How does it work?

Propranolol belongs to a group of medicines called beta-blockers, which block beta receptors in the heart, lungs and other organs of the body. Blocking these receptors prevents the action of two chemicals called noradrenaline and adrenaline that occur naturally in the body. These are often referred to as the 'fight or flight' chemicals as they are responsible for the body's reaction to stressful situations. Blocking the beta receptors in the heart causes the heart to beat more slowly and with less force. The heart therefore uses less energy and the pain of angina is prevented. Slowing the heart also helps control abnormal heart rhythms (arrhythmias), which can seriously undermine the pumping action of the heart and result in inefficient blood circulation around the body. Due to the heart beating more slowly and with less force, the pressure at which blood is pumped out of the heart to the rest of the body is reduced. This is just one of the ways in which beta blockers help to reduce blood pressure, however the whole mechanism is not fully understood. This medicine has been shown to reduce the damage to the heart if taken in the period shortly following a heart attack. This decreases the likelihood of having a further heart attack and lowers the risk of continued illness and death. Propranolol is also used to control symptoms such as rapid heart rate, sweating and tremor associated with anxiety or excess thyroid hormone (thyrotoxicosis). It is also used to prevent migraine, although it is not fully understood how propranolol works in this area.

What is it used for?

Angina pectoris

Anxiety

Heart disease characterised by thickening of the internal heart muscle and a blockage inside the heart (hypertrophic obstructive cardiomyopathy)

High blood pressure

Irregular heart beats (arrhythmias)

Management of thyrotoxicosis and thyrotoxic crisis

Pre-surgical management of adrenal gland tumours (phaeochromocytoma), but only in combination with an alpha blocking medicine

Preventing bleeding in the gut in people with high blood pressure in the portal vein (portal hypertension) / dilated veins in the lower oesophagus (oesophageal varices)

Prevention of further heart attacks following an initial heart attack

Prevention of migraines

Tremor without underlying cause (essential tremor)

Warning!

This medicine may mask the symptoms of low blood sugar such as increased heart rate, tremor and nausea. People with diabetes should carefully monitor their blood sugar.

Treatment with this medicine should not be stopped abruptly, particularly in people with inadequate flow of blood to the heart (ischaemic heart disease).

This medicine may cause fatigue and dizziness. If affected, caution is required when driving or operating machinery due to the possible reduction in physical and/or mental ability.

This medicine may mask the symptoms of the condition caused by an excess of thyroid hormone (thyrotoxicosis).

Use with caution in

Conditions with disturbance of blood circulation in the arteries of the extremities

Decreased kidney function

Decreased liver function

Diabetes

Heart failure

High pressure in the vein taking blood from the gut to the liver

History of severe allergic reactions (anaphylaxis)

Liver cirrhosis

Slowed conduction of electrical messages between the chambers of the heart (1st degree heart block)

Not to be used in

A problem common in the elderly, related to poor control of the working of the heart (sick sinus syndrome)

A severe form of angina pectoris, not caused by exertion

Conditions with severe disturbance of blood circulation in the arteries of the extremities

Failure of the heart to maintain adequate circulation (cardiogenic shock)

History of asthma

History of breathing difficulties due to a narrowing of the airways (bronchospasm)

Increased acid levels in the blood (metabolic acidosis)

Low blood pressure (hypotension)

Prolonged fasting

Serious defect in the heart's electrical message pathways resulting in decreased function of the heart (2nd or 3rd degree heart block)

Slow heart rate (bradycardia)

Uncontrolled heart failure

Untreated tumour of the adrenal gland (phaeochromocytoma)

This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy. If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and Breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

This medicine is not recommended for use in pregnancy unless considered essential by your doctor. Seek medical advice from your doctor.

Significant amounts of this medicine may pass into breast milk. It should not be used by breastfeeding mothers. Discuss this with your doctor.

Label warnings

Do not stop taking this medication except on your doctor's advice.

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