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Propranolol how long to work


Propranolol: medicine for heart problems, anxiety and migraine

1. About propranolol

Propranolol belongs to a group of medicines called beta blockers. It's used to treat heart problems, help with anxiety and prevent migraines.

If you have a heart problem, you can take propranolol to:

  • treat high blood pressure
  • treat conditions that cause an irregular heartbeat (arrhythmia), like atrial fibrillation
  • help prevent future heart disease, heart attacks and strokes
  • help prevent chest pain caused by angina

Propranolol can help reduce your symptoms if you have too much thyroid hormone in your body (thyrotoxicosis). You'll usually take it together with medicines to treat an overactive thyroid.

This medicine is only available on prescription. It comes as tablets, slow release capsules, or as a liquid that you swallow.

2. Key facts

  • Propranolol slows down your heart rate and makes it easier for your heart to pump blood around your body.
  • It's usually prescribed for high blood pressure and other heart problems, but it can also help with the physical signs of anxiety, like sweating and shaking.
  • Your very first dose of propranolol may make you feel dizzy, so take it at bedtime. After that, if you do not feel dizzy, you can take it in the morning.
  • The main side effects of propranolol are feeling dizzy or tired, cold hands or feet, difficulties sleeping and nightmares. These side effects are usually mild and short-lived.

3. Who can and cannot take propranolol

Most adults and children aged 12 and over can take propranolol. But it is not officially approved for treating high blood pressure in children under 12 years old.

Propranolol is not suitable for everyone. To make sure it's safe for you, tell your doctor before starting to take propranolol if you:

  • have ever had an allergic reaction to propranolol or any other medicine
  • have low blood pressure or a slow heart rate
  • have heart failure which is getting worse
  • have diabetes
  • have liver or kidney problems
  • have severe blood circulation problems in your limbs (such as Raynaud's phenomenon), which may make your fingers and toes tingle or turn paler than usual or blue
  • have metabolic acidosis, when there is too much acid in your blood
  • have lung disease or asthma
  • are pregnant, trying to get pregnant or breastfeeding

4.

How and when to take propranolol

Propranolol comes as 2 different types of medicine:

  • standard release – this releases propranolol into your body quickly, so you may need to take it several times a day depending on your dose
  • slow release – this releases the medicine slowly so you do not have to take it as often, once a day is usually enough

If you are taking it once a day, your doctor may advise you to take your first dose before bedtime, because it can make you feel dizzy. After the first dose, if you do not feel dizzy, take propranolol in the morning.

Important

Keep taking propranolol even if you feel well. You will still be getting the benefits of the medicine.

Dosage and strength

Propranolol tablets come in strengths of 10mg, 40mg, 80mg or 160mg. The slow release capsules are 80mg or 160mg. The liquid comes in strengths of 5mg, 10mg, 40mg or 50mg in 5ml.

How much you take depends on why you need propranolol.

The usual doses for adults are:

  • high blood pressure – the starting dose is usually 80mg, taken twice a day. If this dose is not working well enough to reduce your blood pressure, your doctor may increase it to a maximum of 160mg twice a day
  • migraine or angina (chest pain) – 40mg, taken 2 or 3 times a day. This can be increased to 120mg to 240mg a day. Your doctor or pharmacist will explain how to split the dose over the day
  • irregular heartbeat (arrhythmia) – 10mg to 40mg, taken 3 or 4 times a day
  • anxiety – 40mg taken once a day which can be increased to 40mg taken 3 times a day
  • too much thyroid hormone (thyrotoxicosis) – 10mg to 40mg, taken 3 or 4 times a day

Doses are usually lower for people aged over 65 or people with a kidney or liver problem.

If your child needs propranolol, your doctor will usually use your child's weight to work out the right dose.

How to take it

Propranolol does not usually upset your stomach so you can take it with or without food. It's best to do the same each day.

Swallow the tablets whole with a drink of water. If you find the tablets difficult to swallow, some brands have a score line to help you break the tablet in half. Check the information leaflet for your brand to see if you can do this.

If you're taking capsules, swallow them whole with a drink of water. Do not break, chew or crush them.

If you're taking propranolol as a liquid, it will come with a plastic syringe or spoon to help you measure out the right dose. If you do not have one, ask your pharmacist for one. Do not use a kitchen teaspoon as it will not measure the right amount of medicine.

If you forget to take it

If you forget to take a dose of propranolol, take it as soon as you remember, unless it's nearly time for your next dose. In this case, just leave out the missed dose and take your next dose at the usual time.

Never take 2 doses at the same time. Never take an extra dose to make up for a forgotten one.

If you often forget doses, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to help you remember to take your medicine.

If you take too much

An overdose of propranolol can slow down your heart rate and make it difficult to breathe. It can also cause dizziness and trembling.

The amount of propranolol that can lead to an overdose varies from person to person.

Urgent advice: Contact 111 for advice now if:

  • you take more than your prescribed dose of propranolol

Call 111 or go to 111 online

If you need to go to A&E, do not drive yourself. Get someone else to drive you or call for an ambulance.

Take the propranolol packet or leaflet inside it plus any remaining medicine with you.

5. Side effects

Like all medicines, propranolol can cause side effects in some people, but many people have no side effects or only minor ones.

Side effects often improve as your body gets used to the medicine.

Common side effects

These common side effects happen in more than 1 in 100 people. They're usually mild and short-lived.

Talk to your doctor or pharmacist if the side effects bother you or last more than a few days:

  • headaches
  • feeling tired, dizzy or weak
  • cold fingers or toes
  • feeling or being sick (nausea or vomiting), or diarrhoea
  • stomach pain

Serious side effects

It happens rarely, but some people have serious side effects when taking propranolol.

Tell a doctor or contact 111 straight away if:

  • the whites of your eyes turn yellow, your skin turns yellow although this may be less obvious on brown on black skin, or you have pale poo or dark pee – these can be signs of liver problems
  • you get nosebleeds that last for more than 10 minutes, unexplained bruising, or you bruise more easily than usual – these can be signs of low numbers of platelets in your blood (thrombocytopenia)

Go to 111.nhs.uk or call 111.

