M I PROPRANOLOL

MEDICINES INFORMATION
PROPRANOLOL
Pronounced: Pro-pran-o-lol
What is propranolol used for?
Propranolol belongs to a group of drugs called beta-blockers. It is used
to help manage many conditions such as heart and blood pressure
problems, chest pain (angina), disorders of heart rhythm and
prevention of migraines. Propranolol can also be used to control the
physical symptoms of anxiety and may also help people with
restlessness. Medicines are often used to treat more than one
condition, so if you are not sure why you have been prescribed
propranolol, you should discuss this with your doctor. Your medicine
may also have a trade or brand name. This is the name that the
manufacturer gives to the medicine, for example Inderal is a brand
name for propranolol.
What are the benefits of taking propranolol?
People with anxiety may feel uneasy because they may worry, feel
nervous and tense or may be fearful. These feelings may be
experienced as physical symptoms such as sweating, irregular or
unusually fast heartbeat, butterflies or cramps in the stomach and
tremor (feeling shaky). There are different types of anxiety disorders
and these may be mild or severe. An example is panic disorder when
people sometimes feel panicky or frightened and may try to change
their life to avoid situations that make them feel like this. Another
example of an anxiety disorder is generalised anxiety disorder where
people may experience symptoms most of the time. The symptoms
may include sleep problems, worry, difficulty in concentrating and
feeling constantly on edge.
People taking medication for schizophrenia and depression may
experience symptoms of restlessness, which is known as akathisia.
This means that people are unable to sit still and keep moving all the
time. This can make people feel quite uncomfortable.
Propranolol can help relieve these symptoms as well as help people
engage better with other kinds of therapies such as psychological
treatments which may be helpful.
How quickly does propranolol work?
Propranolol will start to work quite quickly. Some symptoms may start
to improve before others, but it usually takes at least a week until it has
a full effect. Not everybody benefits from propranolol, but most people
do. If you do not feel any benefit or improvement in your symptoms,
you should discuss this with your doctor or healthcare worker.
What is the usual dose of propranolol and how should I take it?
The usual dose of propanolol for akathisia (restlessness) or anxiety is
between 40milligrams (mg) and 120mg daily usually given in two or
three divided doses. Do not change your dose of propranolol without
checking with your doctor, as it can affect your response to the
medication or may be harmful.
What should I do if I miss a dose?
You will get the most out of your medication when taken correctly. If
you miss, or forget a dose at your usual time, but remember within an
hour or two then take it straight away. If it is longer than this just leave
out the missed dose and take the next dose at the usual time. Never
take extra medication at the next dose. If you find it difficult to
remember taking medication speak to your pharmacist or healthcare
worker.
For how long should I take propranolol?
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Your doctor will discuss with you the length of treatment, which will
vary depending on the type of illness or symptoms you have. Your
doctor should regularly review your medication to make sure that you
do not take medicines for longer than needed. Propranolol is not
addictive.
What are the side effects of propranolol?
As with all medicines there is a risk of unwanted effects (side effects).
Some can occur soon after starting treatment so you may experience
these before you feel better. Most are temporary and should go away
after a few days or weeks. Not everyone will get side effects and
people experience them to different degrees. If you feel that you have
side effects that are causing you discomfort, discuss this with your
doctor, pharmacist, nurse or healthcare worker. The table on the
following page lists some of the main recognised side effects of
propranolol.
What about alcohol and ‘street’ drugs?
Both alcohol and propranolol can affect the brain so it is not
recommended that you drink alcohol while taking propranolol. Drinking
alcohol can cause drowsiness and in combination with propranolol can
cause severe drowsiness. Once you are used to the medication and
know the effects of taking alcohol you may be able to drink alcohol
occasionally and in small amounts. It is good to be cautious because
alcohol affects people in different ways, especially when taking
medication.
Do not stop taking your medication because you feel like drinking
alcohol. If you drink alcohol, drink only small amounts. Never drink
alcohol and drive while taking medication.
‘Street’ drugs (for example, cannabis, ecstasy, speed, heroin and
cocaine) can also often affect your treatment. There is very little
information on taking propranolol with ‘street’ drugs and so the effect
and safety of doing this is unknown. It is best if you do not take ‘street’
drugs whilst taking propranolol. You may need to get advice and
support to help you do this.
What about other medicines?
If you take any other medicines or herbal remedies including any that
have been newly prescribed or bought, it is important to check with
your doctor or pharmacist that they are safe with propranolol.
When should I be cautious?
