1. Propranolol oral tablet is available only as a generic drug. It doesn’t have a brand-name version.
  2. Propranolol comes in four forms: oral tablet, extended-release oral capsule, oral liquid solution, and injectable.
  3. Propranolol oral tablet reduces your heart’s workload and helps it beat more regularly. It’s used to support heart function after a heart attack as well as treat high blood pressure, angina, atrial fibrillation, and tremor. It’s also used to prevent migraine and help manage thyroid and adrenal gland tumors.
  • Warning for stopping treatment: Do not stop taking this medication without talking with your doctor first. Stopping propranolol suddenly can cause changes in your heart rhythm and blood pressure, worsened chest pain, or a heart attack. Your doctor will slowly lower your dosage over several weeks to help prevent these effects.
  • Drowsiness warning: This drug can cause drowsiness. Do not drive, use machinery, or perform any activities that require alertness until you know how this drug affects you.
  • Diabetes warning: Propranolol can cause hypoglycemia (low blood sugar). It may also mask the signs of low blood sugar, such as a heart rate that’s higher than average, sweating, and shakiness. This drug should be used with caution if you have diabetes, especially if you take insulin or other diabetes drugs that can cause low blood sugar. This drug may also cause low blood sugar in infants, children, and adults who don’t have diabetes. This is more likely after periods of long exercise or if you have kidney problems.
  • Asthma warning: If you have asthma or similar breathing problems, do not take propranolol. It can make your asthma worse.

Propranolol oral tablet is a prescription drug. Propranolol also comes in several other forms: oral extended-release* capsule, oral solution, and injectable.

Propranolol oral tablet is only available in a generic form. Generic drugs usually cost less than brand-name versions.

Propranolol oral tablet may be used in combination with other drugs.

* An extended-release capsule releases its drug slowly over a certain period of time.

Why it’s used

Propranolol reduces your heart’s workload and helps it beat more regularly. It’s used to:

How it works

Propranolol belongs to a group of drugs called beta-blockers. These drugs are often used to treat similar conditions.

Propranolol is a nonselective beta receptor blocking agent. This means it affects the heart, lungs, and other areas of the body similarly.

The way that this drug works to lower blood pressure is not clearly understood. It reduces the workload of the heart and blocks the release of a substance called renin from the kidneys.

The beta-blocking properties help to manage heart rhythm, delay the start of chest pain, prevent migraine episodes, and reduce tremors.

How long it lasts

After you take a single dose of propranolol, half of the drug will be eliminated from your body in about 6 hours. This is known as the drug’s half-life.

Dosage of propranolol varies based on the condition it’s used to treat. Depending on the condition you’re taking propranolol for, you’ll take the drug twice or more per day. Studies have determined the dosage frequency that helps keep an effective level of the drug in the body for the different conditions it treats.

After you stop taking propranolol, the drug should be gone from your body in about 30 hours.

If you have questions about how long propranolol lasts in your body, ask your doctor or pharmacist.

Beta-blockers such as propranolol are sometimes prescribed off-label to treat certain kinds of anxiety. This is because beta-blockers help prevent symptoms of anxiety, such as racing heart, sweating, and tremors. With off-label use, doctors prescribe a drug for a purpose other than what it’s approved for. However, research suggests that more studies are needed to determine the effectiveness and safety of taking propranolol for this use.

To find out more about taking propranolol for anxiety, talk with your doctor.

Propranolol oral tablet may cause drowsiness. Do not drive, use machinery, or perform any activities that require mental alertness until you know how this drug affects you.

Propranolol can also cause other side effects.

More common side effects

The more common side effects of propranolol include:

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk with your doctor or pharmacist.

Serious side effects

Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms include the following:

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare professional who knows your medical history.

Propranolol oral tablet can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.

