How does this medication work? What will it do for me?

Propranolol belongs to the class of medications called beta-blockers. It is used to treat high blood pressure. It is also used to prevent angina (chest pain), to reduce the risk of more heart problems after a heart attack (myocardial infarction), to manage certain heart conditions, and to treat certain types of abnormal heart rhythms. Propranolol works by relaxing blood vessels and reducing the demands on the heart.

Propranolol is also used for the prevention of migraines and the treatment of essential tremor.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. As well, some forms of this medication may not be used for all of the conditions discussed here. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

What form(s) does this medication come in?

10 mg
Each round, orange, biconvex tablet, scored and identified "APO" over "10" on one side, contains propranolol HCl 10 mg. Nonmedicinal ingredients: cornstarch, D&C Yellow No. 10 Aluminum Lake, FD&C Yellow No. 6, lactose monohydrate, magnesium stearate, and microcrystalline cellulose.

20 mg
Each hexagonal, blue, biconvex tablet, scored and identified "APO" over "20" on one side, contains propranolol HCl 20 mg. Nonmedicinal ingredients: cornstarch, FD&C Blue No. 1 Aluminum Lake, FD&C Blue No. 2 Aluminum Lake, lactose monohydrate, magnesium stearate, and microcrystalline cellulose.

40 mg
Each round, green, biconvex tablet, scored and identified "APO" over "40" on one side, contains propranolol HCl 40 mg. Nonmedicinal ingredients: cornstarch, croscarmellose sodium, D&C Yellow No. 10 Aluminum Lake, FD&C Blue No. 2 Aluminum Lake, lactose monohydrate, magnesium stearate, and microcrystalline cellulose.

80 mg
Each round, yellow, biconvex tablet, scored and identified "APO" over "80" on one side, contains propranolol HCl 80 mg. Nonmedicinal ingredients: colloidal silicon dioxide, cornstarch, croscarmellose sodium, D&C Yellow No. 10 Aluminum Lake, FD&C Yellow No. 6, lactose monohydrate, magnesium stearate, and microcrystalline cellulose.

120 mg
Each round, deep rose, biconvex tablet, scored and identified "APO" over "120" on one side, contains propranolol HCl 120 mg. Nonmedicinal ingredients: colloidal silicon dioxide, croscarmellose sodium, lactose monohydrate, magnesium stearate, microcrystalline cellulose, and red ferric oxide.

How should I use this medication?

The recommended adult dose of propranolol varies widely according to the condition being treated and circumstances of the person taking the medication. Propranolol may be taken with or without food. Do not stop taking this medication suddenly unless you have talked with your doctor first.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones given here,do not change the way that you are taking the medication without consulting your doctor.

It is important to take this medication exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

This medication is available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms listed here. The forms available for the specific brand you have searched are listed under "What form(s) does this medication come in?"

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Who should NOT take this medication?

Propranolol should not be taken by anyone who:

  • is allergic to propranolol or to any of the ingredients of the medication
  • is in cardiogenic shock
  • has a severely slow heart rate
  • has allergic rhinitis during the pollen season
  • has asthma or severe chronic obstructive respiratory diseases (e.g., emphysema, chronic bronchitis)
  • has overt heart failure
  • has right ventricular failure secondary to pulmonary hypertension (excessive blood pressure in the lungs)
  • has serious heart block (second- and third-degree AV block)
  • has severe circulatory disorders

What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent. The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

  • dizziness or lightheadedness
  • drowsiness (slight)
  • hives
  • itching of skin
  • skin rash
  • unusual tiredness or weakness

Although most of these side effects listed below don't happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

  • back or joint pain
  • breathing difficulty or wheezing
  • chest pain
  • cold hands and feet
  • confusion
  • depression
  • dizziness upon arising (orthostatic hypotension)
  • fever and sore throat
  • hallucinations
  • irregular heartbeat
  • red, scaling, or crusted skin
  • shortness of breath
  • slow heartbeat (especially less than 50 beats per minute)
  • skin rash
  • swelling of ankles, feet, or lower legs
  • unusual bleeding or bruising

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for this medication?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Breathing problems: People with asthma and certain other breathing problems should not take propranolol.

Congestive heart failure: People with congestive heart failure should not take propranolol.

Diabetes: The signs of low blood sugar may not be as noticeable when taking propranolol. People with diabetes who take insulin or other medications that work by reducing the sugar in the blood should be cautious and monitor blood sugar carefully while taking this medication.

Dizziness: Move slowly when moving from a lying down or sitting position to a standing position as dizziness may occur, especially when this medication is first being started.

Hyperthyroidism (high level of thyroid hormones): People with hyperthyroidism should be cautious while taking propranolol as it may reduce the symptoms of this condition giving a false impression of improvement. Stopping the medication suddenly could worsen this condition.

Severe allergies: People with allergies severe enough to cause anaphylaxis (a severe allergic reaction where swelling of the face, lips, and throat make it difficult to breathe) should talk to their doctor about what to do if they have an allergic reaction. Propranolol may make it more difficult to treat their allergic reaction with epinephrine.

Stopping medication: Propranolol should not be stopped suddenly by people who are taking it to treat angina. There have been reports of severe worsening of angina and of heart attack or abnormal heart rhythms occurring for people with angina pectoris who have stopped the medication abruptly.

Surgery: If you are scheduled for surgery, inform all doctors involved in your care that you take propranolol.

Pregnancy: Not enough information exists on the safe use of propranolol by pregnant women. Propranolol should be used during pregnancy only if the potential benefits justify the potential risks.

Breast-feeding: Propranolol passes into breast milk. Talk to your doctor about the risks and benefits of using this medication while breast-feeding.

Children: There is limited experience in the use of propranolol by children. Caution is advised with its use by this age group.

What other drugs could interact with this medication?

There may be an interaction between propranolol and any of the following:

  • amiodarone
  • antiarrhythmic medications
  • antidiabetes medications (e.g., insulin)
  • asthma medications (e.g., salbutamol, salmeterol)
  • calcium channel blockers (e.g., nifedipine, verapamil)
  • chlorpromazine
  • cimetidine
  • clonidine
  • digoxin
  • diltiazem
  • disopyramide
  • dong quai
  • epinephrine
  • ergot alkaloids (e.g., dihydroergotamine, methysergide)
  • fentanyl
  • haloperidol
  • hydralazine
  • lidocaine
  • medications that reduce blood pressure
  • mefloquine
  • methimazole
  • methyldopa
  • nonsteroidal anti-inflammatory drugs (NSAIDs; e.g., ibuprofen, naproxen)
  • prazosin
  • propafenone
  • quinidine
  • ranitidine
  • selective serotonin reuptake inhibitors(SSRIs; e.g., citalopram, fluoxetine, fluvoxamine paroxetine, sertraline)
  • St. John's wort
  • theophyllines (e.g., theophylline, aminophylline, oxtriphylline)
  • thioridazine
  • verapamil
  • warfarin

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

  • stop taking one of the medications,
  • change one of the medications to another,
  • change how you are taking one or both of the medications, or
  • leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.