Propranolol

Propranolol is used to treat

• high blood pressure
• irregular heartbeats
• pheochromocytoma (tumor on a small gland near the kidneys)
• certain types of tremor
• hypertrophic subaortic stenosis (a heart muscle disease
• angina (chest pain)
• migraine headaches

Propranolol is also used to improve survival after a heart attack.

Propranolol is in a class of medications called beta blockers. It works by relaxing blood vessels and slowing heart rate to improve blood flow and decrease blood pressure.

Propranolol comes as a tablet, solution (liquid), and as an extended-release (long-acting) capsule to take by mouth. Extended-release capsule is taken once a day. You may be told to take it at bedtime or with or without food. Follow the directions on prescription label carefully. All other forms of propranolol are taken 2 to 4 times a day. Take propranolol at around the same time(s) every day.

Take propranolol exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Swallow the extended-release capsules whole; do not split, chew, or crush them.

If you are taking the oral solution, use an oral syringe or dosing cup (measuring device) to accurately measure and take your dose of propranolol solution. Do not use a household spoon or cup. Ask your pharmacist for a measuring device if one is not included with your medication.

Your doctor may start you on a low dose of propranolol and gradually increase your dose to allow your body to adjust to the medication. Talk to your doctor about how you feel and about any symptoms you experience during this time.

Propranolol helps control your condition but will not cure it. Continue to take propranolol even if you feel well. Do not stop taking propranolol without talking to your doctor. If you suddenly stop taking propranolol, you may experience serious heart problems.

Propranolol is also sometimes used to treat anxiety. Talk to your doctor about the risks of using this medication for your condition.

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

Before taking propranolol,

• tell your doctor or pharmacist if you are allergic to this drug, any part of this drug, or any other drugs, foods or substances. Tell your doctor or pharmacist about the allergy and what symptoms you had.
• tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
• the following nonprescription or herbal products may interact with propranolol: antacids containing aluminum, cimetidine, and nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen. Be sure to let your doctor and pharmacist know that you are taking this medication before you start taking propranolol. Do not start this medication while taking propranolol without discussing with your healthcare provider.
• tell your doctor if you have a slow or irregular heartbeat, heart failure, or asthma or other lung disease. Your doctor may tell you not to take propranolol.
• tell your doctor if you have or have ever had: heart, liver, or kidney disease; diabetes; pheochromocytoma (a tumor that develops on a gland near the kidneys and may cause high blood pressure and fast heart rate) or hyperthyroidism (an overactive thyroid gland).
• tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking propranolol, call your doctor.
• if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking propranolol.
• ask your doctor about the safe use of alcoholic beverages while you are taking propranolol. Alcohol may increase the amount of propranolol in your body.
• tell your doctor if you use tobacco products. Cigarette smoking may decrease the effectiveness of this medication.
• you should know that propranolol may increase the risk of hypoglycemia (low blood sugar) and prevent the warning signs and symptoms that would tell you that your blood sugar is low. Let your doctor know if you are unable to eat or drink normally or are vomiting while you are taking propranolol. You should know the symptoms of low blood sugar and what to do if you have these symptoms.
• you should know that if you have allergic reactions to different substances, your reactions may be worse while you are taking propranolol and your allergic reactions may not respond to the usual doses of injectable epinephrine.

Unless your doctor tells you otherwise, continue your normal diet.

Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

Propranolol may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• dizziness or lightheadedness
• tiredness
• diarrhea
• constipation

Some side effects can be serious. If you experience any of the following symptoms, call your doctor immediately or get emergency medical treatment:

• rash, itching, hives, blistering or peeling skin, difficulty breathing or swallowing, or swelling of the face, throat, tongue, or lips
• feeling faint
• unusual weight gain
• shortness of breath
• irregular heartbeat

Propranolol may cause other side effects. Call your doctor if you have any unusual problems while you are using this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (https://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from light, excess heat, and moisture (not in the bathroom).

Dispose of unneeded medications in a way so that pets, children, and other people cannot take them. Do not flush this medication down the toilet. Use a medicine take-back program. Talk to your pharmacist about take-back programs in your community. Visit the FDA's Safe Disposal of Medicines website https://goo.gl/c4Rm4p for more information.

Keep all medication out of sight and reach of children as many containers are not child-resistant. Always lock safety caps. Place the medication in a safe location – one that is up and away and out of their sight and reach. https://www.upandaway.org

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

Symptoms of overdose may include:

• slow heartbeat
• dizziness
• fatigue or weakness
• fainting
• difficulty breathing

Keep all appointments with your doctor and the laboratory.

Before you are tested for glaucoma (increased pressure in your eyes that may lead to vision loss), tell your doctor and the technician that you are taking propranolol.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

Keep a written list of all of the prescription and nonprescription (over-the-counter) medicines, vitamins, minerals, and dietary supplements you are taking. Bring this list with you each time you visit a doctor or if you are admitted to the hospital. You should carry the list with you in case of emergencies.

• Inderal^®¶
• Inderal^® LA
• Inderal^® XL
• InnoPran^®¶
• InnoPran^® XL
• Pronol^®¶

• Inderide^® (containing Hydrochlorothiazide, Propranolol)^¶
• Inderide^® LA (containing Hydrochlorothiazide, Propranolol)^¶