Updated on November 22, 2023
6 min read

Propranolol Uses & Side Effects

What is Propranolol (Zovirax)?

Propranolol is an FDA-approved nonselective beta-blocker for adult and pediatric patients. Beta-blockers subvert beta receptors, which are tiny proteins, while they latch onto the chemical messengers from the central nervous system (CNS).2,3

They prevent those receptors and messengers from binding together. This results in:2,3

  • Slower heart rate
  • Lower blood pressure
  • Relaxed blood vessels

These effects help treat anxiety symptoms, improve blood flow, and regularize your cardiac rhythm. Propranolol is a prescription medication that should be taken under medical guidance. Especially for children.2,3

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Propranolol Uses

Propranolol is used to treat many conditions, including:2,3

  • Generalized anxiety disorder
  • Migraines
  • High blood pressure
  • Irregular heartbeat, such as atrial fibrillation
  • Angina
  • Tremors
  • Hypertension
  • Other heart conditions

Propranolol can also be prescribed off-label for performance anxiety and social anxiety. The dosage for this is typically around 10-40mg. Propranolol is considered safe for breastfeeding women, as there are low levels of propranolol in breast milk.

How Does Propranolol Help with Anxiety Disorders?

Propranolol can make you feel at ease because of how it lowers blood pressure and heart rate. Both of which increase symptoms of anxiety.

When you take propranolol, you may experience a calm feeling, helping you manage stress better. However, it might not work for everyone, so it's important to talk to your doctor about using propranolol for anxiety.

It takes 30 to 60 minutes to feel the effects of propranolol. The medication provides 3 to 4 hours of relief from the physical symptoms associated with performance anxiety.2,3

Propranolol Dosage

Propranolol's dosage will be different for each person and the condition they're treating. The amount you take also depends on the following factors:4

  • Your age
  • The strength of the medication
  • The time allowed between doses
  • The length of time you're prescribed to take the medication

Consult your doctor for any questions or changes in your prescription.

Types of Propranolol

Propranolol comes in tablet form, as an extended-release oral capsule, and as a solution. All forms of propranolol are generally safe, but you should consult your doctor before taking propranolol.2,3

Some brand names for propranolol include:2,3

  • Inderal
  • Inderal LA
  • InnoPran XL
  • Hemangeol

Other beta-blockers for heart conditions include metoprolol and atenolol.  

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How to Safely Take Propranolol

You can swallow an oral dose or take it via injection. Depending on your dosage, your doctor will tell you the best way to take propranolol. Only take propranolol as your doctor prescribes.4

Don't take propranolol any more or less than your doctor directs. Likewise, do not exceed your treatment plan. They may also adjust your dosage depending on your needs.4

If you missed a dose, take it as soon as possible unless it's nearly time for your next dose. In this case, skip the missed dose and take the next dose normally. Don't double your dosage to compensate for the missed one.4

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Who is At Risk When using Propranolol?

Although propranolol is generally considered safe, it can interfere with other pre-existing conditions. This can increase the likelihood of unpleasant side effects and worsen existing symptoms.2,3

Before taking propranolol, let your doctor know if you have any of the following:2,3

  • An allergic reaction to propranolol
  • Low blood sugar or diabetes
  • A severe heart condition
  • Abnormally slow heart rate or rhythm
  • Low blood pressure
  • Thyroid issues
  • Congestive heart failure
  • Liver disease
  • Kidney disease
  • Adrenal gland tumor (pheochromocytoma)
  • Circulation problems, such as Raynaud's syndrome
  • A muscle disorder
  • Glaucoma
  • Breathing disorders, such as asthma, emphysema, or bronchitis
  • Depression

You should also consult your doctor about using propranolol if you're a smoker. Lastly, if you experience an allergic reaction, consult your doctor immediately.

What are the Side Effects of Propranolol?

Some people may experience uncomfortable side effects when taking propranolol. While these side effects aren't life-threatening, they can be enough to make you switch to another beta-blocker.

