1. What’s propranolol
Propranolol belongs to a gaggle of medicines known as beta blockers. It is used to deal with coronary heart issues, assist with anxiousness and stop migraines.
When you’ve got a coronary heart downside, you possibly can take propranolol to:
- deal with hypertension
- deal with sicknesses that trigger an irregular heartbeat, like atrial fibrillation
- stop future coronary heart illness, coronary heart assaults and strokes
- stop chest ache brought on by angina
Propranolol will help scale back your signs when you’ve got an excessive amount of thyroid hormone in your physique (thyrotoxicosis). You may often take it along with medicines to deal with an overactive thyroid. This medication is barely obtainable on prescription. It comes as tablets, capsules, or as a liquid to swallow.
2. Key info
- Propranolol slows down your coronary heart charge and makes it simpler in your coronary heart to pump blood round your physique.
- It’s often prescribed for hypertension and different coronary heart issues, however it could actually additionally assist with the bodily indicators of hysteria, like sweating and shaking.
- Your very first dose of propranolol might make you are feeling dizzy, so take it at bedtime. After that, if you don’t really feel dizzy, you possibly can take it within the morning.
- The primary unwanted side effects of propranolol are feeling dizzy or drained, chilly palms or toes, difficulties sleeping and nightmares. These unwanted side effects are often gentle and brief lived.
3. Who can and can’t take propranolol
Propranolol will be taken by adults and kids. However it isn’t formally accepted for treating hypertension in youngsters below 12 years previous.
It isn’t appropriate for everybody. To verify it’s protected for you, inform your physician earlier than beginning propranolol when you’ve got:
- ever had an allergic response to propranolol or another medication
- low blood strain or a sluggish coronary heart charge
- coronary heart failure which is getting worse
- extreme blood circulation issues in your limbs (corresponding to Raynaud’s phenomenon), which can make your fingers and toes tingle or flip pale or blue
- metabolic acidosis – when there’s an excessive amount of acid in your blood
- lung illness or bronchial asthma
Inform your physician if you happen to’re making an attempt to get pregnant, are already pregnant or if you happen to’re breastfeeding.
4. How and when to take propranolol
Propranolol comes as 2 various kinds of medication:
- normal launch – releases propranolol into your physique shortly, chances are you’ll have to take it a number of instances a day relying in your dose
- sustained launch (SR) – this dissolves slowly so that you shouldn’t have to take it as usually, as soon as a day is often sufficient
In case you are taking it as soon as a day, your physician might advise you to take your first dose earlier than bedtime, as a result of it could actually make you are feeling dizzy. After the primary dose, if you don’t really feel dizzy, take propranolol within the morning.
Hold taking propranolol even if you happen to really feel effectively. You’ll nonetheless be getting the advantages of the medication.
How a lot you’re taking is determined by why you want propranolol. Doses for adults and kids over the age of 12 for:
- hypertension, the beginning dose is often 80mg twice a day. If this dose will not be working effectively sufficient (in case your blood strain doesn’t go down sufficient), your physician might improve it to a most of 160mg twice a day.
- migraine or angina (chest ache), the same old dose is 40mg taken 2 or 3 instances a day. This may be elevated to 120mg to 240mg a day. Your physician or pharmacist will clarify learn how to break up the dose over the day.
- irregular heartbeat (arrhythmia), the same old dose is 10mg to 40mg 3 or 4 instances a day.
- anxiousness, the same old dose is 40mg as soon as a day which will be elevated to 40mg 3 instances a day.
- an excessive amount of thyroid hormone (thyrotoxicosis), the dose is 10mg to 40mg taken 3 or 4 instances a day.
Doses are often decrease for the aged or individuals with a kidney or liver downside. In case your youngster is below 12 years previous they usually want propranolol, your physician will often use your kid’s weight to work out the proper dose.
Find out how to take it
Propranolol doesn’t often upset your tummy so you possibly can take it with or with out meals. It is best to do the identical every day.
Swallow the tablets complete with a drink of water. For those who discover them troublesome to swallow, some manufacturers have a rating line that will help you break the pill in half. Examine the data leaflet in your model to see if you are able to do this.
