-5%
Propranolol is a non-selective beta-adrenergic blocker that inhibits the action of catecholamines on β1 and β2 receptors. This results in:
- Decreased heart rate and contractility
- Reduced myocardial oxygen demand
- Control of blood pressure and cardiac rhythm
It is well absorbed orally, with peak plasma levels reached in 1–1.5 hours. The half-life ranges between 3–6 hours, and it is primarily eliminated through the urine after hepatic metabolism.
Propranolol is prescribed for the management of:
- Essential hypertension
- Angina pectoris
- Cardiac arrhythmias
- Thyrotoxicosis
- Anxiety disorders
- Migraine prophylaxis
- Supportive care in certain cases of Meningitis
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Pharmacology
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Dosage & Administration
Adults:
Hypertension: 80 mg twice daily, titrated to 160–320 mg/day
Angina: 40 mg 2–3 times daily; maintenance 120–240 mg/day
Thyrotoxicosis: 10–40 mg 3–4 times daily
Anxiety: 40 mg once daily; may increase to 3 times/day
Migraine Prophylaxis: 40 mg 2–3 times daily; maintenance 80–160 mg/day
Pediatrics:
Neonates: 0.25–0.5 mg/kg 3 times/day
1 month–12 years: 0.25–1 mg/kg 3 times/day (max 5 mg/kg/day)
12–18 years: Start with 80 mg twice daily; maintain 160–320 mg/day
Contraindications
Bronchospasm or asthma
Cardiogenic shock
Advanced heart block (2nd or 3rd degree)
Severe bradycardia
Uncontrolled diabetes mellitus
Drug Interactions
Use caution with:
Calcium channel blockers (e.g. verapamil)
Beta-agonists (e.g. salbutamol, levosalbutamol)
Ergot derivatives
Lidocaine, phenobarbital – may alter therapeutic effects
Side Effects
Common:
Cold hands and feet
Fatigue, dizziness
Nausea, insomnia
Tingling sensations (paresthesia)
Precautions
Use with caution in hepatic or renal impairment
Monitor closely in pregnancy and lactation
Gradual dose adjustment is advised to avoid withdrawal effects
Pregnancy & Lactation
Pregnancy Category C: Use only if clearly needed
Excreted in breast milk—use with caution in nursing mothers
Storage
Store in a cool, dry place, protected from light.
Keep out of reach of children.