Propranolol

About Propranolol

• Propranolol belongs to a family of medications called beta blockers
• Propranolol reduces the effect of adrenaline on the body, reducing the heart rate and lowering the blood pressure
• Propranolol can also reduce the shaking associated with benign essential tremor
• The mechanism of action of propranolol for treating a tremor is not fully understood
• Like other beta blockers, propranolol can occasionally cause side effects including feeling tired, having a slow heartbeat, having an upset stomach, or noticing that your hands and feet are cold
• It is important to read the patient leaflet for a full list of side effects and cautions.

How Does Propranolol Work?

Propranolol is a beta blocker medication. It works on beta-adrenoceptors to reduce blood pressure and protect the heart following a heart attack. However, propranolol has also been found to reduce the shaking associated with a benign essential tremor.

The mechanism by which propranolol helps benign essential tremor is not fully understood. However, it is possible that it may work by blocking nerve impulses to the muscles, helping to reduce the shaking.

Propranolol is often most effective in minimising tremors in the hands and voice, although they can help with shaking elsewhere, too.

How is Propranolol Taken?

Propranolol is a tablet that is taken by mouth. The tablet should be swallowed with some water and can be taken with or without food. Taking it with a meal may be helpful if you experience digestive side effects. It is best to take propranolol at the same time every day so that you don’t forget to take it.

Dosage of Propranolol

A good response in essential tremor is often seen when 120mg to 240mg is taken every day. This dose may be split into two or three doses per day. For example, to take a total of 120mg every day, your doctor may prescribe 40mg three times daily.

Are there any Side Effects?

Like all medications, propranolol can have some side effects. The most common side effects include:

• Breathlessness
• Sleep disturbances
• Nightmares
• A slow heartbeat which might make you feel sluggish
• Cold extremities
• Feeling tired or fatigued
• Nausea or vomiting (feeling sick or being sick)
• Diarrhoea.

These side effects may settle down, but if they persist or become troublesome you should speak to your doctor for further advice.

Serious allergic reactions happen very rarely. If you have a severe allergic reaction (anaphylaxis) including breathlessness, lip swelling or tongue swelling, call 999 immediately.

Propranolol Warnings

Propranolol may not be suitable for everyone. You should tell your prescriber if you:

• Have ever had an allergic reaction to this or any other medication
• Have heart disease or high blood pressure
• Have asthma or COPD
• Have an abnormal heart rhythm
• Have diabetes
• Are at risk of low blood sugar levels
• Have low blood pressure
• Have a slow average heart rate
• Have angina
• Have disease of the arteries
• Have psoriasis
• Have myasthenia gravis
• Are pregnant, trying to conceive, or breastfeeding.

Your prescriber can then advise whether propranolol is a suitable medication for you.

Some medications can interact with propranolol. You may be advised that propranolol will not suit you if you already take:

• Other medications that affect blood pressure or your heart rate, including other blood pressure medications such as verapamil, amiodarone, nifedipine, and diltiazem
• Digoxin
• Fingolimod
• Barbiturates
• Propafenone
• Warfarin
• Cimetidine
• Fluvoxamine
• Clonidine
• Methyldopa
• Rifampicin
• Chlorpromazine
• Theophylline
• Medications for diabetes including insulin
• A monoaminoxidase inhibitor for depression or Parkinson’s disease.

Because propranolol may not suit everyone, we will complete a Consultation with you including a health questionnaire. This will ensure that the medication will be suitable for you.

A qualified prescriber will review your current medications, including any herbal remedies or supplements, to ensure that propranolol will not interact with them. 

Once prescribed, propranolol will be ordered on your behalf via electronic prescription. Propranolol will then be conveniently dispatched from one of our partner pharmacies.