Immediate action required: Call 999 or go to A&E now if:

  • you have shortness of breath with a cough which gets worse when you exercise (like walking up stairs), swollen ankles or legs, chest pain, or an irregular heartbeat – these are signs of heart problems
  • you have shortness of breath, wheezing and tightening of your chest – these can be signs of lung problems
Serious allergic reaction

In rare cases, propranolol may cause a serious allergic reaction (anaphylaxis).

Immediate action required: Call 999 or go to A&E now if:

  • you get a skin rash that may include itchy, red, swollen, blistered or peeling skin
  • you're wheezing
  • you get tightness in the chest or throat
  • you have trouble breathing or talking
  • your mouth, face, lips, tongue or throat start swelling

You could be having a serious allergic reaction and may need immediate treatment in hospital.

These are not all the side effects of propranolol. For a full list, see the leaflet inside your medicine packet.

Information:

You can report any suspected side effect using the Yellow Card safety scheme.

Visit Yellow Card for further information.

6. How to cope with side effects of propranolol

What to do about:

  • headaches – make sure you rest and drink plenty of fluids. Try not to drink too much alcohol. Ask your pharmacist to recommend a painkiller. Talk to your doctor if the headaches last longer than a week or are severe.
  • feeling tired, dizzy or weak – as your body gets used to propranolol, these side effects should wear off. If propranolol makes you feel dizzy, sit or lie down until you feel better. It's best not to drink alcohol as it will make you feel worse. Do not drive or ride a bike until you feel better.
  • cold fingers or toes – put your hands or feet under warm running water, massage them and wiggle your fingers and toes. Do not smoke or have drinks with caffeine in, as this can make your blood vessels narrower and further restrict blood flow to your hands and feet. Try wearing mittens (they're warmer than gloves) and warm socks. Do not wear tight watches or bracelets.
  • feeling or being sick or diarrhoea – stick to simple meals and do not eat rich or spicy food. It might help to take your propranolol after a meal or snack. Drink lots of fluids, such as water or squash, to avoid dehydration. Take small, frequent sips if you're being sick. Signs of dehydration include peeing less than usual or having dark, strong-smelling pee. Do not take any other medicines to treat diarrhoea and vomiting without speaking to a pharmacist or doctor. If you take contraceptive pills and you're being sick or have severe diarrhoea, your contraception may not protect you from pregnancy. Check the pill packet for advice.
  • stomach pain – try to rest and relax. It can help to eat and drink slowly and have smaller and more frequent meals. Putting a heat pad or covered hot water bottle on your tummy may also help. If you are in a lot of pain, speak to your pharmacist or doctor.

7. Pregnancy and breastfeeding

Propranolol and pregnancy

Propranolol is not thought to be harmful during pregnancy, but it may affect your baby's growth in later pregnancy. Discuss taking propranolol with your doctor or midwife as you may need extra scans to check your baby's growth.

If you're trying to get pregnant or you're already pregnant, talk to your doctor about the benefits and possible harms of taking propranolol. There may be other medicines that are better to use during pregnancy.

Propranolol and breastfeeding

If your doctor or health visitor says that your baby is healthy, it's OK to take propranolol while breastfeeding.

Propranolol passes into breast milk in tiny amounts. It has not been known to cause any side effects in breastfed babies.

It's important to treat your high blood pressure to keep you well. Breastfeeding will also benefit both you and your baby.

If you notice that your baby is not feeding as well as usual, or seems unusually sleepy, or if you have any other concerns about your baby, then talk to your doctor or health visitor.

Non-urgent advice: Tell your doctor if you're:

  • trying to get pregnant
  • pregnant
  • breastfeeding

For more information about how propranolol can affect you and your baby during pregnancy, visit the Best Use of Medicines in Pregnancy (BUMPS) website.

8. Cautions with other medicines

There are some medicines that may affect the way propranolol works.

Tell your doctor if you're taking:

  • other medicines for high blood pressure. The combination with propranolol can sometimes lower your blood pressure too much. This may make you feel dizzy or faint. If this keeps happening to you, your doctor may change your dose
  • other medicines for an irregular heartbeat such as amiodarone or flecainide
  • other medicines which can lower your blood pressure. These include some antidepressants, nitrates (for chest pain), baclofen (a muscle relaxant), medicines for an enlarged prostate gland like tamsulosin, or Parkinson's disease medicines such as levodopa
  • asthma or chronic obstructive pulmonary disease (COPD) medicines
  • diabetes medicines, particularly insulin – propranolol may make it more difficult to recognise the warning signs of low blood sugar. Speak to your doctor if you have low blood sugar levels without getting any of the usual warning signs. Check your blood sugar after exercise, and follow usual advice about checking it before driving, cycling or operating machinery
  • medicines to treat nose or sinus congestion, or other cold remedies (including those you can buy in the pharmacy)
  • medicines for allergies, such as ephedrine, noradrenaline or adrenaline
  • non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, diclofenac or naproxen. These medicines may increase your blood pressure, so it's best to keep them to a minimum

Mixing propranolol with herbal remedies or supplements

There's very little information about taking herbal remedies and supplements with propranolol. They are not tested in the same way as pharmacy and prescription medicines.

Important: Medicine safety

Tell your doctor or pharmacist if you're taking any other medicines, including herbal medicines, vitamins or supplements.

9. Common questions about propranolol

How does propranolol work?

Propranolol is a type of medicine called a beta blocker.

Like other beta blockers, propranolol works by changing the way your body responds to some nerve impulses, including in the heart. It slows down your heart rate and makes it easier for your heart to pump blood around your body.

It works differently if you're using it for anxiety. When you are anxious, your brain makes chemical messengers called adrenaline and noradrenaline. These make your heart rate faster and make you sweat or shake. Propranolol helps block the effects of these chemical messengers. This reduces the physical signs of anxiety.

It's not fully understood how propranolol prevents migraines. It may work by relaxing the blood vessels involved, or by reducing activity in the visual cortex. This is the part of the brain where migraines are believed to start.

How long does propranolol take to work?

Propranolol usually starts to work in a few hours.

For heart conditions or high blood pressure, propranolol can take up to a week to reach its full effect. You may not feel any different but that does not mean it is not working. It's important to keep taking your medicine.

For migraines, it can take several weeks for propranolol to start making a real difference, so keep taking it.

