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Your guide to medication Propranolol

Propranolol is a beta blocker that is sometimes used to treat the physical symptoms associated with anxiety.

Medication name: Propranolol ("Pro-PRAN-oh-lol")
Brand names: Bedranol ("BEH-jran-ol"), Angilol ("AN-ji-lol")
Medication type: Beta blocker

Ways to take propranolol
Tablets: Available in 10mg, 40mg, 80mg and 160mg strengths
Capsules: Long-acting capsules available in 80mg and 160mg strengths
Liquids: Available in 5mg/5ml, 10mg/5ml, 40mg/5ml and 50mg/5ml strengths

What can it be used for?
If you are 18 or over, the doctor can prescribe propranolol for you as a licensed medicine to help with some of the physical symptoms associated with anxiety, such as sweating and shaking.

There is less research about its use and effectiveness in young people under 18. Even so, specialists might prescribe it ‘off-label’ if it is the best medicine for you.

Read our guide to anxiety

About propranolol

How propranolol works

Propranolol is a beta-blocker medicine, which helps to reduce the symptoms of anxiety, including sweating and shaking. It doesn’t treat the feeling of anxiety, only the physical symptoms that come with it.

When you are anxious your brain makes more of the chemicals noradrenaline and adrenaline, both of which can make your heart beat faster and can make you shake and sweat. Propranolol blocks the effects of these chemicals.

Find out more about anxiety

Propranolol and everyday life

Frequently asked questions

You will get the effect of propranolol quickly - usually within a few hours.

There is no evidence that propranolol affects your weight.

You may want to let your family and friends know you are taking propranolol so they can support you and help you look out for side effects.

For guidance on this, check out our page on getting support with your medication.

Alcohol

You can continue to drink alcohol while taking propranolol, but having the two together might make you a little sleepier and unsteady on your feet.

During the first few days, it might be best to stop drinking alcohol until you see how the medicine affects you or until the side effects pass.

If you want to drink alcohol, remember that it may make you sleepier than usual. Make sure you can get home safely.

Drinking alcohol every day, or in large amounts, can make your symptoms worse and the propranolol will not get the best chance to act.

Smoking

Cigarette smoke affects the amount of propranolol in your body.

If you smoke, you may need a higher dose of propranolol than someone who does not smoke.

Tell your doctor if you smoke to make sure you get the right dose for you.

If you stop smoking, the level of propranolol in the body rises, and you might need to reduce your dose of propranolol slowly over one week.

If you (re)start smoking, you will probably need to increase it again.

Go to your doctor for advice if you stop or start smoking.

Propranolol does not mix well with some other medicines and drugs.

Before you take propranolol, tell your doctor or pharmacist if you are taking any other drugs.

Tell the pharmacist you are taking propranolol if you buy medicines over the counter (including things you put on your skin) for common illnesses.

If you have food allergies and carry an adrenaline injection (epi-pen), let your doctor know as propranolol could reduce the effectiveness of this.

Propranolol tablets may not be suitable for you if you have problems eating some sugars or dairy (milk-based) foods, as they contain lactose.

Some propranolol tablets may contain colours that can cause an allergic reaction.

The capsules contain gelatin and sucrose.

Talk to your pharmacist or doctor if you are allergic to any food additives.

Propranolol long-acting capsules contain gelatin, and this may be a problem if you don't eat meat.

The liquid may contain methyl and propyl parahydroxybenzoates and the food additive colour sunset yellow (E110) which may cause an allergic reaction in some people.

The liquid may also contain maltitol (a type of sugar related to fructose). If your doctor has told you that you cannot eat some sugars, check with your doctor before taking it.

Let your pharmacist know if you have any food allergies or intolerances, and always check with them if you’re concerned about any of the ingredients in your medication.

Taking propranolol may affect your eyesight, and make you feel tired, dizzy or faint when you start taking it.

This could affect you if you drive a car, ride a bike, or do anything else that needs a lot of focus. It might be best to stop doing these things for the first few days, until you know how it affects you.

Some people are given propranolol to help them relax and stop any shaking for their driving test, but they should test how they feel on propranolol a few days before they take the test.

Do not worry - most people drive as normal while taking propranolol.

Pregnancy

When deciding whether to take propranolol during pregnancy, it is important to weigh up how necessary propranolol is to your health against the possible risks to you or your baby, some of which will depend on how many weeks pregnant you are.

Most studies with propranolol have looked at mums who take propranolol as part of treatment for their high blood pressure. High blood pressure itself is not good for a developing baby and so when things haven’t gone well it may be due to the high blood pressure itself.