For those who’re taking propranolol as a liquid, it’s going to include a plastic syringe or spoon that will help you measure out the proper dose. For those who shouldn’t have one, ask your pharmacist for one. Don’t use a kitchen teaspoon because it won’t provide the correct amount of medication.
What if I neglect to take it?
For those who neglect to take a dose of propranolol, take it as quickly as you bear in mind, except it’s almost time in your subsequent dose. On this case, simply miss the missed dose and take your subsequent dose as regular.
By no means take 2 doses on the identical time. By no means take an additional dose to make up for a forgotten one.
For those who usually neglect doses, it could assist to set an alarm to remind you. You may additionally ask your pharmacist for recommendation on different methods that will help you bear in mind to take your medication.
What if I take an excessive amount of?
An overdose of propranolol can decelerate your coronary heart charge and make it troublesome to breathe. It will probably additionally trigger dizziness and trembling. The quantity of propranolol that may result in an overdose varies from individual to individual.
Pressing recommendation: Name 111 for recommendation now if:
- you’re taking an excessive amount of propranolol
- Name 111 or go to 111 on-line
- If you could go to hospital, don’t drive your self – get another person to drive you or name for an ambulance.
- Take the propranolol packet or leaflet inside it plus any remaining medication with you.
- Discover your nearest A&E.
5. Negative effects
Like all medicines, propranolol may cause unwanted side effects in some individuals however many individuals don’t have any unwanted side effects or solely minor ones. Negative effects usually enhance as your physique will get used to the medication.
Widespread unwanted side effects
These widespread unwanted side effects occur in additional than 1 in 100 individuals. They’re often gentle and brief lived.
Speak to your physician or pharmacist if the unwanted side effects hassle you or final quite a lot of days:
- feeling drained, dizzy or gentle headed (these will be indicators of a sluggish coronary heart charge)
- chilly fingers or toes (propranolol might have an effect on the blood provide to your palms and toes)
- difficulties sleeping or nightmares
- feeling sick (nausea)
Critical unwanted side effects
It occurs hardly ever, however some individuals have critical unwanted side effects when taking propranolol.
Inform a health care provider right away when you’ve got:
- shortness of breath with a cough which will get worse whenever you train (like strolling up stairs), swollen ankles or legs, chest ache, or an irregular heartbeat – these are indicators of coronary heart issues
- shortness of breath, wheezing and tightening of your chest – these will be indicators of lung issues
- yellow pores and skin or the whites of your eyes flip yellow – these will be indicators of liver issues
Critical allergic response
In uncommon circumstances, propranolol might trigger a critical allergic response (anaphylaxis).
Speedy motion required:
- you get a pores and skin rash that will embrace itchy, pink, swollen, blistered or peeling pores and skin
- you are wheezing
- you get tightness within the chest or throat
- you might have hassle respiration or speaking
- your mouth, face, lips, tongue or throat begin swelling
You may be having a critical allergic response and might have speedy remedy in hospital. These aren’t all of the unwanted side effects of propranolol. For a full listing, see the leaflet inside your medication packet.
6. How to deal with unwanted side effects of propranolol
What to do What’s:
- feeling drained, dizzy or light-headed – as your physique will get used to propranolol, these unwanted side effects ought to put on off. If propranolol makes you are feeling dizzy, sit or lie down till you are feeling higher. Attempt to keep away from alcohol as it’s going to make you are feeling worse.
- chilly fingers or toes – put your palms or toes below heat working water, therapeutic massage them and wiggle your fingers and toes. Don’t smoke or have drinks with caffeine in – this may make your blood vessels narrower and additional prohibit blood circulation to your palms and toes. Strive sporting mittens (they’re hotter than gloves) and heat socks. Don’t put on tight watches or bracelets.
- difficulties sleeping or nightmares – attempt taking your propranolol within the morning. If you must take it greater than as soon as a day, communicate to your physician. They can change your propranolol to the sluggish launch type.
- feeling sick (nausea) – persist with easy meals and don’t eat wealthy or spicy meals. It’d assist to take your propranolol after a meal or snack.
7. Being pregnant and breastfeeding
Propranolol and being pregnant
Propranolol will not be regarded as dangerous throughout being pregnant, however it isn’t potential to make sure. For those who’re making an attempt to get pregnant otherwise you’re already pregnant, speak to your physician What’s the advantages and potential harms of taking propranolol. There could also be different medicines which can be safer for you.