To help avoid interactions, be sure to tell your doctor about all medications, vitamins, or herbs you’re taking. They’ll let you know if any interact with propranolol and adjust your treatment if needed. To find out how this drug might interact with something else you’re taking, talk with your doctor or pharmacist.

Examples of drugs that can cause interactions with propranolol are listed below.

Arrhythmia drugs

Taking propranolol with other drugs that treat heart rhythm problems may cause more side effects. These include lower heart rate, lower blood pressure, or heart blockage. Your doctor will likely use caution if prescribing these medications together.

Examples of these drugs include:

Blood pressure drug clonidine

If you’re switching from clonidine (Kapvay) to propranolol, your doctor should slowly reduce your dosage of clonidine and slowly increase your dosage of propranolol over several days. This is done to avoid side effects, such as lowered blood pressure.

Other blood pressure drugs

Do not use propranolol with another beta-blocker. It can lower your heart rate too much. Examples of beta-blockers include:

Your doctor will likely use caution if they’re prescribing angiotensin-converting enzyme (ACE) inhibitors with propranolol. Taking these drugs together can cause blood pressure that’s lower than usual. Examples of ACE inhibitors include:

Your doctor will likely use caution if they’re prescribing calcium channel blockers with propranolol. Using these drugs together can cause severely low heart rate, heart failure, and heart blockage. Examples of calcium channel blockers include:

Your doctor will likely use caution if they’re prescribing alpha-blockers with propranolol. Using these drugs together can cause blood pressure that’s lower than usual, fainting, or low blood pressure after standing up too fast. Examples of these drugs include:

Anesthetics (drugs that block sensation)

Use caution if you’re taking these medications with propranolol. Propranolol might affect how these medications are cleared from your body, which can be harmful. Examples of these drugs include:

  • lidocaine (Lidoderm, Glydo, Akten)
  • bupivacaine
  • mepivacaine

Drugs used to increase heart rate and blood pressure

Do not use these medications with propranolol. These drugs cancel one another out. This means that neither of them will work. Examples of these drugs include:

Asthma drugs

You should not take these drugs with propranolol. Doing so increases the amount of these drugs in your blood. This can increase your risk of side effects. Examples of these drugs include:

Nonsteroidal anti-inflammatory drugs (NSAIDs)

These drugs may decrease the blood pressure-lowering effects of propranolol. If you take these drugs together, your doctor should monitor your blood pressure. They may need to change your propranolol dosage.

Examples of NSAIDs include:

Blood thinner drug warfarin

When taken with warfarin (Jantoven), propranolol can increase the amount of warfarin in your body. This may cause an increase in how long you bleed from any wound. Your warfarin dosage may need to be changed if you take these drugs together.

Stomach ulcer drug cimetidine

Taking cimetidine (Tagamet HB) with propranolol can increase the levels of propranolol in your blood. This can cause more side effects.

Antacids with aluminum hydroxide

Taking propranolol with antacids containing aluminum hydroxide, such as Mylanta, may make propranolol less effective. Your doctor will need to monitor you and may need to change your dosage of propranolol.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare professional about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.

This drug comes with several warnings.

Allergy warning

Propranolol can cause a severe allergic reaction. Symptoms may include:

  • rash
  • hives
  • wheezing
  • trouble breathing
  • swelling of the mouth, face, lips, tongue, or throat

If you develop these symptoms, call 911 or go to the nearest emergency room.

Do not take this drug again if you have ever had an allergic reaction to it. Taking it again could be fatal.

If you’ve had severe allergic reactions to other substances that can cause anaphylaxis, your allergies may be more reactive when you take propranolol. The usual doses of an emergency epinephrine drug, such as an EpiPen, may not work as well while you take this drug. Propranolol may block some of epinephrine’s effects.

Alcohol interaction warning

Alcohol can increase levels of propranolol in your body. This can cause more side effects. You should not drink alcohol while taking this drug.

Warnings for people with certain health conditions

For people with cardiogenic shock: Do not use propranolol. Propranolol reduces the force of your heartbeat, which could make this condition much worse.

