Propranolol - a beta-blocker

About propranolol

Propranolol is a type of beta-blocker used to treat several medical conditions such as anxiety and high blood pressure. It works on the heart and blood vessels.

Propranolol helps ease the physical symptoms of anxiety, such as a fast heartbeat and trembling. Similar symptoms to these are also experienced by people with an overactive thyroid gland. Propranolol quickly relieves these types of symptoms.

It is also the beta-blocker which is commonly prescribed to help prevent migraines. Propranolol can be helpful for people who find other treatments for migraine unsuitable.

Propranolol slows down the activity of your heart by stopping messages sent by some nerves to your heart. It does this by blocking tiny areas (called beta-adrenergic receptors) where the messages are received by your heart.

As a result, your heart beats more slowly and with less force. This allows the pressure of blood within your blood vessels to be reduced if you have high blood pressure (hypertension), and helps to prevent abnormally fast heart rhythms (arrhythmias).

Because your heart is using less energy, this helps to reduce chest pain if you have angina. Propranolol can also help to protect the heart following a heart attack.

The most common side effects of propranolol are:

• Feeling tired.

• Cold hands and feet.

• Feeling out of breath.

• Disturbed sleep (insomnia).

• Slow heartbeat.

You you also experience other common side effects such as:

• Erectile dysfunction (impotence).

• Reduce sexual desire (libido).

• Mood changes.

• Headache.

• Upset stomach.

You will find a full list in the manufacturer's information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following continue or become troublesome.

If you experience any other symptoms which you think may be due to the medicine, speak with your doctor or pharmacist for further advice.

Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking propranolol it is important that your doctor or pharmacist knows:

• If you are pregnant, trying for a baby or breastfeeding.

• If you have any problems with the way your liver works, or with the way your kidneys work.

• If you have low blood pressure or poor circulation.

• If you have asthma or any other breathing disorder.

• If you have high blood sugar levels (diabetes mellitus).

• If you have a skin problem called psoriasis.

• If you have a condition causing muscle weakness, called myasthenia gravis.

• If you have been told you have a slow heartbeat or heart block (a slow and irregular heartbeat).

• If you have been told you have chest pain called Prinzmetal's angina (caused by spasms of your heart's blood vessels).

• If you are taking any other medicines. This includes any medicines you are taking which are available to buy without a prescription, as well as herbal and complementary medicines.

• If you have ever had an allergic reaction to a medicine, or if you have ever had any other serious allergic reaction.

• Read the manufacturer's printed information leaflet from inside the pack. It will give you more information about propranolol and will provide you with a full list of the side effects which you may experience from taking it.

• Your doctor will tell you what dose of propranolol is right for you, and this information will be printed on the label of the pack to remind you.

• Take propranolol exactly as your doctor tells you to. Propranolol tablets are usually prescribed to be taken in divided doses - so you may be prescribed two, three or four doses to take each day.

  • Propranolol capsules have a more prolonged action and are prescribed to be taken once daily. Swallow the capsule whole with a drink of water - do not chew or open the capsules.

• Propranolol tablets and capsules are available in several different strengths. Each time you collect a fresh supply, it's a good idea to check the strength on the packet to make sure they are the strength you are expecting.

• Try to take your doses at the same times of day each day, as this will help you to remember to take them regularly.

• If you do forget to take a dose of propranolol, take it as soon as you remember unless your next dose is due. If your next dose is due then take the tablet/capsule which is due but leave out the forgotten one. Do not take two doses together to make up for missing one.

• Try to keep your regular appointments with your doctor. This is so your doctor can check on your progress.

• Treatment with propranolol can often be long-term. Continue to take the tablets/capsules unless your doctor tells you to stop.

  • Stopping treatment suddenly can cause problems in some people, so your doctor may want you to reduce your dose gradually if this becomes necessary.

• If you are due to have an operation or dental treatment, it is important to tell the person carrying out the treatment that you are taking a beta-blocker. This is because some anaesthetics may increase the risk of unwanted effects.

• If you drink alcohol, ask your doctor for advice about taking propranolol and alcohol. Alcohol will add to the blood pressure-lowering effect of propranolol and so may not be recommended for you.

• If you have diabetes, propranolol can block the symptoms of low blood sugar. Your doctor will advise you about this.

• If you buy any medicines, check with a pharmacist that they are suitable for you to take. Some medicines (including some cough, cold and flu remedies) may not be.

• Your doctor may give you dietary and lifestyle advice about eating a healthy diet, not smoking, and taking regular exercise. If so, it is important that you follow the advice you are given.

• Keep all medicines out of the reach and sight of children.

• Store in a cool, dry place, away from direct heat and light.

Can I take sertraline and propranolol together?

Yes, sertraline and propranolol are sometimes prescribed together. Sertraline is an antidepressant, while propranolol is a beta-blocker often used for heart conditions or to reduce anxiety symptoms like palpitations

What should you avoid when taking propranolol?

When taking propranolol, you should be careful with other medicines that affect heart rate or blood pressure, such as certain heart medications, calcium channel blockers, or some asthma inhalers. Alcohol can also increase side effects like dizziness.

Is propranolol an antidepressant?

No, propranolol is not an antidepressant. It is a beta-blocker, mainly used to treat high blood pressure, heart conditions, and sometimes anxiety symptoms like palpitations or tremors. While it can help with certain physical effects of anxiety, it does not treat the mood aspects of depression.

How quickly does propranolol work for anxiety?

Propranolol can start working for anxiety-related physical symptoms, like a racing heart or tremors, within an hour. However, it does not treat the underlying mood aspects of anxiety. Its effects are usually short-term, so it’s often taken as needed before stressful situations.

How long does propranolol last?

Propranolol usually lasts 3–6 hours, or up to 24 hours for extended-release tablets, depending on dose and individual response.