Propranolol Uses

• Propranolol indications
• Uses of Propranolol in details
• Propranolol description
• Propranolol dosage
• Propranolol interactions
• Propranolol side effects
• Propranolol contraindications

What is Propranolol?

Propranolol is used alone or together with other medicines to treat high blood pressure (hypertension). High blood pressure adds to the workload of the heart and arteries. If it continues for a long time, the heart and arteries may not function properly. This can damage the blood vessels of the brain, heart, and kidneys, resulting in a stroke, heart failure, or kidney failure. Lowering blood pressure may reduce the risk of stroke and heart attacks.

Propranolol is also used to treat severe chest pain (angina), migraine headaches, or hypertrophic subaortic stenosis (thickened heart muscle).

Propranolol may also be used to treat irregular heartbeats, tremors, or pheochromocytoma (adrenal gland tumor). It may also be used to reduce the risk of death in patients who have heart attacks.

Propranolol oral solution is used to treat proliferating infantile hemangioma.

Propranolol is a beta-blocker. It works by affecting the response to nerve impulses in certain parts of the body, like the heart. As a result, the heart beats slower and decreases the blood pressure. When the blood pressure is lowered, the amount of blood and oxygen is increased to the heart.

Propranolol is available only with your doctor's prescription.

Propranolol indications

Hypertension

Propranolol extended-release capsules are indicated in the management of hypertension. They may be used alone or used in combination with other antihypertensive agents, particularly a thiazide diuretic. Propranolol extended-release capsules are not indicated in the management of hypertensive emergencies.

Angina Pectoris Due to Coronary Atherosclerosis

Propranolol extended-release capsules are indicated to decrease angina frequency and increase exercise tolerance in patients with angina pectoris.

Migraine

Propranolol extended-release capsules are indicated for the prophylaxis of common migraine headache. The efficacy of Propranolol in the treatment of a migraine attack that has started has not been established, and Propranolol is not indicated for such use.

Hypertrophic Subaortic Stenosis

Propranolol extended-release capsules improve NYHA functional class in symptomatic patients with hypertrophic subaortic stenosis.

How should I use Propranolol?

Use Propranolol as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Propranolol is usually given as an injection at your doctor's office, hospital, or clinic.
• Do not use Propranolol if it contains particles, is cloudy or discolored, or if the vial is cracked or damaged.
• Keep this product, as well as syringes and needles, out of the reach of children and pets. Do not reuse needles, syringes, or other materials. Ask your health care provider how to dispose of these materials after use. Follow all local rules for disposal.
• If you miss a dose of Propranolol, contact your doctor right away.

Ask your health care provider any questions you may have about how to use Propranolol.

Uses of Propranolol in details

Use: Labeled Indications

Angina, chronic stable: To decrease angina frequency and increase exercise tolerance in patients with angina pectoris.

Cardiac arrhythmias: Control of supraventricular arrhythmias (eg, atrial fibrillation and flutter, atrioventricular nodal reentrant tachycardia) and ventricular tachycardias (eg, catecholamine-induced arrhythmias, digoxin toxicity).

Essential tremor: Management of familial or hereditary essential tremor.

Hypertension: Management of hypertension. Note: Beta-blockers are not recommended as first-line therapy (ACC/AHA [Whelton 2018]).

Migraine headache prophylaxis: Prophylaxis of common migraine headache.

Myocardial infarction, early treatment and secondary prevention: To reduce cardiovascular mortality in patients who have survived the acute phase of myocardial infarction and are clinically stable.

Obstructive hypertrophic cardiomyopathy: Symptomatic treatment of obstructive hypertrophic cardiomyopathy (formerly known as hypertrophic subaortic stenosis).

Pheochromocytoma: As an adjunct to alpha-adrenergic blockade to control blood pressure and reduce symptoms of catecholamine-secreting tumors.

Proliferating infantile hemangioma (Hemangeol): Treatment of proliferating infantile hemangioma requiring systemic therapy.

Off Label Uses

Akathisia, antipsychotic-induced

Data from a limited number of patients in 5 randomized, double-blind, controlled studies support the use of Propranolol in antipsychotic-induced akathisia.

Based on the American Association for the Study of Liver Diseases guidelines on the management of portal hypertensive bleeding in cirrhosis and the British Society of Gastroenterology guidelines on the management of variceal hemorrhage in cirrhotic patients, use of nonselective beta-blockers, such as Propranolol, is effective and recommended for primary and secondary prophylaxis of variceal hemorrhage.