How long will I take it for?

This depends on why you're taking propranolol.

For heart conditions or high blood pressure, treatment is usually long term and may be for the rest of your life.

For anxiety, you'll usually take propranolol for a short amount of time, to help with your physical symptoms. Speak to your doctor about the risks and benefits of taking it for more than a few months. This will depend on your symptoms, whether it's a one-off or a recurring problem, how well propranolol works for you and whether you get side effects.

For migraines, treatment can last for several months or years, depending on how bad your symptoms are.

Can I take propranolol for a long time?

Propranolol is generally safe to take for a long time.

If you're taking it for a heart condition, or to prevent migraines, it works best when you take it long term.

If you're taking it for anxiety, there do not seem to be any lasting harmful effects if you take it for several months or years. But it's best to take propranolol only for as long as you need it.

You'll need to have your blood pressure checked regularly if you're taking propranolol for a long time for migraines or anxiety.

What will happen if I stop taking it?

Talk to your doctor if you want to stop taking propranolol. If you're bothered by side effects, your doctor may be able to prescribe a different medicine instead.

Stopping propranolol suddenly may make your health problem worse. In addition, if you stop suddenly after taking it for a long time, you may get extra side effects as a reaction to stopping it. These include an irregular heart rate, sweating and shaking.

If you stop taking propranolol, it will take about 1 to 2 days for it to be completely out of your body but the side effects can last for up to 1 week.

How does propranolol compare with other heart medicines?

Propranolol works as well as other beta blockers for reducing blood pressure. The main difference between propranolol and other beta blockers is that it does not just affect your heart. It can affect other parts of your body too, such as your lungs.

There are lots of other medicines to lower your blood pressure and treat chest pain. They work in a different way to beta blockers and include:

  • ACE inhibitors like ramipril and lisinopril
  • angiotensin receptor blockers like candesartan
  • calcium channel blockers like amlodipine
  • medicines that make you pee more (diuretics) like furosemide

Beta blockers are not usually the first choice for high blood pressure. The medicine your doctor prescribes depends on your age and ethnicity.

If you're under 55 and not of African Caribbean or black African origin, you'll usually be offered an ACE inhibitor or an angiotensin receptor blocker.

If you're 55 or older, or you're any age and of African Caribbean or black African origin, you'll usually be offered a calcium channel blocker.

Sometimes you may have to try other blood pressure-lowering medicines if you get side effects. Many people need to take a combination of different medicines to lower their blood pressure.

How does it compare with other medicines for preventing migraine?

Atenolol, metoprolol, timolol and nadolol are all beta blockers and they work well in preventing migraines. However, most doctors prescribe propranolol.

There are some other medicines that are known to prevent migraines but they are not officially approved in the UK. They include amitriptyline, sodium valproate and gabapentin and they may have different side effects.

Topiramate can also be used to prevent migraines. It works just as well as propranolol. However, topiramate has not been officially approved for migraine for children under the age of 16.

Ask your doctor or pharmacist which medicine is best for you.

How does it compare with other medicines for anxiety?

Propranolol treats the physical symptoms of anxiety – for example, it stops your heart beating too fast. You'll usually only take propranolol for a short time.

The physical symptoms of anxiety are caused by chemical imbalances in the brain. Your doctor may prescribe an antidepressant like sertraline to treat these imbalances. You usually take antidepressants long term.

Many doctors prefer medicine-free treatments for anxiety. These include talking therapies like cognitive behavioural therapy. If you're having talking therapy, your doctor may prescribe propranolol at the same time. This will help you with your physical symptoms.

Will I need to stop taking propranolol before surgery?

Tell your doctor that you're taking propranolol if you're going to be put to sleep using general anaesthetic, or you're having any kind of major operation.

Your doctor may advise you to stop taking propranolol before surgery. This is because propranolol can lower your blood pressure too much when it's combined with some anaesthetics.

Can I drink alcohol with it?

Drinking alcohol can increase the blood pressure-lowering effect of propranolol, which can make you feel dizzy or lightheaded.

During the first few days of taking propranolol or after an increase in your dose, it's best to stop drinking alcohol until you see how the medicine affects you.

If you find propranolol makes you feel dizzy it's best to stop drinking alcohol.

Is there any food or drink I need to avoid?

Apart from being careful with alcohol, you can eat and drink normally while taking propranolol.

Eating a healthy, balanced diet can help if you have high blood pressure or another heart condition.

Will it make me put on weight?

Some people on propranolol say they put on weight, especially in the first few months of taking it. This is not known to be a common side effect of taking propranolol, and there is not enough information to say for sure why some people put on weight.

It could, for example, be because propranolol can make you feel tired which could make you less active. It could also affect the way your body uses energy.

If you're worried about putting on weight with propranolol, speak to your doctor.

Will it affect my contraception?

Propranolol will not stop your contraception working.

However, some types of hormonal methods of contraception, like the combined pill and contraceptive patch, are not usually recommended if you're taking propranolol or other medicines for high blood pressure. This is because some hormonal contraceptives can raise your blood pressure and stop propranolol working properly.

Talk to your doctor if you're taking a hormonal contraceptive.

If propranolol makes you sick (vomit) or have severe diarrhoea for more than 24 hours, your contraceptive pills may not protect you from pregnancy. Look on the pill packet to find out what to do.

Read more about what to do if you're on the pill and you're being sick or have diarrhoea.

Will it affect my fertility?

There is no evidence that propranolol affects fertility in men or women.

If you're trying to get pregnant, or you're having problems getting pregnant while on propranolol, speak to your doctor.

Will it affect my sex life?

Some people on propranolol say their sex drive goes down and some men find they cannot get an erection. However, this is not a common side effect and there is not enough evidence to say for sure that propranolol is causing it.

If you're having problems with your sex life, talk to your doctor.

Do I need to avoid playing sports?

You do not need to stop playing sports if you take propranolol. But do not push yourself too much.

Regular exercise is good for you because it lowers blood pressure by keeping your heart and blood vessels in good condition.

Be aware, though, that in some sports propranolol is not allowed if you're competing at a high level.

Can I drive or ride a bike?

Propranolol can make some people feel dizzy, especially when they first start taking it or after taking a bigger dose. If this happens to you, do not drive a car, ride a bike, or use tools or machinery.

