib , diclofenac , indomethacin , meloxicam , and others.
This list is not complete and many other drugs may interact with propranolol. This includes prescription and over-the-counter medicines, vitamins , and herbal products . Not all possible drug interactions are listed here.
Propranolol drug interactions (more detail)
Does propranolol make you sleepy?
Yes, propranolol can make you feel fatigued (tired or sleepy) and lethargic (having a lack of energy). Other central nervous system side effects that may resemble drowsiness include lightheadedness and weakness. Fatigue and lethargy may be associated with increasing doses of the immediate-release product.
Does propranolol help with social anxiety?
Yes, propranolol might be prescribed “off-label” by your doctor to treat some types of anxiety. “Off-label” use of a drug is when a doctor prescribes it for a different purpose than those formally approved by the FDA. Propranolol can help with symptoms of social anxiety like fast heart rate, sweating and shaking in certain circumstances. For example, some people use it short-term to help with stage fright or fear of public-speaking. Propranolol usually starts to work in about 30 minutes to an hour to relieve symptoms.
How long does propranolol last?
Immediate-release propranolol will clear out of your body in about 1 to 2 days after your last dose, but the therapeutic effects may only last about 8 to 12 hours. The half-life of propranolol (the time it takes for its blood concentration to reduce by one-half) is about 3 to 6 hours. It takes close to 5 half-lives (or 15 to 30 hours) for this drug to be fully eliminated. Stopping propranolol suddenly may make your health condition worse or cause serious side effects, so contact your doctor before stopping treatment.
Does propranolol cause weight gain?
Weight gain may occur in some patients using propranolol, a beta-blocker, but it does not appear to be a common side effect. The manufacturer does not list weight gain as a side effect, but several reviews, anecdotal reports and case studies have reported weight gain. A study of the beta-blocker class found that about 1.2 kg (2.6 lbs) of weight was gained in patients overall, possibly due to lowered energy metabolism.
Does propranolol help with anxiety?
Propranolol is not approved by the U.S Food and Drug Administration (FDA) for use in patients with anxiety. Propranolol has been studied for anxiety, but right now there is not enough evidence to support its use. More clinical studies are needed to determine whether propranolol is a safe and effective drug for treating any anxiety disorder.
Can propranolol affect your memory?
Yes, it’s possible that propranolol may affect your memory. Central nervous system (CNS) side effects of propranolol include short-term memory loss. Whether propranolol affects long-term memory is unknown.
How long does propranolol last?
How long propranolol effects last depends on many factors, such as what dosage you take and how your body processes medicines. One study in Clinical Pharmacology and Therapeutics found that some effects could still be seen about 24 hours after the last dose taken.
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