Propranolol, Oral/Injection

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KEY POINTS

• This medicine is taken by mouth to treat high blood pressure, angina, irregular or fast heartbeat, pheochromocytoma, and certain types of tumors. It may also be used to prevent repeat heart attacks or migraine headaches. Take it exactly as directed. Do not stop taking this medicine without your healthcare provider's approval. Stopping abruptly may cause serious side effects.
• Keep all appointments for tests to see how this medicine affects you.
• This medicine may cause unwanted side effects. Tell your healthcare provider if you have any side effects that are serious, continue, or get worse.
• Tell all healthcare providers who treat you about all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take.

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What are other names for this medicine?

Type of medicine: beta blocker

Generic and brand names: propranolol, injection; propranolol, oral; Inderal LA; InnoPran XL

What is this medicine used for?

This medicine is taken by mouth to:

• Lower and control high blood pressure. It may be used alone or in combination with other medicines.
• Treat irregular or fast heartbeat
• Relieve angina (chest pain)
• Prevent repeat heart attacks
• Prevent migraine headaches
• Treat certain type of tremors
• Treat pheochromocytoma (a tumor of the adrenal gland)

This medicine may also be given by injection.

This medicine may be used to treat other conditions as determined by your healthcare provider.

What should my healthcare provider know before I take this medicine?

Before you take this medicine, be sure to tell your healthcare provider if you have ever had:

• An allergic reaction to any other medicine
• A lung disease such as asthma or COPD that causes shortness of breath, coughing, wheezing, or other breathing problems. (This medicine may make these problems worse.)
• A stroke or transient ischemic attack (TIA)
• Depression
• Diabetes
• Heart failure, a heart attack, or any other heart problems
• Liver or kidney disease
• Low blood pressure
• Muscle disease such as myasthenia gravis
• Pheochromocytoma (a tumor of the adrenal gland)
• Problems with blood circulation such as Raynaud's disease or peripheral vascular disease
• Psoriasis
• Thyroid problems

Females of childbearing age: Tell your healthcare provider if you are pregnant or plan to become pregnant. It is not known whether this medicine will harm an unborn baby. Do not breast-feed while taking this medicine without your healthcare provider's approval.

How do I use it?

Check the label on the medicine for directions about your specific dose. Take this medicine exactly as your healthcare provider prescribes, even if you feel better. Take it at the same time each day to help you remember. Do not stop taking this medicine without your healthcare provider's approval. Stopping abruptly may cause serious side effects. You must reduce your dosage gradually.

Check with your healthcare provider before using this medicine in children under age 18 years.

A healthcare provider will give the IV infusions (slow drip through a needle into a large vein).

This medicine may come in different forms. If you have extended-release capsules, do not break, crush, or chew them. Swallow them whole.

You may take the extended-release capsules with or without food. However, it is important to take the extended-release capsules at the same time every day. Ask your pharmacist if you have the extended-release capsules.

If you have the immediate release tablets, take the medicine before meals, as instructed by your healthcare provider. Ask your pharmacist if you have the immediate release form of this medicine.

If you have the liquid form, take it with food. You may mix it with water or juice to make it easier to swallow. To make sure you get the right dose, use the measuring spoon, cup, dropper, or oral syringe that comes with the medicine, or ask your pharmacist for one. Do not use a kitchen spoon because the dose may not be correct.

What if I miss a dose?

If you miss a dose, take it as soon as you remember unless it is almost time for the next scheduled dose. In that case, skip the missed dose and take the next one as directed. Do not take double doses. If you are not sure about what to do if you miss a dose, or if you miss more than one dose, contact your healthcare provider.

What if I overdose?

If you or anyone else has intentionally taken too much of this medicine, call 911 or go to the emergency room right away. If you pass out, have seizures, weakness or confusion, or have trouble breathing, call 911. If you think that you or anyone else may have taken too much of this medicine, call the poison control center. Do this even if there are no signs of discomfort or poisoning. The poison control center number is 800-222-1222.

Symptoms of an acute overdose may include: chest pain, slow or irregular heartbeat, shortness of breath, dizziness, weakness, confusion, fainting, seizures, sweating, tremors, wheezing, anxiety.

What should I watch out for?

Your healthcare provider may want you to check your pulse regularly. Report any unusual slowing or irregularity of your heart rate.

This medicine may cover up a fast heart rate caused by an overactive thyroid gland. Talk with your healthcare provider about this.

If you develop hives, an itchy rash, or peeling skin, stop taking the medicine and contact your provider right away.

Follow your healthcare provider’s instructions about diet and a safe exercise program while you are taking this medicine.

This medicine may make you drowsy or dizzy or cause blurred vision. Do not drive or operate machinery unless you are fully alert and can see clearly. You may also feel dizzy or faint when you get up quickly after sitting or lying down. Getting up slowly may help.