Propranolol and breastfeeding
It’s often protected to take propranolol if you happen to’re breastfeeding. It’s because solely small quantities get into breast milk, which isn’t sufficient to trigger any issues to your child.
Nonetheless, communicate to your physician earlier than taking propranolol in case your child was untimely or has any well being issues.
Non-urgent recommendation: Inform your physician if you happen to’re:
- making an attempt to get pregnant
For extra info What’s how propranolol can have an effect on you and your child throughout being pregnant, go to the Finest Use of Medicines in Being pregnant (BUMPs) web site.
8. Cautions with different medicines
There are some medicines that will intrude with the way in which propranolol works.
Inform your physician if you happen to’re taking:
- different medicines for hypertension. The mixture with propranolol can generally decrease your blood strain an excessive amount of. This will make you are feeling dizzy or faint. If this retains taking place to you, inform your physician – they could change your dose.
- different medicines for an irregular heartbeat corresponding to amiodarone or flecainide
- different medicines which may decrease your blood strain. These embrace some antidepressants, nitrates (for chest ache), baclofen (a muscle relaxant), medicines for an enlarged prostate gland like tamsulosin, or Parkinson’s illness medicines corresponding to levodopa.
- bronchial asthma or continual obstructive pulmonary illness (COPD) medicines
- diabetes medicines, significantly insulin – propranolol might make it harder to recognise the warning indicators of low blood sugar. Communicate to your physician when you’ve got low blood sugar ranges with out getting any of the same old warning indicators. You must test your blood sugar after train, and comply with regular recommendation What’s checking it earlier than driving, or working equipment.
- medicines to deal with nostril or sinus congestion, or different chilly cures (together with these you should buy within the pharmacy)
- medicines for allergy symptoms, corresponding to ephedrine, noradrenaline or adrenaline
- non-steroidal anti-inflammatory medicines (NSAIDs), corresponding to ibuprofen, diclofenac and naproxen. These medicines might improve your blood strain, so it is best to maintain them to a minimal.
Mixing propranolol with natural cures or dietary supplements
There’s little or no info What’s taking natural cures and dietary supplements with propranolol.
Inform your physician or pharmacist if you happen to’re taking another medicines, together with natural medicines, nutritional vitamins or dietary supplements.
9. Widespread questions What’s propranolol
- How does propranolol work?
Propranolol is a kind of medication known as a beta blocker. Like different beta blockers, propranolol works by altering the way in which your physique responds to some nerve impulses, together with within the coronary heart. It slows down your coronary heart charge and makes it simpler in your coronary heart to pump blood round your physique.
It really works otherwise if you happen to're utilizing it for anxiousness. If you find yourself anxious, your mind makes chemical messengers known as adrenaline and noradrenaline. These make your coronary heart charge quicker and make you sweat or shake. Propranolol helps block the results of those chemical messengers. This reduces the bodily indicators of hysteria.
We don't totally perceive how propranolol prevents migraines. It might work by stress-free the blood vessels concerned, or by lowering exercise within the “visible cortex”. That is the a part of the mind the place migraines are believed to begin.
- How lengthy does propranolol take to work?
Propranolol often begins to work in a couple of hours. For coronary heart circumstances or hypertension – propranolol can take as much as per week to succeed in its full impact. Chances are you'll not really feel any totally different however that doesn't imply it isn't working. It is vital to maintain taking your medication.
For migraines – it could actually take a number of weeks for propranolol to begin making an actual distinction, so maintain taking it.
- How lengthy will I take it for?
This is determined by why you take propranolol. For coronary heart circumstances or hypertension – remedy is often long run and could also be for the remainder of your life.
For anxiousness – propranolol is often taken brief time period, to assist along with your bodily signs. Communicate to your physician What's the dangers and advantages of taking it for quite a lot of months. This can rely in your signs, whether or not it is a one-off or a recurring downside, how effectively propranolol works for you and whether or not you get unwanted side effects.
For migraines – remedy can final for a number of months or years, relying on how dangerous your signs are.
- Is it protected to take for a very long time?
