Propranolol – Beta-blocker for heart conditions, anxiety, and migraine prevention.
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What is Propranolol?
Propranolol is a beta-blocker medication with multiple uses including treating high blood pressure, preventing migraines, and managing anxiety symptoms. It’s particularly effective for controlling the physical symptoms of anxiety such as rapid heart rate and trembling.
Book an online consultation if you’re experiencing anxiety symptoms, high blood pressure, or frequent migraines. Our GPs can assess whether Propranolol is suitable for your condition and medical history.
What is Propranolol used for?
- High blood pressure (hypertension)
- Anxiety and performance anxiety
- Migraine prevention
- Heart rhythm abnormalities
- Essential tremor
- Angina (chest pain)
- Thyrotoxicosis symptoms
- Post-heart attack protection
How does Propranolol work?
A beta-blocker that blocks the effects of adrenaline on the heart and blood vessels, reducing heart rate, blood pressure, and physical symptoms of anxiety.
Dosage and Administration
Adults
10-320 mg daily depending on condition—usually started low and gradually increased.
Children
Specialist supervision required—dose calculated based on weight and condition.
Important Notes
- Can be taken with or without food.
- For anxiety: usually 10-40 mg taken 1 hour before stressful situations.
- For regular use: divided into 2-4 doses throughout the day.
- Do not stop suddenly—dose must be gradually reduced.
Side Effects
Common Side Effects
- Fatigue and tiredness
- Cold hands and feet
- Dizziness
- Slow heart rate
- Nausea
- Difficulty sleeping
- Vivid dreams or nightmares
Serious Side Effects
Seek immediate medical attention if you experience:
- Severe breathing difficulties
- Very slow heart rate (bradycardia)
- Low blood pressure
- Heart failure worsening
- Severe depression
- Masking of low blood sugar symptoms
Important Warnings
- Do not use if you have asthma or severe breathing problems.
- Tell your GP if you have diabetes—may mask low blood sugar symptoms.
- Do not stop suddenly—risk of rebound high blood pressure or heart problems.
- May worsen symptoms of peripheral arterial disease.
- Can mask symptoms of overactive thyroid.
Drug Interactions
Tell your GP if you're taking any of the following medications:
- Insulin and diabetic medications—may mask low blood sugar symptoms.
- Calcium channel blockers—may cause dangerous drop in blood pressure.
- NSAIDs—may reduce blood pressure lowering effects.
- Ergot alkaloids—may cause severe vasoconstriction.
- Anaesthetics—inform medical staff you're taking propranolol.
Frequently Asked Questions
How quickly does Propranolol work for anxiety?
For performance anxiety, it typically works within 1 hour. The physical symptoms of anxiety (rapid heart rate, trembling) are usually well controlled.
Can I take Propranolol just when I need it for anxiety?
Yes, many people take it 'as needed' for specific anxious situations like public speaking or exams, usually 1 hour beforehand.
Will Propranolol help with panic attacks?
It can help with the physical symptoms (racing heart, trembling) but doesn't address the psychological aspects. Your GP may recommend additional treatment.
Why can't I stop taking it suddenly?
Stopping suddenly can cause dangerous rebound effects including very high blood pressure, chest pain, or even heart attack in some people.
Medically Reviewed by: Mohammed Hassan - Independent Prescriber
Last Updated: 2025-01-14