There may be a link with propranolol taken early in pregnancy and spine problems or malformations of the mouth, but again it is not clear if this is really the case.

Remaining well is particularly important during pregnancy and while caring for a baby. For some women, treatment with propranolol in pregnancy may be the best option for both mother and baby.

Post-natal

Taking propranolol near to delivery may mean that your baby is born with a slower heart rate, lower blood pressure, some breathing difficulties and a low blood sugar. All these will be checked at birth and can readily be dealt with.

Breastfeeding

Propranolol can be passed to the baby in the breastmilk, but the levels are very low and so the risk of side effects in the baby is also low.

It is generally thought that it is alright to breastfeed while taking propranolol, but as everyone is different it is important to seek advice from your doctor or midwife first.

Remember that it is important for you to remain well while you are bonding with and looking after your baby. For this reason, it may be best to take medicine for your mental health when breastfeeding.

Make sure that your doctor, nurse, or health visitor checks your baby for any side effects.

If your baby was premature or has health problems, then you will need to be extra careful about taking medicines while breastfeeding. It may be best not to breastfeed if this is the case, but you should discuss this with your doctor or midwife.

Propranolol can have side effects that might affect your sex life, though these are rare.

If you have a penis, you may find it more difficult to get and keep an erection.

This and any other effects should pass after the first couple of weeks. If they do not, and this is a problem for you, go back to the doctor and see what else you could try.

Propranolol is a banned substance in some sports.

For most of them, it is only banned while playing competitively.

These sports are:

  • archery (WA) (also prohibited out-of-competition) 
  • automobile (car sports) (FIA)
  • billiards (all disciplines) (WCBS) 
  • darts (WDF) 
  • golf (IGF) 
  • shooting (ISSF, IPC) (also prohibited out-of-competition) 
  • skiing/snowboarding (FIS) in ski jumping, freestyle aerials/halfpipe and snowboard halfpipe/big air
  • underwater sports (CMAS) in constant-weight apnoea with or without fins, dynamic apnoea with and without fins, free immersion apnoea, Jump Blue apnoea, spearfishing, static apnoea, target shooting and variable weight apnoea

When you start taking propranolol, it may make you feel tired, dizzy, faint or confused, and could make your eyesight blurred, so do not do any sports that need a lot of focus just after you start taking propranolol.

Do not worry - most people play sports as normal while taking propranolol.

Try not to take propranolol for the first time just before your exams.

You may feel dizzy, faint or confused when you start taking propranolol, and it can make your eyesight blurred.

You should talk to your doctor about any future exams if you are starting propranolol.

You might decide together to delay starting it until you have done them. 

If they are more than a week away, however, you might find that it is better to start propranolol to improve any shaking or sweating that you get.

Do not worry - most people take exams as normal while taking propranolol.

Your doctor should know

  • You need to talk to your doctor or pharmacist before you take propranolol if any of the following apply to you:

    • you have asthma or any other breathing difficulties
    • you have any heart problems
    • you have low blood pressure
    • you have diabetes mellitus (symptoms of low blood sugar levels may be hidden by this medicine)
    • you have a tight, painful feeling in the chest even when you rest (Prinzmetal’s angina)
    • you have untreated high blood pressure due to a tumour near the kidney (phaeochromocytoma)
    • you have muscle weakness (myasthenia gravis)
    • you have kidney or liver disease
    • you have an overactive thyroid (symptoms of hyperthyroidism include increased appetite, weight loss, sweating)
    • you have, or have ever had, psoriasis
    • you have serious blood circulation problems (which may cause your fingers and toes to tingle or turn pale or blue)
    • you have Raynaud’s disease (cold sensations in fingers and toes) or intermittent claudication (narrowing of arteries in the legs causing pain on walking)
    • you smoke (propranolol may carry a higher risk of making your breathing more difficult)
    • you know that you are going to have surgery soon, as the effects of propranolol on your heart mean a risk of effects on your heartbeat while you are under a general anaesthetic
    • you are having any blood or urine tests (propranolol can change the results of some lab tests)
    • you have food allergies and carry an adrenaline injection (epi-pen), as propranolol could reduce the effectiveness of this

Uses, warnings, safety and side effects

Taking propranolol

How long will I need to take propranolol for?

You should talk to your doctor about how long you will need to take propranolol for before you start treatment.

Some people only need to take propranolol for a few days.

Other people will take it regularly for months or even years.

If you are taking it for a long time, make sure that you see your doctor for a review every six months.

You should only take propranolol as agreed with your doctor

Make sure that you know your dose. If it is not written on the label, check with your pharmacist or doctor.

Your doctor might change your dose a few times at the beginning to find the right level for you.