Propranolol is usually protected to take for a very long time. For those who're taking it for a coronary heart situation, or to stop migraines, it really works finest whenever you take it long run.
For those who're taking it for anxiousness, there don't appear to be any lasting dangerous results if you happen to take it for a number of months or years. Nonetheless, it is best to take propranolol solely for so long as you want it.
You may have to have your blood strain checked frequently if you happen to're taking propranolol for a very long time for migraines or anxiousness.
- What's going to occur if I cease taking it?
Speak to your physician if you wish to cease taking propranolol. For those who're bothered by unwanted side effects, your physician might be able to prescribe a unique medication as a substitute.
Stopping propranolol immediately might make your well being downside worse. As well as, if you happen to cease immediately after taking it for a very long time, chances are you'll get further unwanted side effects as a response to stopping it. These embrace an irregular coronary heart charge, sweating and shaking.
For those who cease taking propranolol, it's going to take What's 1 to 2 days for it to be utterly out of your physique however the unwanted side effects can final for as much as 1 week.
- How does propranolol evaluate with different coronary heart medicines?
Propranolol works in addition to different beta blockers for lowering blood strain. The primary distinction between propranolol and different beta blockers is that it doesn't simply have an effect on your coronary heart. It will probably have an effect on different components of your physique too, corresponding to your lungs.
There are many different medicines to decrease your blood strain and deal with chest ache. They work differently to beta blockers and embrace:
-ACE inhibitors – for instance ramipril and lisinopril
-angiotensin receptor blockers – for instance candesartan
-calcium channel blockers – for instance amlodipine
-diuretics (medicines which make you pee extra) – for instance furosemide
Beta blockers aren't often the primary selection remedy for hypertension. The drugs your physician prescribes is determined by your age and ethnicity.
For those who're below 55, you may often be provided an ACE inhibitor or an angiotensin receptor blocker. For those who're 55 or older, otherwise you're any age and of African Caribbean or black African origin, you may often be provided a calcium channel blocker.
Typically you might have to attempt different blood pressure-lowering medicines if you happen to get unwanted side effects. Many individuals have to take a mixture of various blood pressure-lowering tablets.
- How does it evaluate with different medicines for stopping migraine?
Atenolol, metoprolol, timolol and nadolol are all beta blockers they usually work effectively in stopping migraines. Nonetheless, most docs prescribe propranolol.
There are another medicines which can be identified to stop migraines however they aren't formally accepted within the UK. They embrace amitriptyline, sodium valproate and gabapentin they usually might have totally different unwanted side effects.
Topiramate may also be used to stop migraines. It really works simply in addition to propranolol. Nonetheless, topiramate has not been formally accepted for migraine for kids below the age of 16. Ask your physician or pharmacist which medication is finest for you.
- How does it evaluate with different medicines for anxiousness?
Propranolol treats the bodily signs of hysteria – for instance, it stops your coronary heart beating too quick. You may often solely take propranolol for a short while.
The bodily signs of hysteria are brought on by chemical imbalances within the mind. Your physician might prescribe an antidepressant like sertraline to deal with these imbalances. You often take antidepressants long run.
Many docs want medicine-free remedies. These embrace speaking therapies like cognitive behavioural remedy. For those who're having speaking remedy, your physician might prescribe propranolol on the identical time. This can aid you along with your bodily signs.
- Will I have to cease propranolol earlier than surgical procedure?
Inform your physician that you are taking propranolol if you are going to be put to sleep (utilizing normal anaesthetic), otherwise you're having any form of main operation.
Your physician might advise you to cease taking propranolol earlier than surgical procedure. It's because propranolol can decrease your blood strain an excessive amount of when it is mixed with some anaesthetics.
- Can I drink alcohol with it?
Ingesting alcohol can improve the blood pressure-lowering impact of propranolol, which may make you are feeling dizzy or light-headed.
In the course of the first few days of taking propranolol or after a rise in your dose, it's best to cease consuming alcohol till you see how the medication impacts you. For those who discover propranolol makes you are feeling dizzy it is best to cease consuming alcohol.
- Is there any meals or drink I have to keep away from?
You possibly can eat and drink usually whereas taking propranolol. Consuming a wholesome, balanced weight loss plan will help when you've got hypertension or one other coronary heart situation.