For people with slower than average heart rate: You should not use propranolol. This drug can slow down your heart rate even more, which could be dangerous.

For people with higher than first-degree heart block: You should not use propranolol. Propranolol reduces the force of your heartbeat, which could make your heart block worse.

For people with asthma: You should not use propranolol. This drug can make your asthma worse.

For people with severe chest pain: Suddenly stopping propranolol can worsen your chest pain.

For people with heart failure: You should not take this drug. Propranolol reduces the force of your heartbeat, which could make your heart failure worse. Propranolol may be helpful if you have a history of heart failure, are taking heart failure medications, and are being closely monitored by your doctor.

For people with Wolff-Parkinson-White syndrome: This medical condition can cause a heart rate that’s slower than average. Treatment of this condition with propranolol may reduce your heart rate too much. Treatment with a pacemaker may be needed.

For people with diabetes: Propranolol can cause hypoglycemia (low blood sugar). It may also mask the signs of low blood sugar, such as a heart rate that’s faster than average, sweating, and shakiness. This drug should be used with caution if you have diabetes, especially if you take insulin or other diabetes drugs that can cause low blood sugar.

For people with hyperactive thyroid: Propranolol can mask the symptoms of hyperthyroidism (overactive thyroid), such as a heart rate that’s faster than average. If you suddenly stop taking propranolol and have hyperthyroidism, your symptoms can get worse, or you may get a serious condition called thyroid storm.

For people with chronic bronchitis or emphysema: In general, if you have problems breathing, you should not take propranolol. It can make your lung condition worse.

For people who plan to have major surgery: Tell your doctor that you’re taking propranolol. This drug can change how your heart reacts to general anesthesia and surgery.

For people with glaucoma: Propranolol may decrease the pressure in your eyes. This may make it hard to tell if your medications for glaucoma are working. When you stop taking propranolol, the pressure in your eyes may increase.

For people with allergies: If you have had severe allergic reactions that cause anaphylaxis, your allergies may get worse when you take propranolol. The usual doses of an emergency epinephrine drug, such as an EpiPen, may not work as well while you take this drug. Propranolol may block some of the effects of epinephrine.

For people with unmanaged bleeding or shock: If you have hemorrhage or shock, a serious problem where your organs don’t get enough blood, drugs to treat these conditions may not work as well if you’re taking propranolol. This is especially true if you’re taking propranolol to treat pheochromocytoma, a tumor in the adrenal gland.

Warnings for other groups

For pregnant people: Talk with your doctor if you’re pregnant or planning to become pregnant. There haven’t been enough studies done to be certain how the drug might affect the fetus. This drug should only be used if the potential benefit outweighs the potential risk.

For people who are breastfeeding: Propranolol is passed through breast milk. The drug may be used while you’re breastfeeding, but your child should be monitored. In a child, propranolol may cause a slower heart rate and low blood sugar. It can also cause decreased oxygen in the blood, which can result in cyanosis. This condition turns your child’s skin, lips, or nails blue.

For older adults: Older adults might have decreased liver, kidney, and heart function, and other medical conditions. Your doctor will take these factors and the medications that you’re taking into account when starting you on propranolol.

For children: It hasn’t been determined that propranolol is safe and effective for use in children younger than 18 years old. There have been reports of heart failure and airway spasms in children who have taken this drug.

When to call the doctor

  1. Tell your doctor if you have a cough, cold, allergies, or pain. Your doctor or pharmacist will help you find drugs that can be safely used with propranolol. Tell your doctor or surgeon if you’re going to have surgery. They will monitor your heart rate and blood pressure, and watch for drug interactions with propranolol.
Was this helpful?