These side effects include:4

  • Fatigue or drowsiness
  • Shortness of breath or difficulty breathing
  • Chest pain
  • Tingling sensation
  • Coldness in hands or feet
  • Lightheadedness or dizziness
  • Migraine headaches
  • Insomnia
  • Unusual dreams
  • Nausea
  • Constipation or diarrhea
  • Depression
  • Low libido
  • Skin rash

You may not experience any side effects from taking propranolol. However, most people who take beta-blockers will experience at least one.4

Severe Side Effects of Propranolol

Although it happens rarely, propranolol does have serious side effects. Check with your doctor immediately if you start to experience:4

  • Serious skin reactions like blistering, peeling, rashes, red skin lesions, etc.
  • Dilated neck veins
  • Extreme fatigue
  • Irregular breathing
  • Fast heart rate or irregular heartbeat
  • Swelling in the face or other extremities
  • Weight gain
  • Nosebleeds that last for more than 10 minutes
  • Signs of low platelets in your blood, such as bruising or unexplained bruises
  • Signs of liver problems such as dark urine, pale stool, and jaundice

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What Medications Should Not Be Taken With Propranolol?

Propranolol may interact with other medications and alcohol. Talk to your doctor about any over-the-counter (OTC) or prescription medications you're taking to avoid an adverse reaction.4,6

  • Cigarettes
  • Alcohol
  • Antihypertensive and antidiabetic medications
  • Migraine medications like rizatriptan (Maxalt)
  • Heart rhythm medications like amiodarone (Pacerone)
  • Antidepressants like fluoxetine (Prozac)
  • Blood thinners like warfarin (Coumadin)
  • Cimetidine

Talk to your doctor about alternatives to Propranolol. Especially if you need multiple antihypertensive medications.

Is Propranolol Addictive?

Beta-blockers like propranolol are considered non-addictive medications, unlike other medications for anxiety. However, you may get used to the calming effect that propranolol provides.5

When you're feeling anxious, you may feel inclined to take propranolol to soothe your symptoms. This can lead to drug dependence.

Talk to your doctor if you're worried about becoming dependent on your medication. They may provide alternatives that work better for you.

Propranolol Overdose Symptoms

If you're taking propranolol for social or performance anxiety, it's unlikely to experience an overdose due to its low dosage compared to other uses. However, it is still possible to overdose on propranolol.2,3,5

Symptoms of a propranolol overdose include:

  • Breathing difficulties
  • Dizziness and lightheadedness
  • Blurry vision
  • Fainting
  • Dangerously slow heart rate
  • Severe heart conditions or heart disease

The risk of an overdose increases if you mix propranolol with alcohol and other medications. If you are worried that you are experiencing a propranolol and alcohol overdose, seek immediate medical attention.

Summary

Propranolol is an FDA-approved prescription drug used to treat anxiety and other conditions. Beta-blockers subvert beta receptors while they latch onto the chemical messengers from the central nervous system (CNS), reducing blood pressure and heart rate.

The side effects or propranolol aren't typically serious or life-threatening. However, there are rare severe side effects that require immediate medical attention.

Although propranolol is non-addictive or habit-forming, you can develop a dependence on it. It can also interact with other medications, leading to dangerous drug interactions and overdose.

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Updated on November 22, 2023
9 sources cited
Updated on November 22, 2023
  1. Managing Stress to Control High Blood Pressure.Www.heart.org.

  2. Propranolol (Cardiovascular): MedlinePlus Drug Information.MedlinePlus, U.S. National Library of Medicine.

  3. Propranolol.Drugs and Lactation Database., U.S. National Library of Medicine, 2018.

  4. Propranolol (Oral Route) Side Effects.Mayo Clinic, Mayo Foundation for Medical Education and Research, 2020.

  5. Propranolol.Global.

  6. Publishing, Harvard Health. “Ask the Doctor: Beta Blockers and Alcohol.Harvard Health.

  7. Konieczny K. & Dorian P. "Clinically Important Drug-Drug Interactions Between Antiarrhythmic Drugs and Anticoagulants." J Innov Card Rhythm Manag, 2019.

  8. Publishing, Harvard Health. “Beta Blockers: Cardiac Jacks of All Trades.Harvard Health, www.health.harvard.edu/heart-health/beta-blockers-cardiac-jacks-of-all-trades

  9. RecoveryConnection. “What Are Beta Blockers?: List of Beta Blockers, Side Effects & Uses.Recovery Connection, 2020.

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