Medically reviewed by Patrick Carroll, MD
Written by Our Editorial Team
Last updated 11/1/2019
Searching for information about propranolol? Prescribed to millions of Americans in the United States alone, propranolol is a commonly used beta blocker used to treat heart conditions, anxiety, headaches and more.
Below, we’ve answered 25 of the most frequently asked questions about propranolol, covering everything from common propranolol dosage to propranolol’s primary effects, potential side effects, uses, half-life and more.
Propranolol is a beta blocker medication. It works by blocking the action of stress hormones like adrenaline (epinephrine) and noradrenaline (norepinephrine) on the beta receptors of the heart, lungs and other tissue.
Developed in the 1960s, propranolol is a commonly used beta blocker that has been on the market for decades. Our guide to beta blockers goes into more detail on how propranolol and other beta blocker medications work.
Like other beta blockers, propranolol is primarily used to treat cardiovascular conditions such as arrhythmia (irregular heartbeat) and hypertension. By blocking the action of stress hormones on the heart, propranolol can reduce a person’s heart rate and blood pressure.
Propranolol is also used to relieve angina (chest pain) and to improve heart function after heart attacks. Along with other beta blockers, propranolol is used to treat benign essential tremor—a disorder that can cause uncontrollable shaking in the hands, arms, head, neck and torso.
Propranolol is also prescribed off-label as an effective treatment for certain types of anxiety. Our guide to propranolol and anxiety goes into more detail on how propranolol can treat the symptoms of performance anxiety, social anxiety and other anxiety disorders.
Propranolol is a prescription medication, meaning it isn’t available over the counter. To purchase propranolol, you’ll need to get a prescription from your doctor or complete an online consultation to receive a valid prescription.
Propranolol blocks the physical effects of anxiety, meaning you won’t experience an increased heart rate, sweating and shakiness when you feel nervous. By blocking the physical symptoms of anxiety, propranolol can help you feel calmer, less nervous and more composed.
Propranolol primarily affects your body’s physical response to stress, with few major effects on your cognitive function. A 2000 study found that people who used propranolol performed almost exactly the same on 11 tests of cognitive function after three or 12 months of use.
It’s worth noting that this study was carried out on people who received a significant propranolol dosage daily (80 to 400mg every day) to treat hypertension, instead of the smaller, as-needed dose used to treat social anxiety and performance anxiety.
It takes 30-60 minutes for the effects of propranolol to become noticeable. Most people who take propranolol to treat performance anxiety use the medication about one hour before any stress-inducing events.
Propranolol can be taken with food or on an empty stomach. Food does not seem to have a significant effect on the body’s absorption of propranolol, meaning you shouldn’t notice any difference in effectiveness if you take this medication after a meal.
Propranolol has a half-life of three to six hours, meaning about half of the dose will still be active in your body after three to six hours. Because the drug’s half-life is three to six hours, propranolol’s effects should be noticeable for about three to four hours or so.
Propranolol is also offered in a sustained release form, the half-life of which is bumped to about 12 hours, which would make its effects noticeable for six or so hours.
Propranolol comes in 10mg, 40mg, 80mg and 160mg tablets. The standard propranolol dosage for treating performance or social anxiety ranges from 10 to 80mg, depending on the severity of your symptoms and response to the medication.
As with other medications, there’s no “perfect” dose of propranolol for everyone. Depending on your symptoms, bodyweight and response to the medication, your doctor might recommend a mild or higher propranolol dosage before anxiety-inducing events.
Yes. When used for performance anxiety and social anxiety, propranolol can be taken only when it’s needed. Many people use propranolol as needed before public speaking events, meetings or other stressful, anxiety-inducing situations.
If you’re prescribed propranolol for a heart condition, follow your doctor’s exact instructions and only use propranolol as prescribed.
Propranolol has several potential side effects. Most propranolol side effects are minor, with fatigue, a reduced heart rate and difficulty falling asleep being the most common side effects at a normal dose.
In rare cases, propranolol can cause more serious side effects. Our Propranolol 101 guide lists all of the common and uncommon side effects of this medication, with information on what to do if you experience propranolol side effects.
Used according to your doctor’s instructions, propranolol is a very safe medication. It’s been in use since the 1960s and is prescribed to millions of people in the United States alone, with a long record of safety.
Like all medications, propranolol needs to be used responsibly. If you use propranolol at doses above those recommended by your doctor or more frequently than prescribed, you may have an increased risk of experiencing side effects.
Propranolol can cause weight gain, although it’s more likely to cause extra fluid retention than an increase in body fat. Any weight gained from propranolol and other beta blockers is usually temporary, with most people’s weight stabilizing after the first few months of treatment.
One common side effect of beta-blocker use — including propranolol — is insomnia.
Research indicates that beta blockers inhibit the release of melatonin, a crucial sleep hormone excreted from the pineal gland.
However, research also suggests melatonin supplements help curb this side effect.
Propranolol can cause a significant decrease in blood pressure, especially when used at a high dose.
In a study from 2004 that involved 434 participants with hypertension.
Patients were given placebo and doses of propranol in 80mg, 120mg, 160mg or 640mg daily increments. The study concluded that the decrease in blood pressure was significant in all propranolol dosages after eight weeks of treatment, and that propranolol was well-tolerated among participants.
Because propranolol can reduce your heart rate, it can have several effects on your ability to exercise. After you take propranolol, you might feel fatigued and exhausted more easily after intense exercise.
If you do frequent cardiovascular exercise, it’s important to account for propranolol’s effect on your heart rate if you use a heart rate monitor to track your workout intensity.
Propranolol is not a physically addictive, habit-forming medication. However, it is possible to become accustomed to the feeling of relaxation propranolol provides, especially if you often experience performance or social anxiety.
No. Although propranolol is used to treat certain types of anxiety, it is not a benzodiazepine like alprazolam (Xanax) or diazepam (Valium). Propranolol belongs to a class of medications called beta blockers.
You should not drink alcohol while taking propranolol. Alcohol can interact with propranolol and cause you to feel excessively drowsy and fatigued. It’s also possible for alcohol and propranolol to reduce your heart rate and blood pressure, causing potentially serious side effects.
Propranolol is a nonselective beta blocker, meaning it can block the effects of stress hormones on beta-1, beta-2 and beta-3 receptors. Because of this, the effects of propranolol can occur in tissue outside the heart, such as the airways.
Propranolol is not recommended for people with diabetes. As a nonselective beta blocker, it’s possible for propranolol to cause hypoglycemia. If you have diabetes and anxiety, you should speak to your doctor about safe treatment options before considering any medications.
Yes. Many people experience performance anxiety before giving speeches or performing in front of others. Propranolol is widely used as a performance anxiety treatment by people who perform in public, from event presenters to musicians.
Propranolol can interact with a range of medications, including more than 70 major interactions with other drugs. If you use other prescription medications, it’s important to let your doctor know before considering propranolol or any other beta blockers.
Today, propranolol is mostly sold as a generic without a specific brand name. It’s also been sold under the brand names Inderal (the first name for propranolol, by ICI Pharmaceuticals), Deralin, Inderalici, Dociton, Avlocardyl, InnoPran XL, Anaprilin, Sumial and others.
Propranolol is available in four different forms. The most common is a tablet, which contains 10 to 160mg of propranolol. Propranolol is also available as an extended-release capsule, which is designed primarily for treating heart conditions.
There’s also an oral liquid version of propranolol that provides the same effects as the common, tablet-based form, as well as a propranolol IV injection that’s mainly used in hospitals and other medical settings.
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