All possible dosages and forms of propranolol may not be included here. Your dose, form, and how often you take it will depend on:

  • your age
  • the condition being treated
  • how severe your condition is
  • other medical conditions you have
  • how you react to the first dose

Drug form and strengths

Generic: Propranolol

  • Form: oral tablet
  • Strengths: 10 milligrams (mg), 20 mg, 40 mg, 60 mg, 80 mg

Dosage for atrial fibrillation

Adult dosage (ages 18 years and older)

The usual dosage is 10 mg to 30 mg taken 3 to 4 times per day, before meals and at bedtime.

Child dosage (ages 0 to 17 years)

It hasn’t been established that propranolol is safe and effective for use in children younger than 18 years.

Dosage for hypertension (high blood pressure)

Adult dosage (ages 18 years and older)

  • Usual starting dosage: 40 mg taken twice per day.
  • Dosage increases: Your doctor may slowly increase your dosage.
  • Typical maintenance dosage: 120 mg to 240 mg per day given in 2 to 3 divided doses. Doses up to 640 mg per day have been given in some cases.
  • Notes:
    • It may take a few days to several weeks for this drug to work fully.
    • If you’re taking a low dose twice per day and your blood pressure isn’t managed, your doctor may increase your dosage or tell you to take the drug three times per day.

Child dosage (ages 0 to 17 years)

It hasn’t been established that propranolol is safe and effective for use in children younger than 18 years.

Dosage for angina (chest pain)

Adult dosage (ages 18 years and older)

  • Typical dosage: 80 mg to 320 mg. You’ll take this total amount in divided doses 2 to 4 times per day.

Child dosage (ages 0 to 17 years)

It hasn’t been established that propranolol is safe and effective for use in children younger than 18 years.

Dosage for heart attack

Adult dosage (ages 18 years and older)

  • Typical starting dosage: 40 mg taken three times per day.
  • Dosage increases: After 1 month, your doctor may increase your dosage to 60 mg to 80 mg taken three times per day.
  • Typical maintenance dosage: 180 mg to 240 mg. This is divided into smaller, equal doses and taken two or three times per day.

Child dosage (ages 0 to 17 years)

It hasn’t been established that propranolol is safe and effective for use in children younger than 18 years.

Dosage for hypertrophic subaortic stenosis

Adult dosage (ages 18 years and older)

  • Typical dosage: 20 mg to 40 mg taken 3 to 4 times per day, before meals and at bedtime.

Child dosage (ages 0 to 17 years)

It hasn’t been established that propranolol is safe and effective for use in children younger than 18 years.

Dosage for migraine

Adult dosage (ages 18 years and older)

  • Typical starting dosage: 80 mg per day. You’ll take this amount in smaller, equal doses several times during the day.
  • Typical maintenance dosage: 160 mg to 240 mg per day.
  • Note:
    • If the maximum effective dosage isn’t helping prevent your migraine episodes after 4 to 6 weeks of therapy, your doctor may have you stop taking the medication. Your dosage or how often you take the drug may be slowly reduced over several weeks to avoid side effects from stopping too quickly.

Child dosage (ages 0 to 17 years)

It hasn’t been established that propranolol is safe and effective for use in children younger than 18 years.

Dosage for essential tremor

Adult dosage (ages 18 years and older)

  • Typical starting dosage: 40 mg taken twice per day.
  • Dosage increases: You may need to take a total dosage of 120 mg per day. In some cases, it may be necessary to take 240 mg to 320 mg per day.

Child dosage (ages 0 to 17 years)

It hasn’t been established that propranolol is safe and effective for use in children younger than 18 years.

Dosage for pheochromocytoma (tumor in the adrenal gland)

Adult dosage (ages 18 years and older)

  • Typical maintenance dosage: 60 mg per day taken in divided doses starting 3 days before your surgery.
  • Notes:
    • You’ll take this drug with other medications. Propranolol isn’t used alone to treat pheochromocytoma.
    • If surgery can’t be done for the tumor, the usual dosage of this drug is 30 mg per day taken in divided doses with other drugs.

