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Active substance: propranolol. It is a non-selective beta-adrenergic blocker commonly prescribed for several cardiovascular and non-cardiovascular conditions. For detailed manifestations see Applications for clinical use.
Prescribers select propranolol when its effect on heart rate, rhythm and sympathetic symptoms is desirable. The medicine is available in a number of formulations; see Strengths in Forms to get more information, visit the help center.
Primary strengths and configurations available in Australia
Tablets are the most common presentation in community pharmacies. Typical oral strengths include 40 mg and 80 mg immediate-release tablets. Modified-release products and injectable preparations exist but are less commonly used outside hospitals.
Your clinician will advise which formulation and dose suit your condition and response. If you require a specific release profile or route, discuss this when the prescription is written.
What is it used for?
Examples of indicated uses include control of certain cardiac arrhythmias, reduction of heart rate after myocardial events, treatment of essential tremor, and management of performance or situational anxiety in selected patients.
Clinicians may also prescribe propranolol for other off-label purposes when the likely benefit outweighs risk. For an explanation of the pharmacology see How It Is Built.
Methods for taking propranolol
- Follow the dose and schedule provided by your prescriber exactly.
- It may be taken with or without food; maintaining consistent timing helps steady blood levels.
- If you have any doubt about dose timing or changes, contact the prescriber before altering how you take it.
The way it works
Propranolol blocks beta-adrenergic receptors, which reduces pacemaker activity and slows conduction in the heart. The effects include a lower heart rate, decreased myocardial contractility and reduced cardiac oxygen demand. These actions help control rhythm disturbances and relieve some symptoms linked to sympathetic overactivity.
Steps to take for a i missed one dose
If you forget to take the dose today, take it when you remember unless the next scheduled dose is soon. If it is nearly time for the next dose, omit the forgot to take my dose and continue your normal schedule. Never take a double dose to make up for a forgotten one.
Internal the word storage can refer to both data and goods. and handling
- Keep at typical room temperature, about 20 to 25 C (68 to 77 F).
- Avoid damp or hot places such as bathrooms or near hot appliances.
- Leave tablets in their original container, keep the lid closed, and store out of reach of children and pets.
Medical conditions under which this therapy should be avoided: Do not use propranolol if
- You have a known allergy to propranolol or an ingredient in the product.
- You have severe bradycardia, high-grade atrioventricular block, uncompensated heart failure, cardiogenic shock or persistent low blood pressure after a heart attack.
- You suffer from active bronchospasm or severe peripheral vascular disease such as critical Raynaud syndrome.
- You are using certain drugs that interact seriously with propranolol, for example mibefradil; always discuss current medicines after consulting your prescriber.
If any of the above apply to you, speak to your prescriber without delay.
Warning notices and safety protocols
- Propranolol can cause dizziness, drowsiness or visual disturbance. Test your response before driving or operating machinery; see Status of legal rights in Australia for driving considerations.
- Drinking alcohol may make drowsiness or other central nervous system effects worse. Discuss alcohol use in coordination with your clinician.
- Beta blockers can mask the usual symptoms of low blood glucose and may reduce glycemic response, particularly in infants, children and people with diabetes. Monitor blood glucose carefully.
- In people with severe allergies, beta blockers can reduce the effect of injected epinephrine used to treat anaphylaxis; review risks with your doctor.
- Your doctor may arrange periodic blood pressure and heart rhythm checks while you are taking this medicine.
- If pregnant, planning pregnancy or breastfeeding, consult your prescriber since propranolol passes into breast milk and may need specialist review.
Likely unwanted potential side effects and urgent signs
Mild unwanted effects that often improve with continued treatment include fatigue, lightheadedness, gastrointestinal upset and sleep changes.
- Unsteadiness or feeling sleepy
- Tiredness or reduced energy
- Nausea, vomiting, diarrhea or constipation
- Changes in sleep or vivid dreams
Do not delay seeking urgent medical attention if you experience concerning symptoms. any serious or alarming symptoms such as:
- Widespread rash, swelling of the face or throat, or breathing difficulties
- Marked shortness of breath, chest pain, fainting or severe dizziness
- Very slow heartbeat, sudden severe mood or cognitive changes, severe skin reactions, unexplained bleeding, high fever with sore throat, or sudden marked swelling in the limbs
For dosing details refer back to Administration and Dosing and What to Do In case you forget a dose.
Secondary options and drugs of a similar class
Treatment choices depend on the condition treated and individual tolerability. Plan B options may include:
- Other beta blockers: metoprolol, atenolol, bisoprolol, carvedilol and sotalol. These agents differ in cardioselectivity, dosing frequency and side effect profiles.
- For rate control in some arrhythmias: calcium channel blockers such as verapamil or diltiazem.
- For performance anxiety or tremor: short-term benzodiazepines or centrally acting agents like clonidine may be considered in selected cases.
- For hypertension: ACE inhibitors, angiotensin receptor blockers, thiazide diuretics and calcium channel blockers are commonly used options; beta blockers are added when clinically appropriate.
Price-wise, generic metoprolol or atenolol are often similarly priced to generic propranolol. Bisoprolol and carvedilol frequently cost more. See Price Points in Australian Dollars for indicative ranges.
Regular prices in AUD currency
Prices vary with brand, pack size and whether PBS subsidy applies. The figures below are indicative only; contact your pharmacy for current retail costs.
- Propranolol 40 mg or 80 mg (generic): when not subsidised private retail cost for larger packs can be in the range AUD 12 to 25 for up to 100 tablets.
- PBS-subsidised prescriptions: general patient co-payment is typically in the low 30s AUD per prescription, while concession rates are around single digit AUD values, subject to periodic changes and safety net arrangements.
- Comparable medicines:
- Metoprolol, atenolol: private prices commonly AUD 10 to 25 depending on pack size and brand.
- Bisoprolol, carvedilol: private prices often AUD 15 to 35 or more.
- Verapamil and diltiazem: private retail can range from AUD 15 to 40 depending on formulation.
If cost is a concern, ask a pharmacist about generic options, different pack sizes or PBS eligibility to reduce out-of-pocket expense.
Status under law and regulation in Australia
- Scheduling: propranolol is a Schedule 4 Prescription Only Medicine found in Australia. A valid prescription from an authorised prescriber is required to obtain it.
- Regulatory oversight: products must be registered with the Therapeutic Goods Administration (TGA) prior to supply. Some strengths and uses may be listed on the Pharmaceutical Benefits Scheme (PBS), which can lower patient costs for eligible individuals.
- Personal importation: under the Personal Importation Arrangement limited quantities for personal use may be imported, but obtaining medicines locally with an Australian prescription is generally safer and recommended.
- Driving and safety: you must ensure you can drive safely. If propranolol causes drowsiness, dizziness or visual problems, do not drive; discuss implications with your clinician present.
- Sporting bans: beta blockers may be prohibited in some precision sports by anti-doping authorities. Athletes should consult Sport Integrity Australia and seek a Therapeutic Use Exemption in case it is necessary.
- Off-label use: doctors may prescribe off-label when clinically justified. The same standards for prescribing and keeping track of metrics apply.
For safety reminders see Cautions and General warnings.
Additional recommendations and good practice
- Only use propranolol yourself if it was prescribed to you. Do not give your medication to others.
- If symptoms do not improve or become worse, contact your prescriber or local pharmacy promptly.
- Keep an up-to-date list of all medicines, including over-the-counter products and supplements, and show this at every medical appointment.
- For more on pharmacology see An Inside Look at How It Works; for dosing questions refer to Administration and Dosing.
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