Propranolol – Patient Safety Information

Propranolol is a beta-blocker medication. Beta-blockers affect the heart, lungs and circulation (blood flow through arteries and veins). Propranolol is used to treat tremors, angina (chest pain), hypertension (high blood pressure), heart rhythm disorders, and other heart or circulatory conditions. It is also used to treat or prevent heart attack, and to reduce the severity and frequency of migraine headaches.

Doctors may prescribe propranolol to control some of the more physical signs of so called performance anxiety. For example, mild shaking or tremor, racing heartbeat and sweating. The more you have these symptoms, the more anxious you may feel.

WHAT ARE THE POSSIBLE SIDE EFFECTS OF PROPRANOLOL?

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Consult your doctor at once if you have:

• slow or uneven heartbeats;
• a light-headed feeling, like you might pass out;
• wheezing or trouble breathing;
• shortness of breath (even with mild exertion), swelling, rapid weight gain;
• sudden weakness, vision problems, or loss of coordination (especially in a child with hemangioma that affects the face or head);
• cold feeling in your hands and feet;
• depression, confusion, hallucinations;
• liver problems--nausea, upper stomach pain, itching, tired feeling, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);
• low blood sugar--headache, hunger, weakness, sweating, confusion, irritability, dizziness, fast heart rate, or feeling jittery;
• low blood sugar in a baby--pale skin, blue or purple skin, sweating, fussiness, crying, not wanting to eat, feeling cold, - drowsiness, weak or shallow breathing (breathing may stop for short periods), seizure (convulsions), or loss of consciousness; or
• severe skin reaction--fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.

Common side effects may include:

• nausea, vomiting, diarrhea, constipation, stomach cramps;
• decreased sex drive, impotence, or difficulty having an orgasm;
• sleep problems (insomnia); or
• tired feeling.

This is not a complete list of side effects and others may occur. Consult your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

WHAT SHOULD I DISCUSS WITH MY DOCTOR BEFORE TAKING PROPRANOLOL?

You should not use propranolol if you are allergic to it, or if you have:

• Asthma; COPD
• very slow heart beats that have caused you to faint; or a serious heart condition such as "sick sinus syndrome" or "AV block" (unless you have a pacemaker).

To make sure propranolol is safe for you, tell your doctor if you have:

• a muscle disorder;
• bronchitis, emphysema, or other breathing disorders;
• low blood sugar, or diabetes (propranolol can make it harder for you to tell when you have low blood sugar);
• slow heartbeats, low blood pressure;
• congestive heart failure;
• depression;
• liver or kidney disease;
• a thyroid disorder;
• pheochromocytoma (tumor of the adrenal gland); or
• problems with circulation (such as Raynaud's syndrome).

It is not known whether propranolol will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medicine.

Propranolol can pass into breast milk and may harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

HOW SHOULD I TAKE PROPRANOLOL?

If you are taking propranolol for performance anxiety please take 1 tablet 30-60 minutes prior to the event or situation. Do not take more than 2 tablets in a 24 hour period.

Do not take this medicine in larger or smaller amounts or for longer than recommended.

Adults may take propranolol with or without food, but take it the same way each time.

If you need surgery, tell the surgeon ahead of time that you are using propranolol. You may need to stop using the medicine for a short time.

This medicine can cause unusual results with certain medical tests. Tell any doctor who treats you that you are using propranolol.

Store at room temperature away from moisture and heat. Do not allow liquid medicine to freeze.

WHAT HAPPENS IF I OVERDOSE?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. Overdose symptoms may include slow or uneven heartbeats, dizziness, weakness, or fainting.

WHAT OTHER DRUGS WILL AFFECT PROPRANOLOL?

Tell your doctor about all medicines you use, and those you start or stop using during your treatment with propranolol, especially:

• a blood thinner--warfarin, Coumadin, Jantoven;
• an antidepressant--amitriptyline, clomipramine, desipramine, imipramine, and others;
• drugs to treat high blood pressure or a prostate disorder--doxazosin, prazosin, terazosin;
• heart or blood pressure medicine--amiodarone, diltiazem, propafenone, quinidine, verapamil, and others;
• NSAIDs (nonsteroidal anti-inflammatory drugs)--aspirin, ibuprofen (Advil, Motrin), naproxen(Aleve), celecoxib, diclofenac, indomethacin, meloxicam, and others; or
• steroid medicine--prednisone and others.
• This list is not complete. Other drugs may interact with propranolol, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

REMEMBER, KEEP THIS AND ALL OTHER MEDICINES OUT OF THE REACH OF CHILDREN, NEVER SHARE YOUR MEDICINES WITH OTHERS, AND USE THIS MEDICATION ONLY FOR THE INDICATION PRESCRIBED.