Overview and Fast Facts

Active ingredient: propranolol.

Typical strengths: 40 mg and 80 mg tablets are common; extended-release capsules are also available.

Primary use: management of certain irregular heart rhythms. Clinicians may also prescribe it for other conditions when appropriate.

Related conditions: heart disease and rhythm disorders. For safety considerations, see Warnings and Precautions.

How Propranolol Works

Propranolol is a nonselective beta blocker. By blocking beta-adrenergic receptors in the heart and blood vessels, it reduces the firing of the heart's pacemaker cells and slows the spread of certain electrical impulses. This can help stabilize an irregular heartbeat and reduce cardiac workload.

How to Take Propranolol

Use propranolol exactly as your prescriber directs. Swallow tablets or capsules with water. You can take it with or without food, but try to be consistent day to day.

If you have questions about timing, dose changes, or interactions, ask your healthcare provider. For missed doses, see this section. For storage tips, jump to Safe Storage.

What to Do if You Miss a Dose

If you take propranolol on a regular schedule and miss a dose, take it when you remember. If it is close to the next scheduled dose, skip the missed one and return to your normal plan. Do not take two doses at once.

Safe Storage

  • Keep at room temperature, ideally 68 to 77 F (20 to 25 C).
  • Protect from moisture, heat, and direct light; avoid bathroom storage.
  • Store in a tightly closed, light-resistant container.
  • Keep away from children and pets.

Warnings and Precautions

Do not use propranolol if any of the following apply:

  • You currently take mibefradil.
  • You have asthma or a history of bronchospasm.
  • You have moderate to severe heart block, very slow heart rate with block, or cardiogenic shock.
  • You have uncontrolled heart failure or very low blood pressure after a heart attack.
  • You are allergic to propranolol or any component in the product.
  • You have Raynaud syndrome with severe symptoms.
  • The intended patient is a child with diabetes or heart failure unless a specialist directs otherwise.

Important safety notes

  • Propranolol can cause dizziness, tiredness, lightheadedness, or changes in vision. Until you know your response, avoid driving or operating machinery.
  • Alcohol may intensify side effects. Check with your healthcare provider before drinking while taking propranolol.
  • Do not exceed the prescribed dose without medical advice.
  • Some people feel fatigued for the first weeks of blood pressure or heart therapy. Continue taking the medicine as prescribed and report new or worsening symptoms.
  • Severe allergy history: beta blockers may increase the risk of serious allergic reactions and can reduce the effectiveness of some rescue treatments for anaphylaxis.
  • Blood sugar effects: propranolol may lower blood glucose and can mask certain signs of low blood sugar (such as a fast heartbeat). This is especially relevant for infants, children, patients with diabetes or kidney problems, after prolonged exercise, or during fasting.
  • If low blood sugar occurs, take quick sugar sources such as table sugar, honey, regular soda, candy, or orange juice, then contact your clinician.
  • Laboratory/diagnostic interference: can affect glaucoma screening results and dobutamine stress echocardiography. Inform your clinicians that you use propranolol before tests.
  • Monitoring may include blood pressure and heart function checks. Keep all appointments.
  • Pregnancy and breastfeeding: discuss risks and benefits with your clinician if you are pregnant or planning pregnancy. Propranolol passes into breast milk; consult your provider if you are breastfeeding.

Possible Side Effects

Not everyone experiences side effects. Contact your prescriber if common effects persist or bother you.

Common effects

  • Diarrhea or constipation
  • Fatigue or weakness
  • Nausea, stomach upset, or cramping
  • Dizziness or drowsiness
  • Trouble sleeping
  • Vomiting
  • Mild redness, swelling, or pain at an injection site if receiving non-oral forms
  • Lightheadedness

Serious effects that require urgent care

  • Severe allergic reaction: rash, hives, itching, swelling of face, lips, mouth, or tongue, trouble breathing, or chest tightness
  • Shortness of breath or wheezing
  • Markedly slow heartbeat, very cold or blue fingers or toes
  • Chest pain or sudden weight gain; swelling of feet, ankles, or hands
  • Severe dizziness, confusion, or disorientation
  • Hallucinations, mood or memory changes
  • Fever with sore throat and body aches
  • Red, blistered, swollen, or peeling skin
  • Persistent or significant vision changes
  • Unusual bruising or tingling/numb hands

Approximate Prices in the USA

Prices vary widely by pharmacy, strength, quantity, and insurance. The ranges below are rough cash prices for common fills and may be lower with coupons or insurance:

  • Propranolol immediate-release tablets (generic), 40 mg, 60 tablets: about USD 4 to 15.
  • Propranolol immediate-release tablets (generic), 80 mg, 60 tablets: about USD 6 to 20.
  • Propranolol extended-release capsules (generic), 80 to 160 mg, 30 capsules: about USD 15 to 60.
  • Brand Inderal LA (extended-release), 30 capsules: about USD 200 to 350.

Compare with alternatives in Similar or Alternative Medicines.

Similar or Alternative Medicines

Depending on your diagnosis and medical history, clinicians may recommend another beta blocker or a different class. Never switch without medical guidance.

Other beta blockers

  • Metoprolol (tartrate or succinate): cardioselective. Often used for rate control and blood pressure. Typical monthly cash cost: USD 5 to 20 for generics.
  • Atenolol: cardioselective. Common for blood pressure and certain arrhythmias. Roughly USD 4 to 15 per month generic.
  • Carvedilol: nonselective with alpha blockade; helpful in heart failure. About USD 4 to 20 per month generic.
  • Bisoprolol: cardioselective; sometimes preferred for tolerability. About USD 10 to 25 per month generic.
  • Nadolol: long-acting nonselective. About USD 15 to 40 per month generic.
  • Sotalol: has antiarrhythmic properties and requires careful monitoring. Around USD 10 to 35 per month generic.
  • Labetalol: nonselective with alpha blockade; often used in pregnancy-related hypertension settings. About USD 10 to 30 per month generic.

Other classes sometimes considered

  • Calcium channel blockers (verapamil, diltiazem): may help with rate control in some arrhythmias.
  • Antiarrhythmics (amiodarone, flecainide, propafenone): used for specific rhythm disorders under specialist care.
  • For tremor or performance anxiety when appropriate: alternatives include behavioral strategies or, in select cases, different medications as guided by a clinician.

Price comparisons are approximate USD cash ranges for generics and do not reflect your out-of-pocket cost with insurance. For legal access details, see Legal Status and Access.

More Information

Propranolol should be used only by the person for whom it is prescribed. Do not share your medication.

If your symptoms do not improve or worsen, contact your healthcare provider. For dosing guidance go to How to Take Propranolol, and for critical safety items see Warnings and Precautions.