Child dosage (ages 0 to 17 years)

It hasn’t been established that propranolol is safe and effective for use in children younger than 18 years.

Special dosage considerations

  • For people with kidney problems: Your doctor will likely use caution when prescribing this drug for you.
  • For people with liver problems: Your doctor will likely use caution when prescribing this drug for you.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always speak with your doctor or pharmacist about dosages that are right for you.

Propranolol oral tablet is used for long-term treatment. It comes with serious risks if you don’t take it as prescribed.

If you don’t take it at all: Your condition will get worse and you may be at risk of serious heart problems, such as heart attack or stroke.

If you skip or miss doses: The condition you’re treating may get worse.

If you take too much: If you think you’ve taken too much of this drug, contact your doctor right away. You can also call America’s Poison Centers at 800-222-1222 or use its online tool. If your symptoms are severe, call 911 or go to the nearest emergency room right away.

What to do if you miss a dose: If you miss a dose, take it as soon as you remember. If it’s close to the time of your next dose, only take one dose at that time. Do not double the dose to try to make up for the missed dose. This can cause dangerous effects.

How to tell if the drug is working: Your symptoms should improve. For instance, your blood pressure and heart rate should be lower. Or you should have less chest pain, tremors, or shaking, or fewer migraine headaches.

Keep these considerations in mind if your doctor prescribes propranolol for you.

General

  • Take this drug before meals and at bedtime.
  • You can cut or crush the tablet.

Storage

  • Store tablets between 59°F to 86°F (15°C to 30°C).
  • Protect this drug from light.
  • Don’t store this medication in moist or damp areas, such as bathrooms.

Refills

A prescription for this medication is refillable. You should not need a new prescription for this medication to be refilled. Your doctor will write the number of refills authorized on your prescription.

Travel

When traveling with your medication:

  • Always carry your medication with you. When flying, never put it into a checked bag. Keep it in your carry-on bag.
  • Don’t worry about airport X-ray machines. They can’t harm your medication.
  • You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled container with you.
  • Don’t put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.

Self-management

While you’re taking propranolol, you’ll need to monitor your:

  • blood pressure
  • heart rate
  • blood sugar (if you have diabetes)

Clinical monitoring

While you’re taking this drug, your doctor will periodically do blood tests to check your:

Availability

Not every pharmacy stocks this drug. When filling your prescription, be sure to call ahead to make sure your pharmacy carries it.

There are other drugs available to treat your condition. Some may be better suited for you than others. Examples of alternatives for the conditions propranolol treats are listed below. Not all of the alternatives available for treating the same conditions as propranolol are included. Talk with your doctor about other drug options that may work for you.

For atrial fibrillation

Below are a few examples of alternatives to propranolol that are used to treat atrial fibrillation:

For hypertension (high blood pressure)

Below are a few examples of alternatives to propranolol that are used to treat high blood pressure:

For angina (chest pain)

Below are a few examples of alternatives to propranolol that are used to treat angina:

  • statins, such as atorvastatin (Lipitor)
  • calcium channel blockers, such as amlodipine (Norvasc)
  • aspirin (Bayer, Bufferin)

For heart attack

Below are a few examples of alternatives to propranolol that are used to treat heart attack:

  • aspirin (Bayer, Bufferin)
  • nitroglycerin (Nitrostat)
  • angiotensin-converting enzyme (ACE) inhibitors, such as lisinopril (Zestril)

For hypertrophic subaortic stenosis

Below are a few examples of alternatives to propranolol that are used to treat hypertrophic subaortic stenosis:

For migraine

Below are a few examples of alternatives to propranolol that are used to help prevent migraine episodes:

For essential tremor

Below is another alternative to propranolol that is used to treat essential tremor:

For pheochromocytoma (tumor in the adrenal gland)

Below are a few examples of alternatives to propranolol that are used to treat pheochromocytoma:

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.