It's an offence to drive a car if your ability to drive safely is affected. It's your responsibility to decide if it's safe to drive. If you're in any doubt, do not drive.

Talk to your doctor or pharmacist if you're unsure whether it's safe for you to drive while taking propranolol. GOV.UK has more information on the law on drugs and driving.

Can lifestyle changes help?

If you have heart problems, you can boost the health of your heart by making some key lifestyle changes. These changes will also help if you have high blood pressure.

  • Quit smoking – smoking increases your heart rate and blood pressure. Quitting smoking brings down your blood pressure and relieves heart failure symptoms. Try to avoid second-hand smoke too.
  • Cut down on alcohol – drinking alcohol while you're taking propranolol can make you feel dizzy or light headed. Also drinking too much alcohol raises blood pressure over time and makes heart failure worse. It's best to keep to the recommended limit of no more than 14 units of alcohol a week. A standard glass of wine (175ml) is 2 units. A pint of lager or beer is usually 2 to 3 units of alcohol.
  • Exercise – regular exercise lowers blood pressure by keeping your heart and blood vessels in good condition. It does not need to be too energetic, walking every day will help.
  • Eat well – aim to eat a diet that includes plenty of fruit and vegetables, wholegrains, fat-free or low-fat dairy products and lean proteins. It's a good idea to follow these tips for a lower salt diet too. Eating too much salt is the biggest cause of high blood pressure. The more salt you eat, the higher your blood pressure will be. Aim for no more than 6g of salt a day.
  • Deal with stress – when you're anxious or upset, your heart beats faster, you breathe more heavily and your blood pressure often goes up. This can make heart failure worse too. Find ways to reduce stress in your life. To give your heart a rest, try napping or putting your feet up when possible. Spend time with friends and family to be social and help avoid stress.

If you get severe headaches, there are steps you can take to help prevent migraines. This includes working out what things trigger an attack so you can avoid them.

How Long Does Propranolol Take To Work?

Propranolol

  • Relieves social & situational anxiety

From
£12.99 View Product

Propranolol is a beta blocker. Beta blockers are designed to show down the heart, calming down the body and lessening the stress. Following this, levels of adrenaline will lower. Like other beta blockers, Propranolol is mostly used to treat various heart conditions such as an irregular heartbeat and hypertension, which further down the line can help lower your blood pressure. It can also be used to treat chest pains and to improve your heart’s function after a heart attack. Another condition that Propranolol can treat is benign essential tremors (BET). BET is a disorder than can affect parts of the body, causing uncontrollable shaking. This can happen anywhere but most commonly it occurs in the arms, hands, neck, torso and head.`

How does Propranolol work? What effect will it give me?

Propranolol works by blocking the physical effects of anxiety. These physical effects include a faster heart rate, sweating and shaking. By blocking the physical symptoms of anxiety, Propranolol can help you feel calmer, less nervous and more composed. It does not affect your cognitive functions, instead focusing on your body’s reactions to stress.

Propranolol has been known to cause weight gain. Although, this extra weight is usually extra fluid retention rather than body fat. Any weight that has been gained by beta blockers is most often only temporary and the majority of people find that their weight stabilises after the first few months of them taking the medication.

Your ability to exercise may be affected by taking Propranolol as it reduces your heart rate. This is usually experienced by feeling more tired and exhausted 

Because Propranolol can reduce your heart rate, it can have several effects on your ability to exercise. After you take propranolol, you might feel fatigued and exhausted more easily after intense exercise. If you do frequently participate in cardiovascular exercise, it is very important to take the effects of Propranolol on board. Using a heart rate monitor to track your workout is recommended.

Are there any side effects of taking Propranolol?

Propranolol is extremely safe when taken correctly, however like all medications, there are potential side effects.

Common side effects: These common side effects happen in more than 1 in 100 people. They're usually mild and short lived.

  • Feeling tired, dizzy or lightheaded
  • Cold fingers or toes
  • Difficulties sleeping or nightmares
  • Feeling sick
  • Serious side effects

It happens rarely, but some people have serious side effects when taking propranolol. Tell your GP straight away if you have:

  • A shortness of breath with a cough which gets worse when you exercise
  • Swollen ankles or legs
  • Chest pain
  • Irregular heartbeat
  • Shortness of breath
  • Wheezing and tightening of your chest
  • Yellow skin or the whites of your eyes turn yellow

How do I take Propranolol?

Propranolol is not known to upset your stomach, so you can take it with food or without – that is entirely your choice. However, regardless of food, it is best to take it as the same time each day to allow you to get into a routine. It’s good to swallow the tablets whole with some water.

What if I forget to take it?

Sometimes we can forget to take our medication, regardless of how rock solid our routine is. If you do forget to a take a dose of Propranolol, you must take it as soon as you remember, regardless of the time. However, if it is very close to your next dosage, you can just wait for the next dosage and take it as normal. You must never take two doses at once because of a missed tablet.

If you forget to take a dose of propranolol, take it as soon as you remember, unless it is nearly time for your next dose. In this case, just leave out the missed dose and take your next dose as normal.

What if I take too much?

The amount of Propranolol that would equate to an overdose can vary from person to person. However, signs of taking too much are a slowed down heart rate and difficulty breathing. You can also feel dizzy and begin to tremble.

How long does Propranolol take to work?

Propranolol usually starts to work within a few hours. For heart conditions or to treat high blood pressure, Propranolol can sometimes take up to a week to begin fully working. You may not feel any different but that does not mean it is not working - it's vital to keep taking your dosage.

How do I buy Propranolol online?

You can safely buy Propranolol online at UK Meds. You will first need to have an online consultation with a pharmacist independent prescriber before your order will be supplied. The online consultation will ensure that Propranolol is the right medication for your medical condition.