You may have to take it up to three times a day.

It doesn’t matter what time you take it each day - choose a time that you can always remember. This could be a mealtime, or when you brush your teeth. If you take propranolol more than once a day, spread the doses as evenly as possible throughout the day.

If you can, take it before a meal or some food.

Swallow the tablet with a drink of water - if you chew it, it tastes bitter.

If you find it difficult to take it more than once a day, ask your doctor about the long-acting capsules because they only need to be taken once a day.

Swallow the capsules whole with a drink of water - they are specially made to release the medicine over a few hours into your body and should not be crushed or chewed.

What if I miss a dose?

If you remember later, take it as soon as possible.

If you forget to take it until just before your next dose, just start again with the next dose.

Do not take a double dose.

What will happen if I forget to take my propranolol?

If you forget to take your tablets for a few days, you may start getting withdrawal symptoms, some of which can be dangerous to your heart.

Please talk to your doctor or pharmacist and look out for any withdrawal symptoms.

Stopping the use of propranolol

If you want to stop taking propranolol, you should ask your doctor for help. Stopping this medicine quickly, or reducing the dose too much at once, may cause withdrawal symptoms that are dangerous to your heart.

These symptoms include:

  • sweating
  • shaking
  • irregular heartbeat
  • chest pain, which may be angina or a heart attack

You will need to go to hospital if you get these symptoms, as your heart could be in serious trouble.

If you go to your doctor for help to stop, they will reduce your dose slowly and safely over about two weeks.

Warnings and safety

Safety headlines

If you have taken more propranolol than the dosage recommended by the doctor who prescribed it to you, you must get medical help immediately – even if you do not feel any different.

Propranolol can cause rare but serious side effects such as allergic reactions (difficulty breathing, swelling of your face or throat, itching skin lumps), a slow heartbeat or a heartbeat that is not regular. Go to a hospital if you get any of these symptoms and take your medicine with you.

Tell your doctor that you are taking propranolol if you are due to have an operation with a general anaesthetic. You may need to stop the medicine before the operation day.

Stopping propranolol suddenly can cause serious side effects that might include sweating, shaking, and an irregular heartbeat or chest pain. Go to your doctor if you want to stop, or if you are having these effects.

You might feel sleepy or dizzy in the first few days after taking propranolol. Do not drive a car, ride a bike or operate machines until you see how this affects you.

If you are pregnant, or thinking of becoming pregnant, please read the pregnancy, post-natal and breastfeeding section (under the 'Side Effects' tab) because propranolol may affect the developing baby.

When to go to the hospital

If you have taken more propranolol than the dosage recommended by the doctor who prescribed it to you, you must get medical help immediately – even if you do not feel any different. Go to A&E. Take your medicine with you to show to the doctors. Tell them how much you have taken. Get a friend or family member to go with you, if you can, just in case you feel ill on the way.

You might get any of the following signs:

  • slow heartbeat
  • dizziness
  • sickness
  • confusion
  • hallucinations (seeing, hearing or sensing things that are not there)
  • body spasms
  • breathlessness when you try to get up and do something
  • fainting or coma
  • you could also be in danger of a heart attack

Stop taking propranolol and go to a doctor or hospital straight away if you get any of the following symptoms:

  • slow heartbeat and low blood pressure causing dizziness, lightheadedness, fainting or blurred eyesight
  • itching, difficulty breathing or swelling of the face, lips, throat or tongue – this could be an allergic reaction

Side effects

Side effects

Not everyone will experience side effects with propranolol. Some of the more common side effects are listed at the bottom of this page. If you are experiencing a problem that might be a side effect, but is not listed here, please look at the patient information leaflet that was in the medicine packet, or speak to your pharmacist or doctor.

If you think you have a side effect that has not got better within a few days, go back to your doctor.

Some side effects that appear should go away after a few days. If they do not, you should go back to your doctor.

Don't stop taking propranolol until you talk to your doctor or you may get withdrawal symptoms as well.

Common side effects of taking propranolol, affecting up to one in ten people, include:

  • slower heartbeat and pulse rate (this isn’t dangerous, but talk to your doctor if you are concerned about it)
  • colds hands and feet
  • numbness and spasm in your hands and fingers which is followed by warmth and pain (Raynaud’s disease)
  • disturbed sleep or nightmares
  • feeling tired

Taking propranolol

How long will I need to take propranolol for?

You should talk to your doctor about how long you will need to take propranolol for before you start treatment.

Some people only need to take propranolol for a few days.

Other people will take it regularly for months or even years.

If you are taking it for a long time, make sure that you see your doctor for a review every six months.