Propranolol description

A widely used non-cardioselective beta-adrenergic antagonist. Propranolol is used in the treatment or prevention of many disorders including acute myocardial infarction, arrhythmias, angina pectoris, hypertension, hypertensive emergencies, hyperthyroidism, migraine, pheochromocytoma, menopause, and anxiety. [PubChem]

Propranolol dosage

General

Propranolol extended-release capsules provide Propranolol in a sustained-release capsule for administration once daily. If patients are switched from Propranolol tablets to Propranolol extended-release capsules, care should be taken to assure that the desired therapeutic effect is maintained. Propranolol extended-release capsules should not be considered a simple mg-for-mg substitute for Propranolol tablets. Propranolol extended-release capsules have different kinetics and produce lower blood levels. Retitration may be necessary, especially to maintain effectiveness at the end of the 24-hour dosing interval.

Hypertension

The usual initial dosage is 80 mg Propranolol extended-release capsules once daily, whether used alone or added to a diuretic. The dosage may be increased to 120 mg once daily or higher until adequate blood pressure control is achieved. The usual maintenance dosage is 120 to 160 mg once daily. In some instances a dosage of 640 mg may be required. The time needed for full hypertensive response to a given dosage is variable and may range from a few days to several weeks.

Angina Pectoris

Starting with 80 mg Propranolol extended-release capsules once daily, dosage should be gradually increased at three- to seven-day intervals until optimal response is obtained. Although individual patients may respond at any dosage level, the average optimal dosage appears to be 160 mg once daily. In angina pectoris, the value and safety of dosage exceeding 320 mg per day have not been established.

If treatment is to be discontinued, reduce dosage gradually over a period of a few weeks.

Migraine

The initial oral dose is 80 mg Propranolol extended-release capsules once daily. The usual effective dose range is 160 to 240 mg once daily. The dosage may be increased gradually to achieve optimal migraine prophylaxis. If a satisfactory response is not obtained within four to six weeks after reaching the maximal dose, Propranolol extended-release capsules therapy should be discontinued. It may be advisable to withdraw the drug gradually over a period of several weeks depending on the patient's age, comorbidity, and dose of Propranolol extended-release capsules.

Hypertrophic Subaortic Stenosis

The usual dosage is 80 to 160 mg Propranolol extended-release capsules once daily.

Propranolol interactions

See also:
What other drugs will affect Propranolol?

This medicine strengthens (relatively) the negative effect of verapamil and diltiazem on myocardium, prolongs the action non depolarizing muscle relaxant, inhibits the excretion of lidocaine. NSAIDs, corticosteroids, estrogens, cocaine weaken the anti-hypertensive effect of Propranolol Zydus Pharmaceuticals; nitrates and other antihypertensive drugs increase it. Heparin, antacids decrease the level of this drug in plasma; cimetidine and phenothiazines increase it. It is not recommended for concomitant use with MAO inhibitors. Slows down the metabolism of theophylline and increase its concentration in blood plasma.

Propranolol side effects

See also:
What are the possible side effects of Propranolol?

The following adverse events were observed and have been reported in patients using Propranolol.

Cardiovascular: Bradycardia; congestive heart failure; intensification of AV block; hypotension; paresthesia of hands; thrombocytopenic purpura; arterial insufficiency, usually of the Raynaud type.

Central Nervous System: Light-headedness; mental depression manifested by insomnia, lassitude, weakness, fatigue; catatonia; visual disturbances; hallucinations; vivid dreams; an acute reversible syndrome characterized by disorientation for time and place, short-term memory loss, emotional lability, slightly clouded sensorium, and decreased performance on neuropsychometrics. For immediate release formulations, fatigue, lethargy, and vivid dreams appear dose related.

Gastrointestinal: Nausea, vomiting, epigastric distress, abdominal cramping, diarrhea, constipation, mesenteric arterial thrombosis, ischemic colitis.

Allergic: Hypersensitivity reactions, including anaphylactic/anaphylactoid reactions; pharyngitis and agranulocytosis; erythematous rash; fever combined with aching and sore throat; laryngospasm; respiratory distress.

Respiratory: Bronchospasm.

Hematologic: Agranulocytosis, nonthrombocytopenic purpura, and thrombocytopenic purpura.

Autoimmune: Systemic lupus erythematosus (SLE).

