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Propranolol – a drug for migraines, anxiety and heart problems


Propranolol is a medicine that belongs to the group of medicines called beta blockers . It is used to treat heart problems, relieve anxiety, and prevent migraine attacks.


Your doctor may prescribe propranolol to:

  • Treat high blood pressure.
  • Treating problems that cause an irregular heartbeat (such as atrial fibrillation).
  • Prevention of heart disease that may occur in the future (such as heart attack or stroke).
  • Reducing pain in the chest that occurs due to angina.

Propranolol may also relieve symptoms caused by hyperthyroidism , that is, when your body has too many thyroid hormones , this condition is known as thyrotoxicosis.

This medicine is available in several forms (capsules – tablets – syrup), all of which are taken orally, and it is not sold in pharmacies without a prescription.

general information

Taking propranolol slows the heartbeat and makes it easier to pump blood into the body. Generally, this drug is prescribed to treat various heart disorders and high blood pressure, but it can also be used to relieve symptoms of psychological anxiety such as tremors and sweating.

After taking the first dose of the drug, the patient may suffer from dizziness, therefore, doctors advise that it be taken before bed, and if it does not cause dizziness, it can be taken in the morning.

In addition to dizziness, the drug can cause a feeling of tiredness and coldness in the feet and hands, and it may also cause difficulty sleeping and bad dreams, but all of these effects are mild and last for a short period.

Who is propranolol prescribed for?

This medicine is prescribed for both children and adults, but it is not used to treat high blood pressure in children under 12 years of age.

This medicine is not suitable for all patients, and in order to be sure that it is suitable for you, you must discuss this with the doctor. It is necessary to inform the doctor if you suffer from:

  • An allergic reaction to propranolol, any of its ingredients, or any other medicine.
  • Low blood pressure or a slow heart rate.
  • Congestive heart.
  • Any problem with blood circulation.
  • Metabolic acidosis (too much acid in your blood).
  • Asthma or any of the respiratory diseases.

The doctor should also know if the woman is planning pregnancy, or whether she is already pregnant or breastfeeding her baby.

How and when to take propranolol?

There are two types of propranolol:

  • The rapid type: which dissolves in the body quickly and has a rapid effect, this type may need to be taken several times a day.
  • Slow type: It dissolves slowly in the body and therefore its effect is not as fast. In general, most patients only need one dose per day.

If it was prescribed to you as one dose per day, the doctor may ask you to take it before bed, so that you do not feel dizzy, and if you do not feel dizzy after taking the first dose, you can take it in the morning.

Important note: You should not stop taking the medicine even if you feel better, only your doctor should decide to stop taking the medicine or reduce the dose after evaluating your condition.


How much medicine to take depends on your condition. This will be decided by the doctor.

For adult patients and children 12 years of age or older, the dosage is as follows:

  • For the treatment of high blood pressure: 80 mg twice a day. However, if the patient does not feel any improvement and the high blood pressure persists, the dose may be increased to 160 mg twice a day as a maximum.
  • For migraine or angina (chest pain): 40 mg 2 – 3 times a day. The doctor may also increase this dose to 240 mg.
  • For the treatment of arrhythmias: 10 – 40 mg 3 – 4 times a day.
  • For anxiety treatment: 40 mg once a day, 40 mg 3 times a day can also be taken.
  • Hyperthyroidism (thyrotoxicosis): 10 – 40 mg 3 – 4 times a day.

For elderly patients or those with kidney or liver disease. Doses may be lower.

If the doctor finds it necessary to give propranolol to a child under 12 years old, the doctor will measure the child’s weight and determine the appropriate dose for him.

How to take medication

Propranolol can be taken with or without meals. But you should take it the same way every day.

The tablets are taken with water, and if it feels difficult to swallow all at once, divide the tablet in half.

For syrup, the medicine usually comes from a spoon that helps determine the amount of dose, if you do not find the spoon, consult a doctor or pharmacist, we do not advise you to use a tablespoon.

If you forget to take the medicine

If you forget to take the medicine, you should take it as soon as you remember, but if it is almost time for the next dose, then there is no need to take the forgotten dose. Wait a while and then take the next dose as scheduled.

Under no circumstances should two doses be taken at the same time, do not take an extra dose to make up for the forgotten dose.

If you always forget to take your medication, we recommend that you use the alarm on your phone to remember dosing times on time.

