Propranolol Extended Release Side Effects

Propranolol hydrochloride is a medication used to treat high blood pressure, irregular heart rhythms (arrhythmia), myocardial infarction (heart attack), and it is also used to prevent migraines. Propranolol slows down a person's heart rate and makes it easier for the heart to beat. This action gives propranolol its antihypertensive (blood pressure lowering) effects. Higher doses of propranolol work to control heart arhrythmias. Side effects of this medication can affect a variety of body functions.

Is This an Emergency?

If you are experiencing serious medical symptoms, seek emergency treatment immediately.


Adverse reactions to propranolol that might affect the body as a whole. These reactions include fever, cold extremities, joint pain and leg fatigue. Patients may experience weight gain. A skin reaction similar to lupus erythematous (an autoimmune disorder) in which raised, red, disc-like lesions appear on the face in a butterfly pattern, may occur in some patients. As with most medications, allergic reactions are possible, including serious life-threatening anaphylactic responses.

Central Nervous System

Propranolol can cause:

  • sleep disturbances
  • drowsiness
  • fatigue
  • lightheadedness
  • vertigo,
  • fainting


Propranolol might cause profound bradycardia (slow heart rate) and hypotension. Palpitations, chest pain, atrioventricular heart block (a disruption of signals traveling between heart chambers), congestive heart failure or cardiac arrest. Peripheral circulation can be affected, causing symptoms similar to Raynaud’s disease that could include cold, numb or painful hands and cyanosis (bluish discoloring of the hands) caused by the decrease blood flow. Once the peripheral blood flow is back to normal, patient's may feel burning pain in the hands.


Patients taking propranolol might experience a sore throat from swelling in the pharynx, painful spasms in the larynx and constriction of the upper airways of the lungs along with shortness of breath .

Special Senses

Visual disturbances, dry eyes and conjunctivitis can be experienced while taking propranolol. Ringing in the ears or hearing loss is also possible, and patients might also experience nasal congestion.


Propranolol can cause:

  • dry mouth
  • nausea
  • vomiting
  • heartburn
  • diarrhea or constipation
  • abdominal cramps
  • flatulence

More serious gastrointestinal side effects include inflammation of the pancreas, mesenteric artery thrombosis (blockage in the arteries of the intestines) and ischemic colitis (swelling of the large intestine along with diminished blood flow).


Propranolol can cause a decreased libido or impotence.

Dermatologic Side Effects

Redness, itching, or a psoriasis-like skin eruption is possible while taking propranolol. Propranolol can cause more severe dermatologic reactions such as Stevens-Johnson syndrome (toxic epidermal necrolysis) which is characterized by a severe, blistering rash to skin and mucosa along with gastrointestinal problems 2.


Propranolol can affect white blood cell production causing a decrease in the number of eosinophils (white blood cells that respond to allergens) and platelets. If severe enough, the drop in white blood cells may result in an even more acute reduction of white blood cells called agranulocytosis.

Metabolic Side Effects

Propranolol hydrochloride can affect blood glucose levels, causing either low or high blood sugar. Patients who have hyperthyroidism (overactive thyroid) experience decreased calcium levels while taking propranolol. Therefore, patients with diabetes or hyperthyroidism should be monitored closely by a physician.