Long-Term Side Effects of Propranolol
Propranolol is in a family of pharmaceutical drugs called beta-blockers and sold under the brand name Inderal 3. This type of medication affects the heart and circulation system, and is used to prevent heart attacks and treat angina, or chest pain; hypertension or, high blood pressure; heart rhythm disorders; and prevent other heart and vascular, or blood vessel, conditions. According to the U.S. Food and Drug Administration (FDA), propranolol is also prescribed for muscle tremors, hyperthyroid conditions, to decrease the frequency and severity of migraine headaches, and for certain anxiety conditions 3.
If you are experiencing serious medical symptoms, seek emergency treatment immediately.
Difficulty Breathing
Beta blockers work by blocking certain sites in the central nervous system called beta-adrenergic receptor sites, as described by Drugs.com. Blocking these nerve sites decreases heart rate, blood pressure and anxiety. However, propranolol and other beta blockers can also worsen breathing disorders, such as emphysema and asthma, because they constrict the air passageways of the lungs and can cause fluid build-up in the lungs 3. This can result in shortness of breath, difficulty breathing and chest tightness in patients who are on propranolol for long periods of time, or who have respiratory disorders 3. To prevent or decrease this side effect, propranolol is prescribed in divided doses, extended-release capsules, or combined with the diuretic, hydrochlorothiazide, which causes the body to excrete fluids 3.
Low Blood Pressure
Side Effects of Propranolol
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As propranolol and other beta blocker drugs are used to treat hypertension, or high blood pressure, and heart rate, some patients may experience fluctuating blood pressure levels or chronic low blood pressure 3. This can lead to symptoms such as:
- drowsiness
- tiredness
- dizziness
- lightheadedness
- fainting
- fatigue
- as noted by MentalHealth.com 2
These side effects are more likely to occur if the patient does not take propranolol as recommended, or takes doses of the medication that are too high 3. These side effects may be more noticeable when getting up from a sitting or reclining position.
Decrease Diabetic Symptoms
MayoClinic.com advises that propranolol and other beta-blockers are not recommended for patients with diabetes because they may mask or cover some of the symptoms of the disease 123. Diabetic patients generally experience a fast or pounding heartbeat during hypoglycemia, or when the blood sugar levels fall too low. Propranolol decreases heart rate, so this symptom does not occur even with hypoglycemia 3. Other symptoms of hypoglycemia such as dizziness and sweating will still occur.
Digestive Symptoms
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Other side effects of propranolol involve the digestive system 3. Bloating and fluid retention may also occur, and to decrease this side effect, propranolol may be combined with the diuretic, hydrochlorothiazide 3.
Related Articles
References
- MayoClinic.com: Propranolol
- Mentalhealth.com: Propranolol
- Drugs.com: Propranolol
- Silberstein SD, Holland S, Freitag F, et al. Evidence-based guideline update: pharmacologic treatment for episodic migraine prevention in adults: report of the Quality Standards Subcommittee of the American Academy of Neurology and the American Headache Society. Neurology. 2012;78(17):1337-45. doi:10.1212/WNL.0b013e3182535d20
- Lu J, Anvari R, Wang J, et al. Propranolol as a potentially novel treatment of arteriovenous malformations. JAAD Case Rep. 2018;4(4):355–358. doi:10.1016/j.jdcr.2017.11.005
- Pringsheim T, Davenport WJ, Becker WJ. Prophylaxis of migraine headache. CMAJ. 2010;182(7):E269-76. doi:10.1503/cmaj.081657
- Limmroth V, Michel MC. The prevention of migraine: a critical review with special emphasis on beta-adrenoceptor blockers. Br J Clin Pharmacol. 2001;52(3):237‐243. doi:10.1046/j.0306-5251.2001.01459.x
- Jackson JL, Kuriyama A, Kuwatsuka Y, et al. Beta-blockers for the prevention of headache in adults, a systematic review and meta-analysis. PLoS ONE. 2019;14(3):e0212785. doi:10.1371/journal.pone.0212785
- Food and Drug Administration. Propranolol hydrochloride extended-release capsules. Updated December 2010.
Writer Bio
Noreen Kassem is a hospital doctor and a medical writer. Her articles have been featured in "Women's Health," "Nutrition News," "Check Up" and "Alive Magazine." Kassem also covers travel, books, fitness, nutrition, cooking and green living.