If you take a large dose

Taking more propranolol will cause the heart rate to slow down, make breathing more difficult, and may lead to shivering and dizziness.

In the event that a large dose was taken and you felt abnormal symptoms, call an ambulance immediately or go to the nearest hospital, in this case, you should not drive the car because you may feel dizzy and lose control, which causes a danger to your life and the lives of others, ask another person to drive the car Or go to the hospital by taxi.

When you go to the hospital, take the medicine package with you so that the doctors know the condition they are treating.

Side effects

As with all types of medicines, people may develop side effects after taking propranolol, but these symptoms are often mild and sometimes not at all.

In addition, the patient’s condition improves and the side effects disappear after the body gets used to the drug.

The most common side effects

These effects appear in 1 in 100 people who take this medicine, and in most cases they are mild and do not last for long.

If you experience any of the following symptoms for several days, we recommend that you discuss them with your doctor:

  • General fatigue and dizziness (symptom of a slowed heart rate).
  • Cold feet and hands (due to the medicine’s effect on blood flow to your hands and feet).
  • Inability to sleep or have bad dreams.
  • Feeling sick.

Serious side effects

These effects occur very rarely, if you experience them, tell your doctor immediately:

  • Coughing with shortness of breath, this condition worsens when performing activities such as climbing stairs. Swelling of the ankles or legs, chest pain, or an irregular heartbeat (all of these symptoms indicate heart problems).
  • Shortness of breath and chest tightness (this could be a sign of a problem in the lungs).
  • Yellowing of the skin and the whites of the eyes (this may be a sign of a liver problem).

Allergic reaction

Call 911 immediately if you develop the following symptoms:

  • A rash with redness, itching, swelling, crusting, and blisters.
  • Wheezing when breathing in.
  • Severe shortness of breath or throat.
  • Inability to speak or difficulty breathing.
  • Swelling of the face, mouth, lips, tongue, or throat.

All of these symptoms are signs of a serious allergic reaction, and this may require immediate hospitalization.

Important note: We haven’t mentioned all of the side effects of propranolol. You can review the leaflet supplied with the medicine for more details or consult your doctor.

Dealing with the side effects of propranolol

Feeling tired or dizzy

After taking the medicine for several days, your body will get used to it and these symptoms will gradually disappear. If you feel dizzy, sit or lie down until you feel better.

Cold hands or feet

To deal with this problem, put your hands and feet in warm water, and fingers can be massaged together. Also, you should stop smoking and drink any beverages that contain caffeine, as this leads to narrowing of the blood vessels and reduces blood flow to your extremities.

Try wearing gloves and socks, and removing tight watches, bracelets and rings that obstruct blood flow.

Difficulty sleeping and bad dreams

Take the medicine in the morning after you wake up. If you take more than one dose per day, consult your doctor to give you the slow, one dose per day.

Feeling sick

Eat smaller meals and avoid spicy foods. And take the medicine after food.

Pregnancy and breast-feeding

There is not enough information about whether the drug is safe during pregnancy, so you should talk to your doctor if you want to become pregnant or if you are already pregnant.

If you are breastfeeding, the medicine is usually safe, just a little bit of the medicine passes into breast milk, and this small amount will never affect your baby. You should inform the doctor if you are breast-feeding a baby born early (premature labor) or if the baby has any health problems.

Drug interactions

Some medicines can interact with propranolol, and this may affect the effectiveness of this medicine or these medicines:

Tell your doctor if you are taking the following medicines:

  • Other high blood pressure medications: Taking propranolol with other high blood pressure medications might cause a severe drop in blood pressure, which could cause dizziness and fainting.
  • Other antiarrhythmic medicines such as amiodarone or flecainide.
  • Any type of medication that may lower blood pressure such as antidepressants, nitrates (to treat chest pain), baclofen (a muscle relaxer), tamsulosin (to treat an enlarged prostate ), and levodopa (to treat Parkinson’s disease).
  • Asthma or chronic obstructive pulmonary disease (COPD) medications.
  • Diabetes medications, especially insulin.
  • Any medicines used to treat nasal congestion, sinus congestion or the common cold.
  • Allergy medications such as ephedrine, noradrenaline, or adrenaline.
  • Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, diclofenac, and naproxen.
  • Any other medicines, including herbal medicines, vitamins, and nutritional supplements.


Propranolol – UK National Health Service



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