It is usually safe to take propranolol regularly, as prescribed by your
doctor, but it is not suitable for everyone. If any of the following
situations apply to you, you should tell your doctor immediately:
1 If you are allergic to propranolol (if you have taken it before and
developed a rash, itching, swollen mouth or throat);
2 If you have diabetes, epilepsy (or have had a fit in the past),
Parkinson’s disease, suffer from kidney, liver or heart disease;
3 If you have low blood pressure or slow heart beat;
4 If you suffer from angina (heart pain);
5 If you have breathing difficulties (eg wheezing or asthma);
6 If you suffer from dementia;
7 If you are pregnant, or are planning to become pregnant; or
8 If you are breastfeeding.
Side effect
Dizziness
Feeling light-headed and faint.
What should I do if it happens to me?
Do not stand up too quickly. Try and lie down when you feel
dizzy. Do not drive. Speak to your doctor over the next few
days if this continues after a couple of weeks.
Insomnia
Not being able to sleep, or waking up earlier
than usual.
Try taking medication in the morning. If this does not help,
speak to your doctor at your next appointment.
Wheeziness
Blurred vision
What is it?
Shortness of breath. Difficulty breathing.
High-pitched, whistling sound produced
during breathing.
Things look blurry and you cannot focus
properly.
Speak to your doctor over the next few days if this continues or
gets worse.
Do not drive. Speak to your doctor over the next few days if
this continues or gets worse.
Visual disturbances
Flashing lights or black spots or herringbone patterns.
Do not drive. Speak to your doctor over the next few days if
this continues or gets worse.
Upset stomach
Feeling or being sick. You may also have
loose bowel motion.
Reduce coffee, citrus fruits, fatty foods, onions, alcohol and
chocolate intake. Drink plenty of water.
Hypotension
A low blood pressure. You may feel faint or
dizzy when you stand up.
Speak to your doctor immediately.
Bradycardia
Slowing of the heartbeat.
Speak to your doctor immediately.
Cold extremities
Your fingers and toes feel cold.
This is most common at the start of treatment. It should settle
after a couple of weeks. If this continues after a couple of
weeks, speak to your doctor at your next appointment.
Aggravation of psoriasis
Your psoriasis symptoms become worse
than usual.
Speak to your doctor over the next few days.
Confusion
Unclear thoughts.
Drowsiness
Feeling sleepy or sluggish.
Dry eyes
Irritation; may be gritty or burning in the
eyes.
Hair loss
Loss of hair on head.
Rashes
Red rashes on skin that may be itchy.
Sexual dysfunction
Change in sex drive or sexual ability, for
example lack of orgasm, abnormal erection
and ejaculation.
Speak with your doctor over the next few days if this continues
or gets worse.
Do not drive or use machinery. This is most common at the
start of treatment. If you take your medicine once a day it may
help to take it at bedtime. If this continues for more than a
couple of weeks speak to your doctor over the next few days.
Speak to your doctor at your next appointment or your
pharmacist as you may be able to use eye drops to help.
Speak to your doctor at your next appointment if this is
becomes noticeable.
If the rash is severe or does not go away, contact your doctor
over the next few days.
Speak to your doctor at your next appointment.
.
Please refer to the manufacturer’s patient information leaflet that comes
of any inaccuracy or error contained in this leaflet, including (for the
with your medicine for more information and the full list of side effects
avoidance of doubt) in relation to breach of contract, misrepresentation
and precautions. If you have any questions or concerns about your
or negligence whether of CNWL or any other person; but nothing in this
medicines, or if you are worried about anything you think might be a side
leaflet shall exclude or restrict liability for death or personal injury
effect, ask your doctor, pharmacist or nurse.
resulting from negligence.
This leaflet gives you some information about this medicine. It does not
The information given in this leaflet is current as at the publication date.
replace the expertise or judgement of a doctor, pharmacist or other
This leaflet has been written by Central and North West London NHS
healthcare professional. It is not a manufacturer’s patient information
Foundation Trust, Greater London House, Hampstead Road, London
leaflet and is not to be taken as a substitute for, or an endorsement of,
NW1 7QY. Tel: 020 3214 5700
Publication Number: CNWL/MM004 Publication Date: May 2007
Copyright 2007
the manufacturer’s information or advice in respect of any medicine
referred to in this leaflet. You might find more information in other leaflets
or books, or on the internet but remember, the internet is not always
accurate.
Whilst every care has been taken in the compilation of this leaflet, CNWL
is not responsible for any loss or damage howsoever caused as a result