Skin and mucous membranes: Stevens-Johnson Syndrome, toxic epidermal necrolysis, dry eyes, exfoliative dermatitis, erythema multiforme, urticaria, alopecia, SLE-like reactions, and psoriasisiform rashes. Oculomucocutaneous syndrome involving the skin, serous membranes, and conjunctivae reported for a beta-blocker (practolol) have not been associated with Propranolol.

Genitourinary: Male impotence; Peyronie's disease.

Propranolol contraindications

See also:
What is the most important information I should know about Propranolol?

Hypersensitivity to Propranolol, beta-blockers, or any component of the formulation; uncompensated heart failure (unless the failure is due to tachyarrhythmias being treated with Propranolol); cardiogenic shock; severe sinus bradycardia; sick sinus syndrome; or heart block greater than first-degree (except in patients with a functioning artificial pacemaker); bronchial asthma

Hemangeol (additional contraindications): Premature infants with corrected age <5 weeks; infants weighing <2 kg; heart rate <80 bpm; blood pressure <50/30 mm Hg; pheochromocytoma; history of bronchospasm

Documentation of allergenic cross-reactivity for beta-blockers is limited. However, because of similarities in chemical structure and/or pharmacologic actions, the possibility of cross-sensitivity cannot be ruled out with certainty.

Canadian labeling: Additional contraindications (not in US labeling): Cor pulmonale; allergic rhinitis during pollen season; patients prone to hypoglycemia; hypotension (blood pressure parameters not specified in labeling); metabolic acidosis; vasospastic angina (also referred to as Prinzmetal angina or variant angina); severe peripheral arterial circulatory disturbance

Hemangiol (additional contraindications): Infants weighing <2.5 kg; breastfed infants if mother is treated with medicines contraindicated with Propranolol; heart rate <100 bpm or blood pressure <65/45 mm Hg (<3 months of age), heart rate <90 bpm or blood pressure <70/50 mm Hg (3 to <6 months of age), heart rate <80 bpm or blood pressure <80/55 mm Hg (6 to 12 months of age)

Active ingredient matches for Propranolol:

Propranolol Oral Solution in Argentina, Australia, Austria, Bahrain, Belgium, Brazil, Canada, Colombia, Ecuador, Ethiopia, Greece, Hong Kong, India, Indonesia, Ireland, Italy, Japan, Luxembourg, Malaysia, Oman, Peru, Philippines, Portugal, South Africa, Sweden, Switzerland, Taiwan, Thailand, United Kingdom, United States, Vietnam.

Propranolol hydrochloride

Propranolol in Romania.