Propranolol

  • Relieves social & situational anxiety

From
£12.99 View Product

Propranolol prolongs life and protects against cancer

In animal studies, lipophilic metoprolol given daily from 12 months of age extended median lifespan in long-lived male mice by 10%. A 2017 meta-analysis concludes that lipophilic beta-blockers (metoprolol and propranolol) are significantly better at reducing the risk of cardiovascular death in people than hydrophilic ones. Propranolol significantly and more than other beta-blockers reduce platelet aggregation, reduces mortality within 2-3 years after myocardial infarction by 23-26%. Propranolol is on the list of first line drugs to reduce the frequency of migraine attacks, the only drug approved by the US FDA for the treatment of essential tremors, used to treat anxiety disorders, hyperthyroidism. Proparnolol is associated with a 71% reduction in breast cancer mortality over a 10-year survival period, is associated with an increase in life expectancy compared to selective beta-blockers in women with epithelial ovarian cancer, with improved survival and a reduced risk of melanoma progression, and is able to stop angiosarcoma. Treatment with propranolol is associated with a high statistically significant reduction in the incidence of hepatocellular carcinoma (liver cancer) in patients with cirrhosis of the liver. nine0003

Medicines can be life-threatening. They can only be used with a doctor's prescription! The material in this article is for illustrative and educational purposes only and is not warranted for any medical use. For more information, please contact your doctor.

What are beta-adrenergic blockers and how propranolol differs from selective adrenoblockers

Beta-blockers block the sensitivity of β-adrenergic receptors to adrenaline and norepinephrine. But if selective andenoblockers do not block all types of β-adrenergic receptors, but only one type, then propranolol, as a non-selective beta-adrenergic blocker, blocks all β-adrenergic receptors (β1, β2 and β3): nine0004

  • β1-adrenergic receptors are located mainly in the heart and kidneys
  • β2-adrenergic receptors are found mainly in the lungs, gastrointestinal tract, liver, uterus, vascular smooth muscle, and skeletal muscle.
  • β3-adrenergic receptors are found in fat cells.

Link to source:

  • https://en.m.wikipedia.org/wiki/Beta_blocker

Propranolol, as a non-selective beta-blocker, blocks all β-adrenergic receptors (β1, β2 and β3). Selective beta-blockers (eg, bisoprolol/concor) do not affect β2 receptors and are therefore ineffective in delaying the progression of cancers whose growth is delayed or prevented by propranolol. Propranolol is a blocker of both β2 and β3 receptors that play a large role in the progression of cancer growth . This is especially true of breast cancer and brain metastases. The use of propranolol reduced breast cancer mortality by 71% over a 10-year survival period.

Research links:

  • www.ncbi.nlm.nih.gov/pubmed/21632503
  • www.ncbi.nlm.nih.gov/pubmed/27035124
  • www.ncbi.nlm.nih.gov/pubmed/21317458

The use of propranolol in early-stage breast cancer patients may result in reduced tumor proliferation (www.ncbi.nlm.nih.gov/pubmed/28031536). In triple-negative breast cancer, the combination of propranolol with metformin at clinically available concentrations reduced tumor cell proliferation, their mitochondrial activity, migration, invasion, and also reduced tumor growth rates in vitro and in vivo, which provides a good basis for testing this combination in clinical trials (www. .ncbi.nlm.nih.gov/pubmed/27926515).

In addition, propranolol, unlike most beta-blockers, is able to cross the blood-brain barrier (protective barrier of the brain) and affect the central nervous system in addition to peripheral activity

Research links:

  • http://jop . sagepub.com/content/30/2/128
  • www.ncbi.nlm.nih.gov/pubmed/21180298
  • www.ncbi.nlm.nih.gov/pubmed/2865152

Commonly used therapeutics for anxiety disorders are selective serotonin reuptake inhibitors, tricyclic antidepressants and benzodiazepines, and probably also propranolol (www.ncbi.nlm.nih.gov/pubmed/8679756) (www.ncbi.nlm.nih.gov/pubmed/8679756). Although a 2016 meta-analysis concludes that the quality of evidence for the efficacy of propranolol is currently insufficient for its routine use in the treatment of anxiety disorders (www.ncbi.nlm.nih.gov/pubmed/26487439).

Therefore, non-selective beta-blockers are used to prevent many types of cancer.

Propranolol prevents and treats some types of malignant and benign tumors

Over the past 10 years, it has become obvious that the prevention of cancerous tumors will allow you to push (delay) the moment of the disease to a later age. Thanks to such prevention, people can live longer for many years. In recent decades, mortality from cardiovascular diseases has sharply decreased due to the chemoprevention of diseases of the heart and blood vessels. If this trend continues, then people will soon die mainly not from cardiovascular diseases, but from cancer. One of the candidates for cancer prevention is considered propranolol. It is well studied as it has been used since 1965 years old.

In 2015, a study in women with epithelial ovarian cancer showed that propranolol was associated with increased life expectancy compared to selective beta-blockers.

Study Link:

  • www.ncbi.nlm.nih.gov/pubmed/26301456

Propranolol was demonstrated in 2014 in human clinical trials to stop angiosarcoma with a very poor initial prognosis, one of the most aggressive malignant tumors that kill even with treatment 91% of patients. It is interesting that already a week after the start of taking propranolol (40 mg 2 times a day), angiosarcoma stops growing, and when chemotherapy is added, in some patients it completely regresses, dramatically increasing the overall survival of study participants. Propranolol costs "penny". For comparison, the previously ineffective treatment of angiosarcoma cost patients about $10,000.

Study links:

  • www.ncbi.nlm.nih.gov/pubmed/27211551
    • nine0014 http://archderm.jamanetwork.com/article.aspx?articleid=2436318
  • www.newswise.com/articles/conventional-heart-drug-stops-the-progression-of-cancer

Human clinical trials of stage II propranolol began today after good results in animals to test its ability to slow the growth of breast cancer .

Research links:

  • www.newswise.com/articles/conventional-heart-drug-stops-the-progression-of-cancer
  • www.ncbi.nlm.nih.gov/pubmed/19442150
  • www.ncbi.nlm.nih.gov/pmc/articles/PMC3248157
  • www.ncbi.nlm.nih.gov/pubmed/21632501
  • www.ncbi.nlm.nih.gov/pubmed/21317458

Studies show that treatment with propranolol is associated with a high statistically significant reduction in the incidence of hepatocellular carcinoma (liver cancer) in patients with cirrhosis of the liver and associated esophageal varices. This amazing finding needs confirmation, but the result is biologically plausible. nine0004

Study Link:

  • www.ncbi.nlm.nih.gov/pubmed/22869451

Multiple myeloma is a malignant tumor with predominant localization of the process in the bone marrow. Multiple myeloma is still considered a disease that is not curable, but well controlled, in which a long-term remission is possible. A potential cure can only be discussed in cases of successful donor bone marrow transplantation. However, studies show that propranolol can be a good and very cheap way to treat multiple myeloma. nine0006 2017, Mayo Clinic, USA. A preclinical study demonstrated the antiproliferative and apoptotic effects of propranolol on multiple myeloma cells. A retrospective analysis has shown that the use of beta-adrenergic locators is associated with improved survival in patients with multiple myeloma.

