There are some side effects and complications to consider before taking propranolol, however, as well as certain people who should avoid it altogether.
There is also some new research into possible new uses for the medication. Understanding how propranolol works can help patients and doctors alike to decide if the medication is right for them.
Contents of this article:
What is propranolol?
As well as slowing the heart down, propranolol also decreases the blood pressure. This makes sure a safe amount of blood and oxygen is pumping through the heart to the rest of the body.
Propranolol can slow down the rate at which the heart beats and reduce blood pressure.
Brand names of propranolol include Inderal, Inderal LA, InnoPran XL, and Hemangeol. It is a prescription drug, so it is only available from a doctor. Propranolol comes in the form of tablets, capsules, an oral solution (Hemangeol) and a solution used for injection.
How is propranolol used?
Propranolol is typically used alone or combined with other medications to treat high blood pressure.
High blood pressure makes the heart work too hard. If it is left unchecked, the heart and arteries may begin to wear down over time. The heart controls the blood supply and if it is not working properly it can cause damage to many areas of the body.
The medication is also used for many other specific conditions. Doctors may prescribe propranolol for:
- portal hypertension
- pheochromocytoma, a tumor of the adrenal gland
- essential tremor
- supraventricular arrhythmia, an abnormal rhythm in the top chambers of the heart
- panic disorders
- aggressive behaviors
- restlessness caused by antipsychotics
- infantile hemangioma
Can propranolol help with mental disorders?
Negative emotions play a huge role in mental disorders such as post-traumatic stress disorder (PTSD).
There are a number of ways psychiatrists help people work around these emotions at the moment. A recent study published in Neurobiology of Learning and Memory found some promising evidence that propranolol may help with this as well.
Researchers found that the drug can block the strengthening of emotional memories if it is taken before the memory is recalled. This basically degrades the emotional memory in a way. This means that the person's emotional attachment to the negative memory may not be as strong while taking propranolol. This could help people get past a powerful negative emotional memory or traumatic event.
Another study posted to the Journal of Affective Disorders has already indicated that people with PTSD have better ability to think while taking propranolol. These combined studies indicate that propranolol may play an effective role in helping people with PTSD.
Propranolol is usually taken by mouth in the form of pills or capsules.
The amount of propranolol a person should take varies. The correct dose for one person may be too much or too little for another. It is very important to work directly with a doctor to make sure that the level of propranolol is correct and will have the desired effect.
There are a few different ways to take propranolol, but it is mostly taken orally. Extended-release capsules slowly release the drug into the bloodstream over the course of the day. These are usually taken once a day, and the effects last for 24 hours.
There are also immediate-release pills that begin releasing the drug into the blood soon after being taken. These are taken in multiple doses throughout the day. The number of pills taken depends on the person's response to the medication.
Side effects and complications
A number of side effect of propranolol have been highlighted. The most common side effects include:
- dry eyes
- wheezing or symptoms of bronchitis
- fatigue, feeling weak
- hair loss
- slower heart rate
- changes in sex drive
- changes in sexual performance
Some symptoms are mild and tend to go away within a few weeks as the body adjusts to the medication. Any severe symptoms or symptoms that don't go away should be discussed with a doctor. It may be that the person is taking too much of the drug or their body may not be responding well to it.
There are also some less common, yet more severe symptoms associated with propranolol. A person who experiences any of these symptoms should call their doctor right away.
- breathing problems or bronchospasms
- slow heart rate
- allergic reactions, such as itching, rashes and hives, or swelling in the face or tongue
- sudden weight gain
- swelling of legs, ankles, or feet
- circulation problems such as cold hands and feet
- sudden changes in blood sugar
- trouble sleeping or nightmares
Because of specific side effects, there are a few things that doctors will look out for to decide if a patient is able to take propranolol.
People with asthma or other breathing disorders should not take propranolol.
Doctors will also need to know if the patient has a history of:
- liver or kidney disease
- blood sugar problems or diabetes
- circulation problems
- thyroid disorders
- congestive heart failure
- muscular disorders
- symptoms of depression
Nursing women should also avoid taking the drug as it can pass into breast milk and harm a nursing baby. Babies under 4.5 pounds should not be given propranolol.
Taking other medications can interfere with how propranolol works in the body. Anyone taking a medication to treat heart rhythm problems should talk to their doctor before taking propranolol.
People switching from other blood pressure medications such as clonidine should do so slowly. Over the course of a few days, the doctor may recommend to slowly decrease the dose of the other medication while increasing the dose of propranolol to avoid side effects.
Because propranolol is a beta-blocker, it should not be taken with other beta-blockers. The combined effect lowers the heart rate to unsafe levels. This is also the case with ACE inhibitors, calcium channel blockers, and alpha-blockers, which all have similar functions. Taking different drugs meant for the same purpose can cause a dangerously low heart rate or even heart failure.
People taking propranolol should also avoid nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen. These drugs may reduce the effects of propranolol.
If a person needs to take NSAIDs, they should work directly with a doctor. The doctor can help to decide which drug is best and monitor the heart rate in order to adjust the levels of each drug as needed.
Propranolol can also interact with other substances such as alcohol. Drinking alcohol while taking propranolol is not advised as alcohol can increase the levels of propranolol in the body. This causes more side effects for many people.
Alternatives to propranolol
Because of the complications and risks associated with propranolol, many people turn to alternative medications to relieve their symptoms.
A selective beta-blocker such as metoprolol may have fewer respiratory side effects for cardiovascular issues in people worried about their respiratory health.
Because propranolol is also prescribed for conditions such as tremors and migraine prevention, alternatives that fit every single use are difficult to give.
The best course of action for a patient is to talk to their doctor. Keeping the patient's full medical history in mind, doctors can prescribe an alternative that is best suited to their specific needs.