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 of propranolol
These common side effects of propranolol happen in more than 1 in 100 people. They're usually mild and do not last long. There are things you can do to help cope with them:
Headaches
Make sure you rest and drink plenty of fluids. It's best not to drink too much alcohol. Ask your pharmacist to recommend a painkiller. Talk to your doctor if they do not go away 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
Stick to simple meals and do not eat rich or spicy food.
If you're being sick, try small frequent sips of water to avoid dehydration. Signs of dehydration include peeing less than usual or having strong-smelling pee.
If you take the combined pill or progestogen-only pill and you're being sick, your contraception may not protect you from pregnancy. Check the pill packet for advice.
Diarrhoea
Drink lots of fluids, such as water or squash, to avoid dehydration. Signs of dehydration include peeing less than usual or having dark, strong-smelling pee. Do not take any other medicines to treat diarrhoea without speaking to a pharmacist or doctor.
If you take the combined pill or progestogen-only pill and you have severe, watery diarrhoea or diarrhoea that lasts for more than 24 hours, your contraception may not protect you from pregnancy. Check the pill packet for advice.
Difficulty sleeping or nightmares
Avoid having a big meal, smoking, or drinking alcohol, tea or coffee in the evening. Try not to watch television or use your mobile phone before going to bed. Instead, try to relax for an hour before bedtime.
Talk to a doctor or pharmacist if the advice on how to cope does not help and a side effect is still bothering you or does not go away.
Serious side effects
It happens rarely, but some people have serious side effects when taking propranolol.
Contact a doctor or call 111 straight away if:
- you get bruising, or you bruise more easily than usual. These can be signs of low numbers of platelets in your blood (thrombocytopenia)
- you have shortness of breath with a cough that gets worse when you exercise (like walking up stairs), swollen ankles or legs, or an irregular heartbeat – these are signs of heart problems
If you get chest pain and you've already been diagnosed with angina, follow the instructions you've been given for treating your angina:
- Stop what you're doing and rest.
- Use any medicine you've been prescribed – this is usually glyceryl trinitrate (GTN).
- Take another dose after 5 minutes if the first dose does not help.
- If you still have symptoms 5 minutes after taking the 2nd dose, call 999 for an ambulance.
Immediate action required: Call 999 now if:
- you get chest pain that does not stop after a few minutes, or is new or worse if you already have angina
Chest pain is a possible sign of a heart attack and needs to be checked out as soon as possible.
Do not drive yourself to A&E.
The person you speak to at 999 will give you advice about what to do.
Serious allergic reaction
In rare cases, it's possible to have a serious allergic reaction (anaphylaxis) to propranolol.
Immediate action required: Call 999 now if:
- your lips, mouth, throat or tongue suddenly become swollen
- you're breathing very fast or struggling to breathe (you may become very wheezy or feel like you're choking or gasping for air)
- your throat feels tight or you're struggling to swallow
- your skin, tongue or lips turn blue, grey or pale (if you have black or brown skin, this may be easier to see on the palms of your hands or soles of your feet)
- you suddenly become very confused, drowsy or dizzy
- someone faints and cannot be woken up
- a child is limp, floppy or not responding like they normally do (their head may fall to the side, backwards or forwards, or they may find it difficult to lift their head or focus on your face)
You or the person who's unwell may also have a rash that's swollen, raised, itchy, blistered or peeling.
These can be signs of a serious allergic reaction and may need immediate treatment in hospital.
Do not drive yourself to A&E.
The person you speak to at 999 will give you advice about what to do.
Other side effects
These are not all the side effects of propranolol. For a full list see the leaflet inside your medicine packet.
Reporting side effects
You can report any suspected side effect using the Yellow Card safety scheme.
Visit the Yellow Card website for more information about reporting side effects.