Study link:

  • www.ncbi.nlm.nih.gov/pubmed/23080133
  • www. ncbi.nlm.nih.gov/pubmed/27733010

2011 University of Florence, Italy. nine0007 Preclinical data show that β-adrenergic antagonists (β-blockers) inhibit tumor progression and metastasis in animal models of melanoma. A pilot clinical study in the adjunctive treatment of melanoma with propranolol for a year showed a reduction in the percentage of disease progression and mortality www.ncbi.nlm.nih.gov/pubmed/21518948. 2011 Ohio State University, USA . Experimental evidence suggests that catecholamine hormones may be involved in stimulating the aggressiveness of malignant melanoma. 4179patients diagnosed with malignant melanoma in Denmark were followed up for an average of 4.9 years. About 372 were treated with β-blockers and their survival time was extended www.ncbi.nlm.nih.gov/pubmed/21933972 www.ncbi.nlm.nih.gov/pubmed/22322621

Propranolol may help treat colon cancer according to preclinical studies. 2014, Department of Clinical Epidemiology and Aging Research, German Center for Cancer Research, Germany. The use of beta-blockers may be associated with longer survival in patients with stage IV colorectal cancer.0004

It is amazing how propranolol (at a dosage of 2-3 mg per kg of body weight per day) in a few months (on average 6 months) easily completely and without a trace removes huge hemangiomas (benign tumors) , which are most often found in babies), even if they occupied the entire face or half of the head. But provided that they are treated in infants, then too late.

Research links:

  • www.ncbi.nlm.nih.gov/pubmed/19467330
  • www.ncbi.nlm.nih.gov/pubmed/25693013

Propranolol treats benign liver tumors (haemangiomas) in infants

Research links:

  • www.ncbi.nlm.nih.gov/pubmed/212601702
  • www.ncbi.nlm.nih.gov/pubmed/20488455
  • www.ncbi.nlm.nih.gov/pubmed/25558685

Propranolol blocks anxiety, allows you to forget bad memories, blocks panic phobias

Today, there are almost no safe drugs available for the treatment of post-traumatic syndrome. Propranolol is being investigated as a potential drug for the treatment of Post Traumatic Trauma Syndrome. Propranolol inhibits the action of norepinephrine, which contributes to the consolidation of memory of bad events in life. Propranolol can also reduce emotional distress from already formed negative memories. For this reason, it is also being studied in the treatment of specific phobias. For example, fear of spiders, fears of visiting the dentist, social phobias. As experiments have shown, if people are given propranolol before showing spiders, then all the symptoms of fright disappear. Moreover, they do not return even after the volunteers go through the repeated stage of the attempt to "form fear of spiders." In addition, propranolol improves cognitive functions (memory, thinking, etc.) in post-traumatic syndrome

Research links:

  • www.ncbi.nlm.nih.gov/pubmed/23182304
  • www.nbcnews.com/id/10806799/
  • www.ncbi.nlm.nih.gov/pubmed/17588604
  • www. biologicalpsychiatryjournal.com/article/S0006-3223(03)00412-8/abstract
  • http://jop.sagepub.com/content/30/2/128
  • www.ncbi.nlm.nih.gov/pubmed/27014009
  • www.ncbi.nlm.nih.gov/pubmed/26808441
  • www.ncbi.nlm.nih.gov/pubmed/26942318
  • www.ncbi.nlm.nih.gov/pubmed/26707354
  • www.ncbi.nlm.nih.gov/pubmed/26487439
  • www.ncbi.nlm.nih.gov/pubmed/17200914

Commonly used therapeutics for anxiety disorders are selective serotonin reuptake inhibitors, tricyclic antidepressants and benzodiazepines, as well as propranolol www.ncbi.nlm.nih.gov/pubmed/8679756 www.ncbi.nlm.nih.gov/pubmed /8679756 Although a 2016 meta-analysis concludes that the quality of evidence for the efficacy of propranolol is currently insufficient for its routine use in the treatment of anxiety disorders. www.ncbi.nlm.nih.gov/pubmed/26487439

A controlled human trial showed that propranolol at 80 mg one hour before a dentist visit and 40 mg immediately after a visit reduced anxiety before going to the dentist for a tooth extraction this time and the next.

Research links:

  • www.ncbi.nlm.nih.gov/pubmed/26607848

Musicians, public speakers, actors and professional dancers in many Western countries use propranolol to block their anxiety before public speaking. nine0004

Research links:

  • https://en.m.wikipedia.org/wiki/Beta_blocker

Propranolol improves social communication skills in people with autism disorder

Research links:

  • www.ncbi.nlm.nih.gov/pubmed/7
  • 8

Theranostics of Aging evaluates the diagnostic parameters of your body and informs about the existing ways to increase your life expectancy. nine0004

After diagnosing the parameters of your body (https://nestarenie.ru/novaya-teranostika-stareniya-1-5.html) at the medical center, make an appointment for an appointment with a doctor .

Follow your doctor's advice to help you live longer. See you in the 22nd century .