- Will it make me placed on weight?
Some individuals on propranolol say they placed on weight, particularly within the first few months of taking it. This isn't identified to be a standard facet impact of taking propranolol, nevertheless, and there's not sufficient info to say for certain why some individuals placed on weight.
It might, for instance, be as a result of propranolol could make you are feeling drained which might make you much less lively. It might additionally have an effect on the way in which your physique makes use of power.
For those who're fearful What's placing on weight with propranolol, communicate to your physician.
- Will it have an effect on my contraception?
Propranolol won't cease your contraception working. Nonetheless, some kinds of hormonal strategies of contraception, just like the mixed capsule and contraceptive patch, aren't often really helpful for ladies taking propranolol and different medicines for hypertension.
It's because some hormonal contraceptives can elevate your blood strain and cease propranolol working correctly. Speak to your physician if you happen to're taking a hormonal contraceptive.
- Will it have an effect on my fertility?
It is unlikely that propranolol impacts fertility in males or ladies. Nonetheless there's not sufficient proof to say for sure. For those who're making an attempt for a child, otherwise you're having issues getting pregnant whereas on propranolol, communicate to your physician.
- Will it have an effect on my intercourse life?
Some individuals on propranolol say their intercourse drive goes down and a few males discover they can't get an erection. Nonetheless, this isn't a standard facet impact and there's not sufficient proof to say for certain that propranolol is inflicting it. For those who're having issues along with your intercourse life, speak to your physician.
- Do I have to keep away from taking part in sports activities?
You do not want to cease taking part in sports activities if you happen to take propranolol. However don't push your self an excessive amount of.
Common train is sweet for you as a result of it lowers blood strain by protecting your coronary heart and blood vessels in good situation. Remember, although, that in some sports activities propranolol will not be allowed if you happen to're competing at a excessive degree.
- Can I drive or trip a motorbike?
Propranolol could make some individuals really feel dizzy particularly whenever you first begin taking it or after taking a much bigger dose. If this occurs to you, don't drive a automotive, trip a motorbike, or use instruments or equipment.
- Can life-style modifications assist?
When you've got coronary heart issues, you possibly can enhance the well being of your coronary heart by making some key life-style modifications. These may even assist when you've got hypertension.
Stop smoking – smoking will increase your coronary heart charge and blood strain. Quitting smoking brings down your blood strain and relieves coronary heart failure signs. Attempt to keep away from second-hand smoke.
Minimize down on alcohol – consuming alcohol when you're taking propranolol could make you are feeling dizzy or gentle headed. Additionally consuming an excessive amount of alcohol raises blood strain over time and makes coronary heart failure worse. Women and men shouldn't drink greater than 14 items of alcohol per week. A regular glass of wine (175ml) is 2 items. A pint of lager or beer is often 2 to three items of alcohol.
Train – common train lowers blood strain by protecting your coronary heart and blood vessels in good situation. It doesn't should be too energetic – strolling daily will assist.
Eat effectively – purpose to eat a weight loss plan that features loads of fruit and veg, wholegrains, fat-free or low-fat dairy merchandise and lean proteins. It is a good suggestion to reduce down on salt too. Consuming an excessive amount of salt is the most important reason behind hypertension – the extra salt you eat, the upper your blood strain shall be. Goal for not more than 6g of salt a day.
Cope with stress – whenever you're anxious or upset, your coronary heart beats quicker, you breathe extra closely and your blood strain usually goes up. This may make coronary heart failure worse too. Discover methods to scale back stress in your life. To present your coronary heart a relaxation, attempt napping or placing your toes up when potential. Spend time with family and friends to be social and assist keep away from stress.
For those who get extreme complications, there are steps you possibly can take to assist stop migraines. This contains figuring out what issues set off an assault so you possibly can keep away from them.
- Anxiousness, concern and panic
- Coronary heart assault
- Coronary heart failure
- Hypertension (hypertension)
- HealthUnlocked: propranolol discussion board
- Anxiousness UK: charity
- Blood Strain UK: charity
- Migraine Motion: charity
- Healthtalk: actual tales of coronary heart assaults
- NHS Well being Examine: free well being check-up