You should only take propranolol as agreed with your doctor

Make sure that you know your dose. If it is not written on the label, check with your pharmacist or doctor.

Your doctor might change your dose a few times at the beginning to find the right level for you.

You may have to take it up to three times a day.

It doesn’t matter what time you take it each day - choose a time that you can always remember. This could be a mealtime, or when you brush your teeth. If you take propranolol more than once a day, spread the doses as evenly as possible throughout the day.

If you can, take it before a meal or some food.

Swallow the tablet with a drink of water - if you chew it, it tastes bitter.

If you find it difficult to take it more than once a day, ask your doctor about the long-acting capsules because they only need to be taken once a day.

Swallow the capsules whole with a drink of water - they are specially made to release the medicine over a few hours into your body and should not be crushed or chewed.

What if I miss a dose?

If you remember later, take it as soon as possible.

If you forget to take it until just before your next dose, just start again with the next dose.

Do not take a double dose.

What will happen if I forget to take my propranolol?

If you forget to take your tablets for a few days, you may start getting withdrawal symptoms, some of which can be dangerous to your heart.

Please talk to your doctor or pharmacist and look out for any withdrawal symptoms.

Stopping the use of propranolol

If you want to stop taking propranolol, you should ask your doctor for help. Stopping this medicine quickly, or reducing the dose too much at once, may cause withdrawal symptoms that are dangerous to your heart.

These symptoms include:

  • sweating
  • shaking
  • irregular heartbeat
  • chest pain, which may be angina or a heart attack

You will need to go to hospital if you get these symptoms, as your heart could be in serious trouble.

If you go to your doctor for help to stop, they will reduce your dose slowly and safely over about two weeks.

Warnings and safety

Safety headlines

If you have taken more propranolol than the dosage recommended by the doctor who prescribed it to you, you must get medical help immediately – even if you do not feel any different.

Propranolol can cause rare but serious side effects such as allergic reactions (difficulty breathing, swelling of your face or throat, itching skin lumps), a slow heartbeat or a heartbeat that is not regular. Go to a hospital if you get any of these symptoms and take your medicine with you.

Tell your doctor that you are taking propranolol if you are due to have an operation with a general anaesthetic. You may need to stop the medicine before the operation day.

Stopping propranolol suddenly can cause serious side effects that might include sweating, shaking, and an irregular heartbeat or chest pain. Go to your doctor if you want to stop, or if you are having these effects.

You might feel sleepy or dizzy in the first few days after taking propranolol. Do not drive a car, ride a bike or operate machines until you see how this affects you.

If you are pregnant, or thinking of becoming pregnant, please read the pregnancy, post-natal and breastfeeding section (under the 'Side Effects' tab) because propranolol may affect the developing baby.

When to go to the hospital

If you have taken more propranolol than the dosage recommended by the doctor who prescribed it to you, you must get medical help immediately – even if you do not feel any different. Go to A&E. Take your medicine with you to show to the doctors. Tell them how much you have taken. Get a friend or family member to go with you, if you can, just in case you feel ill on the way.

You might get any of the following signs:

  • slow heartbeat
  • dizziness
  • sickness
  • confusion
  • hallucinations (seeing, hearing or sensing things that are not there)
  • body spasms
  • breathlessness when you try to get up and do something
  • fainting or coma
  • you could also be in danger of a heart attack

Stop taking propranolol and go to a doctor or hospital straight away if you get any of the following symptoms:

  • slow heartbeat and low blood pressure causing dizziness, lightheadedness, fainting or blurred eyesight
  • itching, difficulty breathing or swelling of the face, lips, throat or tongue – this could be an allergic reaction

Side effects

Side effects

Not everyone will experience side effects with propranolol. Some of the more common side effects are listed at the bottom of this page. If you are experiencing a problem that might be a side effect, but is not listed here, please look at the patient information leaflet that was in the medicine packet, or speak to your pharmacist or doctor.

If you think you have a side effect that has not got better within a few days, go back to your doctor.

Some side effects that appear should go away after a few days. If they do not, you should go back to your doctor.

Don't stop taking propranolol until you talk to your doctor or you may get withdrawal symptoms as well.

Common side effects of taking propranolol, affecting up to one in ten people, include:

  • slower heartbeat and pulse rate (this isn’t dangerous, but talk to your doctor if you are concerned about it)
  • colds hands and feet
  • numbness and spasm in your hands and fingers which is followed by warmth and pain (Raynaud’s disease)
  • disturbed sleep or nightmares
  • feeling tired

About this information

The information on this page was reviewed by the College of Mental Health Pharmacy in March 2020.

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