Propranolol slightly inhibits platelet aggregation

A decrease in platelet aggregation, which increases with age, is a good prevention of deadly blood clots. Propranolol significantly and more than other beta-blockers reduces platelet aggregation, which has advantages in reducing the risk of death due to blood clots. nine0004

Study Link:

  • www.ncbi.nlm.nih.gov/pubmed/24730697

Propranolol helps improve athletic performance in shooting accuracy

Propranolol lowers heart rate and reduces tremors. Therefore, propranolol and other beta-blockers are used in some sports where high accuracy is important: archery, billiards, golf, pistol shooting, etc. But today, beta blockers are banned by the International Olympic Committee. The last high-profile crime occurred in 2008 at the Summer Olympics. Shooting bronze medalist Kim Yong-Soo was stripped of his bronze medal due to the use of beta blockers. For the same reasons, beta blockers are used by neurosurgeons. nine0004

Research links:

  • https://en.m.wikipedia.org/wiki/World_Anti-Doping_Agency
  • www.ncbi.nlm.nih.gov/pubmed/10360293
  • www.ncbi.nlm.nih.gov/pmc/articles/PMC1298399

Essential tremor is the most common movement disorder and its cause is unknown. Usually involves tremors in the arms, hands, or fingers, but sometimes the head, vocal cords, or other parts of the body are involved during intentional movements such as eating or writing. It is a separate disease from Parkinson's disease and is often misdiagnosed as some features are common to both conditions. Propranolol is the only drug approved by the US Food and Drug Administration (FDA) for the treatment of essential tremors. nine0004

Research links:

  • www.ncbi.nlm.nih.gov/pubmed/24385718
  • www.ncbi.nlm.nih.gov/pubmed/22013182

Propranolol prevents migraine

Migraine (headache, nausea, etc.) is a common, severe disease affecting up to 15% of the population. Propranolol has been proven to significantly reduce the frequency of migraines. Of all the beta-blockers, the ability to prevent migraine attacks has been proven only for propranolol and timolol. nine0004

Research links:

  • http://brain.oxfordjournals.org/content/128/1/86.full
  • www.worldcat.org/title/biochemistry-of-migraine/oclc/11726870

Migraine is one of the most common causes of headaches. It is a debilitating disease characterized by episodes of unilateral throbbing headache associated with symptoms such as nausea, vomiting, photophobia, and phonophobia. Propranolol is on the list of first-line drugs to reduce the frequency of migraine attacks (www.ncbi.nlm.nih.gov/pubmed/22529202). Propranolol is safe and effective for the treatment of migraine (www.ncbi.nlm.nih.gov/pubmed/15106196 www.ncbi.nlm.nih.gov/pubmed/1830566). Propranolol has also been shown to be better tolerated, most effective, and the most preferred treatment for migraine than other drugs (www. ncbi.nlm.nih.gov/pubmed/28220376 www.ncbi.nlm.nih.gov/pubmed/28220376) . Although a 2019 meta-analysis concludes that more research is needed (www.ncbi.nlm.nih.gov/pubmed/30893319).

Propranolol prolongs life and reduces mortality from recurrent heart attack and stroke

Beta-blockers (preferably non-selective - propranolol or carvedilol) indirect inhibitors of mTOR. Substances capable of inhibiting mTOR are candidates for anti-aging drugs. It is the mTOR gene that plays one of the leading roles, thanks to which a reduction in calorie intake can prolong life.

In addition, propranolol, through the blockade of receptors for stress hormones, suppresses stress. Stress greatly shortens our lives and accelerates aging, creates wrinkles, raises blood pressure, damages the heart and blood vessels, shortens telomeres, reduces the level of longevity protein Klotho. nine0004

The fact that emotional stress raises blood pressure and causes heart disease is clearly shown in the work of J. Kaplan. Kaplan, using the example of primates, showed that if you collect a group of male primates, then within a few days the monkeys will have a social hierarchy. The worst place in such a hierarchy is at the bottom. Male primates in a subordinate position show a range of indicators of chronic stress. Often such primates develop atherosclerosis. But if scientists gave male primates at the bottom of the social hierarchy (risk group) beta-blockers that suppress the activity of the sympathetic nervous system, then they did not develop atherosclerosis of the vessels. This showed how the sympathetic nervous system, due to stress, negatively affects the development of atherosclerosis and is involved in problems with the heart and blood vessels. The truth is that emotional stress manifests itself through the sympathetic (adrenergic) autonomic nervous system, which links the control centers of our brain and internal organs. Including - with immune, bone marrow, etc. And atherosclerosis is the main factor that leads to the largest number of deaths in developed countries from heart attack and brain stroke. nine0004

Study link:

  • www.ncbi.nlm.nih.gov/pubmed/2899392

Human clinical trials show that propranolol reduces cardiovascular mortality (#1 cause of death in the world),

Link to study:

  • www.ncbi.nlm.nih.gov/pubmed/6342840

A 3-year follow-up of patients aged 60-69 who had myocardial infarction showed that propranolol reduced overall mortality in these patients by 23-37%. In addition, propranolol caused a reduction in signs of heart disease and aging (a significantly greater increase in left ventricular ejection fraction and a significantly greater decrease in left ventricular myocardial mass.

Study links:

  • www.ncbi.nlm.nih.gov/pubmed/9230162
  • www.ncbi.nlm.nih.gov/pubmed/6342843
  • http://pda.rlsnet.ru/mnn_index_id_370.htm
  • www.ncbi.nlm.nih.gov/pubmed/6342840
  • www.ncbi.nlm.nih.gov/pubmed/3
    • 6
  • www.ncbi.nlm.nih.gov/pubmed/10381708

In animal studies, lipophilic metaprolol given daily from 12 months of age extended median lifespan in long-lived male mice by 10% (www. ncbi.nlm.nih.gov/pubmed/23314750). Meta-analysis 2017 with analysis 90 935 patients conclude that lipophilic beta-blockers (metoprolol, propranolol and oxyprenolol) reduce the risk of CVD mortality significantly better than hydrophilic ones (atenolol and others) (www.ncbi.nlm.nih.gov/pubmed/28760243) . Atenolol (a hydrophilic beta-blocker) is associated with an increased risk of stroke in the elderly, while lipophilic beta-blockers, mainly metoprolol and propranolol (with moderate to high lipophilicity), do not increase the risk of stroke in this population. In addition, highly lipophilic drugs may more readily penetrate the brain and cell membrane, which may help prevent stroke and cardiac death, indicating that moderate to high lipophilic beta-blockers may have a greater impact on clinical outcomes than hydrophilic ones. beta-adrenergic blockers. nine0004

Currently, propranolol is being considered for the treatment of resistant hypertension, along with other antihypertensive drugs, when other drugs are not sufficient to control blood pressure.

