Propranolol comes as 2 different types of medicine:
- standard tablets or liquid – this releases propranolol into your body quickly, so you may need to take it several times a day depending on your dose
- slow-release capsules – this releases the medicine slowly so you do not have to take it as often, once a day is usually enough
If you're 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.
Always follow the instructions from a pharmacist or doctor, or the leaflet in the medicine packet.
Dosage and how to take propranolol
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 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 kidney or liver problems.
If your child needs propranolol, your doctor will usually use your child's weight to work out the right dose.
How to take it
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.
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.
How long to 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.
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 be very serious. It can significantly slow your heart rate, lower your blood pressure, cause dizziness, seizures or fits, and make it difficult to breathe.
The amount of propranolol that can lead to an overdose varies from person to person.
Immediate action required: Call 999 or go to A&E if:
You take more than your prescribed dose of propranolol and you:
- have a slow heart rate
- have breathing problems
- feel dizzy or shaky
- have a seizure or fit
- have pain in your chest, or a fast heart rate (heart palpitations)
Urgent advice: Contact 111 for advice now if:
- you've taken more than your prescribed dose of propranolol
Call 111 or get help from 111 online.
If you need to go to A&E, do not drive. Ask someone to drive you or call 999 and ask for an ambulance.
Bring the propranolol packet or leaflet inside it, plus any remaining medicine, and any other medicine you take.
Stopping propranolol
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. If you stop suddenly after taking it for a long time, you may also get extra side effects as a reaction to stopping it. These include an irregular heart rate, sweating and shaking.
Your doctor will usually reduce your dose gradually over 1 to 2 weeks. Follow their instructions on how to do this.
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.