Unit description / dosage (Manufacturer)	Price, USD
Injectable; Injection; Propranolol Hydrochloride 1 mg / ml
Tablet; Oral; Propranolol Hydrochloride 10 mg
Tablet; Oral; Propranolol Hydrochloride 120 mg
Tablet; Oral; Propranolol Hydrochloride 20 mg
Tablet; Oral; Propranolol Hydrochloride 40 mg
Tablet; Oral; Propranolol Hydrochloride 80 mg
Tablet, Film-Coated; Oral; Propranolol Hydrochloride 10 mg
Tablet, Film-Coated; Oral; Propranolol Hydrochloride 40 mg
Tablet, Film-Coated; Oral; Propranolol Hydrochloride 80 mg
Tablet; Oral; Propranolol Hydrochloride 60 mg
Tablet; Oral; Propranolol 10 mg
Tablet; Oral; Propranolol 40 mg
Capsule, Sustained Release; Oral; Propranolol Hydrochloride 160 mg
Capsule, Sustained Release; Oral; Propranolol Hydrochloride 80 mg
Tablet; Oral; Propranolol Hydrochloride 90 mg
Solution; Oral; Propranolol Hydrochloride 20 mg / 5 ml
Solution; Oral; Propranolol Hydrochloride 40 mg / 5 ml
Capsule, Extended Release; Oral; Propranolol Hydrochloride 120 mg
Capsule, Extended Release; Oral; Propranolol Hydrochloride 160 mg
Capsule, Extended Release; Oral; Propranolol Hydrochloride 60 mg
Capsule, Extended Release; Oral; Propranolol Hydrochloride 80 mg
Concentrate; Oral; Propranolol Hydrochloride 80 mg / ml
Capsule, Prolonged Release; Oral; Propranolol Hydrochloride 160 mg
Capsule, Prolonged Release; Oral; Propranolol Hydrochloride 80 mg
Propranolol hcl powder	$ 11.63
Propranolol 1 mg/ml vial	$ 10.00
Inderal la 160 mg capsule	$ 8.41
Inderal LA 160 mg 24 Hour Capsule	$ 7.60
Inderal la 160 mg capsule sa	$ 7.01
Inderal la 120 mg capsule	$ 6.42
Inderal LA 120 mg 24 Hour Capsule	$ 5.80
Inderal la 120 mg capsule sa	$ 5.36
Inderal la 80 mg capsule	$ 5.18
Inderal LA 60 mg 24 Hour Capsule	$ 4.79
Inderal LA 80 mg 24 Hour Capsule	$ 4.68
Inderal la 60 mg capsule	$ 4.43
Inderal la 80 mg capsule sa	$ 4.32
Inderal la 60 mg capsule sa	$ 3.70
Propranolol HCl CR 160 mg 24 Hour Capsule	$ 2.62
InnoPran XL 80 mg 24 Hour Capsule	$ 2.50
InnoPran XL 120 mg 24 Hour Capsule	$ 2.46
Innopran xl 120 mg capsule	$ 2.41
Innopran xl 80 mg capsule	$ 2.41
Inderide 80-25 mg tablet	$ 2.17
Propranolol HCl CR 120 mg 24 Hour Capsule	$ 2.00
Inderide 40-25 mg tablet	$ 1.74
Propranolol HCl CR 80 mg 24 Hour Capsule	$ 1.61
Propranolol HCl CR 60 mg 24 Hour Capsule	$ 1.38
Propranolol HCl 60 mg tablet	$ 1.27
Inderal-La 160 mg Sustained-Release Capsule	$ 1.26
Inderal-La 120 mg Sustained-Release Capsule	$ 1.07
Inderal-La 80 mg Sustained-Release Capsule	$ 0.69
Propranolol HCl 80 mg tablet	$ 0.66
Propranolol-HCTZ 80-25 mg tablet	$ 0.65
Inderal-La 60 mg Sustained-Release Capsule	$ 0.62
Propranolol-HCTZ 40-25 mg tablet	$ 0.61
Propranolol 80 mg tablet	$ 0.58
Propranolol 60 mg tablet	$ 0.56
Propranolol HCl 40 mg tablet	$ 0.53
Propranolol 40 mg tablet	$ 0.45
Propranolol HCl 20 mg tablet	$ 0.36
Propranolol 20 mg tablet	$ 0.33
Apo-Propranolol 120 mg Tablet	$ 0.32
Propranolol HCl 10 mg tablet	$ 0.29
Propranolol 10 mg tablet	$ 0.22
Propranolol HCl 20 mg/5ml Solution	$ 0.11
Apo-Propranolol 80 mg Tablet	$ 0.06
Novo-Pranol 80 mg Tablet	$ 0.06
Pms-Propranolol 80 mg Tablet	$ 0.06
Apo-Propranolol 20 mg Tablet	$ 0.04
Apo-Propranolol 40 mg Tablet	$ 0.04
Novo-Pranol 20 mg Tablet	$ 0.04
Novo-Pranol 40 mg Tablet	$ 0.04
Apo-Propranolol 10 mg Tablet	$ 0.02
Novo-Pranol 10 mg Tablet	$ 0.02
PROPRANOLOL Capsule/ Tablet / 10mg / 10 units (ICI)	$ 0.03
PROPRANOLOL Capsule/ Tablet / 40mg / 10 units (ICI)	$ 0.08
Propranolol / Yu Sheng 40 mg x 1000's
Propranolol / Yung Shin 40 mg
Propranolol / Y.S. 40 mg
Propranolol / Shinlon 40 mg
Propranolol / C.H. 10 mg
Propranolol / Standard 10 mg x 1000's
Propranolol / Standard 10 mg x 100 x 10's
Propranolol / Standard 40 mg
1 mg x 1 mL x 1's	$ 1.45
Tablets; Oral; Propranolol Hydrochloride 10 mg
Tablets; Oral; Propranolol Hydrochloride 120 mg
Tablets; Oral; Propranolol Hydrochloride 20 mg
Tablets; Oral; Propranolol Hydrochloride 40 mg