Study link:

  • www.ncbi.nlm.nih.gov/pubmed/28292320

Propranolol is used to treat hyperthyroidism, an overactive thyroid gland.

In hyperthyroidism, there is an increased level of thyroid hormones in the circulation, resulting in tachycardia, palpitations, tremors and anxiety. Propranolol has been widely used to treat such symptoms of hyperthyroidism. In addition, propranolol reduces the conversion of thyroid hormone T4 to the more active T3

Study link:

  • www.ncbi.nlm.nih.gov/pubmed/1688102

Who should not use propranolol

Propranolol is a drug that is well tolerated by healthy people, but can be dangerous in certain health conditions. Therefore, propranolol should not be used without a doctor's prescription!!!

  • Propranolol is contraindicated and dangerous for patients with diseases of the lungs and respiratory tract: chronic obstructive pulmonary disease, bronchial asthma, etc.
  • Dangerous for patients diagnosed with bradycardia (pulse below 55 beats per minute), sick sinus syndrome (diagnosed by ECG of the heart)
  • Deadly in case of blockade of the AV node of the heart (2nd and 3rd degree) (diagnosed by ECG of the heart)
  • Dangerous at low pressure as it also reduces pressure.
  • Propranolol is fatal when combined with the calcium channel blocker verapamil due to possible excessive blockade of the AV node of the heart and cardiac arrest. nine0015
  • Propranolol should not be used in renal failure.
  • Propranolol is best not used in type 2 diabetes mellitus without special need
  • Propranolol should not be used in hepatic impairment, although low doses have been shown to be useful in some studies in liver cirrhosis.
  • Propranolol should not be used in psoriasis and in the elderly without special need.
  • Propranolol is dangerous in overdose. Therefore, the dose for treatment should be selected, gradually increasing, and coordinating it with the attending physician. nine0015

Study Link:

  • https://en.m.wikipedia.org/wiki/Propranolol

Caution:

During treatment with propranolol, you should:

  1. reduce your caloric intake, as it slows down the overall metabolism in the body.
  2. if possible, do not drive a car (dulls the sense of danger)
  3. Avoid drinking alcohol (though not dangerous in small doses).
  4. stop treatment with propranolol gradually over 2 weeks
  5. use with caution in peripheral vascular disease, "intermittent claudication", etc.

Research links:

  • www.cvpharmacology.com/cardioinhibitory/beta-blockers
  • www.ncbi.nlm.nih.gov/pubmed/16809680

Due to its high penetration through the blood-brain barrier of the brain, propranolol can cause sleep disturbance and nightmares in some people. Although I personally drink it and sleep very well.

Study link:

  • www. ncbi.nlm.nih.gov/pubmed/21180298

Conclusions:

  1. In animal studies, lipophilic metoprolol administered daily from 12 months of age extended median lifespan in long-lived male mice by 10%. A 2017 meta-analysis concludes that lipophilic beta-blockers (metoprolol and propranolol) are significantly better at reducing the risk of cardiovascular death in people than hydrophilic ones. Propranolol significantly and more than other beta-blockers reduce platelet aggregation, reduces mortality within 2-3 years after myocardial infarction by 23-26%. Propranolol is on the list of first line drugs to reduce the frequency of migraine attacks, the only drug approved by the US FDA for the treatment of essential tremors, used to treat anxiety disorders, hyperthyroidism. Proparnolol is associated with a 71% reduction in breast cancer mortality over a 10-year survival period, is associated with an increase in life expectancy compared to selective beta-blockers in women with epithelial ovarian cancer, with improved survival and a reduced risk of melanoma progression, and is able to stop angiosarcoma. Treatment with propranolol is associated with a high statistically significant reduction in the incidence of hepatocellular carcinoma (liver cancer) in patients with cirrhosis of the liver. nine0015
  2. Self-administration of propranolol without a doctor's prescription is deadly.

Attention. The information in this article cannot be used for self-medication, as the drug has a dangerous incompatibility with some other drugs and is unsafe for use in certain heart conditions. Its use is possible only after the permission of the doctor.

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Increase in blood pressure

INCREASE IN ARTERIAL PRESSURE - the patient may be disturbed by headaches, nausea, vomiting, visual disturbances, chest pain, weakness and other complaints.
What to do if you have a hypertensive crisis

Correct. Most importantly, when the first symptoms appear, it is necessary to take a medicine that will lower blood pressure in a short time. Talk to your doctor about what kind of medicine and in what dosage you need to keep with you in case of a hypertensive crisis. nine0004

It will not be superfluous to take a sedative medicine (for example, "Tricardin"). It is necessary to provide an influx of fresh air, for example, open a window or window. If the attack was accompanied by a feeling of paresthesia, nausea and vomiting, impaired vision or speech, it is imperative to call an ambulance.

Wrong. A common mistake that can be made in a hypertensive crisis is to take a drug that reduces blood pressure, which is used regularly. These are the drugs that are taken every day with arterial hypertension to stabilize the condition. Their use during a crisis is practically meaningless. Such drugs have a long-term and cumulative effect, and in this situation, it is precisely those that will start their “work” quickly that are needed. nine0004

Don't panic and take pill after pill. Many of them begin to act at least 20 minutes after ingestion. Very often, in a person who has had a hypertensive crisis, who has taken a large dose of drugs, the pressure simply “drops” to low values. This can lead to heart rhythm disturbances.

If a hypertensive crisis is accompanied by tachycardia (palpitations), trembling and agitation, you need to take a medicine that will remove these symptoms. For example, Anaprilin (40 mg), or Moxonidine (0.2 - 0.4 mg), which should be chewed. You can use "Carvedilol" (12.5 - 25 mg). Such drugs are particularly indicated for heart rates above 80 beats per minute. nine0004

In case of elevated systolic and diastolic (upper and lower) pressure, you should take "Captopril" (or "Kapoten") - 12.5 - 25 mg. Its action begins in 15-20 minutes.

Another drug that can help in these situations is Furosemide (40 mg), a diuretic drug. It begins to act within 30-60 minutes. The drug is more often used in the edematous version of the crisis, when pastosity of the legs is noted (a small degree of swelling of the skin and fiber), swelling under the eyes.

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