What adverse side effects would be reported by a patient receiving propranolol?

Propranolol has a number of different uses such as to prevent migraines, to prevent chest pain (angina), reduce the symptoms of tremor or trembling and shakes and to ease the symptoms of anxiety, such as a fast heartbeat and sweating. Find out how to take it safely and possible side effects.

What is propranolol?

Propranolol is used to treat a number of different conditions and related symptoms, such as:

• to lower high blood pressure (hypertension)
• to prevent chest pain (angina)
• to reduce heart rate in people with abnormally fast heart rhythms (arrhythmias)
• following a heart attack, to protect the heart
• for essential tremor to reduce the symptoms of trembling and shakes 
• to ease the symptoms of anxiety, such as a fast heartbeat, sweating, trembling
• for overactive thyroid gland, to reduce symptoms such as tremor or fast heartbeat
• to prevent migraines.

Propranolol belongs to a group of medicines called beta-blockers. Propranolol works by slowing down your heart rate and making it easier for your heart to pump blood around your body.

Dose

Propranolol comes as immediate release tablets or controlled release capsules.

• The dose of propranolol will be different for different people depending your medical condition and response to treatment.
• Always take your propranolol exactly as your doctor has told you. The pharmacy label on your medicine will tell you how much propranolol to take, how often to take it, and any special instructions.

How to take propranolol

• Immediate release tablets 
  • Take these as you have been prescribed (usually between 2 to 4 times a day).
  • Take your doses at the same times each day.
• Controlled release capsules (usually has LA after the name)
  • Take these once a day, in the morning – the capsules are designed to release the medication slowly over a few hours.
  • Swallow the controlled release capsule whole, with a glass of water.
  • Do not crush or chew them – this will release all the medication at once and increase your chance of side effects.  
• You can take propranolol with or without food.
• If you forget your dose, take it as soon as you remember that day. But, if it is nearly time for your next dose, just take the next dose at the right time. Do not take double the dose.
• Do not stop taking propranolol suddenly; speak to your doctor or nurse before stopping.

Things to consider while you are taking propranolol

• Avoid alcohol while you are taking propranolol, especially when you first start treatment. Alcohol can increase your risk of side effects such as dizziness.
• Propranolol can interact with other medicines. Tell your doctor or pharmacist about all medicines you are taking including over the counter medicines or herbal and complementary medicines.

If you have diabetes

• If you have diabetes, propranolol may cause changes in your blood glucose level. This effect usually settles with time.
• Beta-blockers may reduce the warning signs of a low blood sugar level (hypoglycaemia – often called a hypo). For example, you may not have the feeling of fast, irregular or strong heartbeats (palpitations) or tremor, which can occur when your blood glucose is going too low.
• If you are worried about this, talk to your doctor. Do not stop taking your beta-blocker without checking with your doctor first. Read more about hypoglycaemia.

If you have asthma

• If you have asthma, taking a beta blocker may trigger your asthma symptoms or make them worse. Not everybody with asthma is sensitive to these medicines.
• If you are worried about this, talk to your doctor. They may be able to prescribe a different medicine or increase the dose of your asthma preventer medication.
• Do not suddenly stop taking your beta-blocker without talking to your doctor first. This can be dangerous and make you feel unwell. Read more about medicines that may trigger asthma symptoms.

What are the side effects of propranolol?

Like all medicines, propranolol can cause side effects, although not everyone gets them. Often side effects improve as your body gets used to the new medicine.

Learn more

The following links provide further information on propranolol.

Medsafe Consumer Information Sheet: Cardinol LA 
New Zealand Formulary Patient Information: propranolol

References

1. Propranolol hydrochloride New Zealand Formulary

The Māori Pharmacists’ Association Ngā Kaitiaki o Te Puna Rongoā has a free phone line to answer questions whānau have about their medicines. Call 0800 664 688.

Note: This is a non-urgent service and they will get back to you within 24 hours.
For urgent health advice freephone Healthline 0800 611 116.

High blood pressure

Chest pain

Heart attack | Hē manawa

Essential tremors

Anxiety | Mate māharahara

Overactive thyroid

Migraine disease | Māhunga ānini

Beta blockers