Tablets; Oral; Propranolol Hydrochloride 80 mg
Tablets, Film-Coated; Oral; Propranolol Hydrochloride 10 mg
Tablets, Film-Coated; Oral; Propranolol Hydrochloride 40 mg
Tablets, Film-Coated; Oral; Propranolol Hydrochloride 80 mg
Tablets; Oral; Propranolol Hydrochloride 60 mg
Tablets; Oral; Propranolol 10 mg
Tablets; Oral; Propranolol 40 mg
Capsules, Sustained Release; Oral; Propranolol Hydrochloride 160 mg
Capsules, Sustained Release; Oral; Propranolol Hydrochloride 80 mg
Tablets; Oral; Propranolol Hydrochloride 90 mg
Capsules, Extended Release; Oral; Propranolol Hydrochloride 120 mg
Capsules, Extended Release; Oral; Propranolol Hydrochloride 160 mg
Capsules, Extended Release; Oral; Propranolol Hydrochloride 60 mg
Capsules, Extended Release; Oral; Propranolol Hydrochloride 80 mg
Capsules, Prolonged Release; Oral; Propranolol Hydrochloride 160 mg
Capsules, Prolonged Release; Oral; Propranolol Hydrochloride 80 mg
Propranolol 1mg x 1mL VIAL / 1	$ 1.45
PROPRANOLOL / SAMARTH inj 1 mg x 1 mL x 1ml (Samarth)	$ 1.45
Propranolol injection 1 mg/mL (General Injectables & Vaccines, Inc (US))
Propranolol injection, solution 1 mg/mL (APP Pharmaceuticals, LLC (US))
Propranolol tablet 10 mg/1 (STAT Rx USA LLC (US))
List of Propranolol substitutes (brand and generic names):
Propranolil (Brazil)
PROPRANOLOL (SAMARTH)
PROPRANOLOL / SAMARTH Injection / 1mg / 1ml units (Samarth Pharma)	$ 1.45
PROPRANOLOL 40MG TABLET
PROPRANOLOL 40MG TABLET 1 strip / 10 tablets each (Jan Aushadhi)	$ 0.06
Propranolol A-Z Pharma (Colombia)
Propranolol Accord (Estonia, Malta, Poland, Portugal, United Kingdom)
Propranolol AccordHealthcare (Netherlands)
Propranolol Actavis (Bulgaria, Lithuania, United Kingdom)
Propranolol Actavis 10 mg x 1, 000's (Actavis)
Propranolol Actavis 40 mg x 1, 000's (Actavis)
Propranolol Actavis film-coated tab 10 mg 1000's (Actavis)
Propranolol Actavis film-coated tab 10 mg 28's (Actavis)
Propranolol Actavis film-coated tab 40 mg 1000's (Actavis)
Propranolol Actavis film-coated tab 40 mg 28's (Actavis)
Propranolol Akadimpex (Hungary)
Propranolol Akadimpex 40 mg (Hungary)
Propranolol AL (Germany)
Propranolol AL 40 (Germany)
Propranolol AL 80 (Germany)
Propranolol Alpharma ApS (Singapore)
Propranolol American Generics (Colombia)
Propranolol Anglopharma (Colombia)
Propranolol Arena (Romania)
Propranolol Ayerst (Brazil)
Propranolol Balkanpharma (Bulgaria)
Propranolol Biogaran (France)
Propranolol Biogen (Colombia)
Propranolol Biotech RX (Venezuela)
Propranolol Bussié (Colombia)
Propranolol Cipla (Georgia)
Propranolol Clorhidrato (Colombia)
Propranolol Clorhidrato Mintlab (Paraguay)
Propranolol Clorhidrato Sanderson (Chile)
Propranolol Coaspharma (Colombia)
Propranolol Concentrate
Propranolol Dak (Denmark)
Propranolol Ecar (Colombia)
Propranolol EEL (Romania)
Propranolol EG (Belgium, France)
Propranolol EG 40mg (Luxembourg)
Propranolol EG Retard (Belgium)
Propranolol EG Retard 160mg (Luxembourg)
Propranolol Eurogenerics (Luxembourg)
Propranolol Fabiol (Romania)
See 1310 substitutes for Propranolol

References

1. PubChem. "propranolol". https://pubchem.ncbi.nlm.nih.gov/com... (accessed September 17, 2018).
2. DrugBank. "propranolol". http://www.drugbank.ca/drugs/DB00571 (accessed September 17, 2018).
3. MeSH. "Vasodilator Agents". https://www.ncbi.nlm.nih.gov/mesh/68... (accessed September 17, 2018).

Reviews

The results of a survey conducted on ndrugs.com for Propranolol are given in detail below. The results of the survey conducted are based on the impressions and views of the website users and consumers taking Propranolol. We implore you to kindly base your medical condition or therapeutic choices on the result or test conducted by a physician or licensed medical practitioners.

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Information checked by Dr. Sachin Kumar, MD Pharmacology