Talk to your healthcare provider before you use any nasal decongestants or take cold medicines, including nonprescription products.

Adults over the age of 65 may be at greater risk for side effects. Talk with your healthcare provider about this.

If you need emergency care, surgery, lab tests, or dental work, tell the healthcare provider or dentist you are taking this medicine.

If you have diabetes: This medicine may affect your blood sugar and cover up the symptoms of low blood sugar. It may be harder to tell if your blood sugar level is too low or too high. Talk with your healthcare provider about this. Be sure you understand how this medicine might affect you and what to do if you have a problem.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away. If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help.): Allergic reaction (hives; itching; rash; tightness in your chest; trouble breathing; swelling of your face, throat, or tongue).

Serious (Report these to your healthcare provider right away.): Chest pain; cold hands or feet; numbness or tingling in hand or feet; swelling of the arms, feet, or legs; increased coughing or night cough; confusion; depression; slow or irregular heartbeat; severe dizziness or fainting; change in vision; trouble breathing; severe skin redness, peeling, or blisters; unusual bruising or bleeding.

Other: Dizziness, drowsiness, tiredness, weakness, trouble sleeping, change in sexual ability or desire, abnormal dreams, headache, constipation, diarrhea, nausea, vomiting, nervousness, muscle or joint pain, mild itching, hair loss, injection site pain, redness, or swelling.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• ACE inhibitors such as benazepril (Lotensin), captopril, enalapril (Vasotec), fosinopril, lisinopril (Prinivil, Zestril), quinapril (Accupril), and ramipril (Altace)
• Alpha blockers such as alfuzosin (Uroxatral), doxazosin (Cardura), silodosin (Rapaflo), and tamsulosin (Flomax)
• Angiotensin receptor blockers (ARBs) such as azilsartan (Edarbi), candesartan (Atacand), eprosartan (Teveten), irbesartan (Avapro), losartan (Cozaar), olmesartan (Benicar), telmisartan (Micardis), and valsartan (Diovan)
• Antibiotics such as ciprofloxacin (Cipro), isoniazid, ofloxacin, and rifampin (Rifadin)
• Antidepressants such as amitriptyline, clomipramine, desipramine (Norpramin), duloxetine (Cymbalta), fluoxetine (Prozac), fluvoxamine (Luvox), imipramine (Tofranil), nortriptyline (Pamelor), sertraline (Zoloft), and trazodone
• Antifungal medicines such as ketoconazole (Nizoral) and terbinafine (Lamisil)
• Antipsychotic medicines such as chlorpromazine, clozapine (Clozaril, FazaClo), haloperidol (Haldol), perphenazine, prochlorperazine (Compro), thioridazine, and trifluoperazine
• Antiseizure medicines such as carbamazepine (Carbatrol, Epitol, Equetro, Tegretol), oxcarbazepine (Trileptal), phenytoin (Dilantin, Phenytek), and primidone (Mysoline)
• Barbiturates such as butabarbital (Butisol), pentobarbital (Nembutal), phenobarbital, and secobarbital (Seconal)
• Bupropion (Aplenzin, Forfivo, Wellbutrin, Buproban, Zyban)
• Cancer medicines such as abiraterone (Zytiga), bosutinib (Bosulif), brentuximab (Adcetris), ceritinib (Zykadia), doxorubicin (Doxil), imatinib (Gleevec), nilotinib (Tasigna), pazopanib (Votrient), rituximab (Rituxan), teniposide, topotecan (Hycamtin), vemurafenib (Zelboraf), and vincristine (Marqibo)
• Cholesterol-lowering medicines such as cholestyramine (Prevalite) and colestipol (Colestid)
• Cimetidine (Tagamet)
• Cinacalcet (Sensipar)
• Clobazam (Onfi)
• Clonidine (Catapres, Kapvay)
• Cough, cold, or allergy medicines such as diphenhydramine (Benadryl), phenylephrine (Neo-Synephrine, Sudafed PE), and pseudoephedrine (Sudafed)
• Cyclosporine (Gengraf, Neoral, Sandimmune)
• Dexamethasone
• Dextromethorphan/quinidine (Nuedexta)
• Diabetes medicines such as canagliflozin (Invokana), glipizide (Glucotrol), glyburide (Glynase), insulin, metformin (Fortamet, Glucophage, Riomet), pioglitazone (Actos), repaglinide (Prandin), rosiglitazone (Avandia), sitagliptin (Januvia), and tolbutamide
• Dipyridamole (Persantine)
• Diuretics (water pills) such as amiloride, bumetanide, chlorthalidone, ethacrynic acid (Edecrin), furosemide (Lasix), hydrochlorothiazide (Microzide), spironolactone (Aldactone), and torsemide (Demadex)
• Doxepin (Silenor)
• Epinephrine (Adrenalin, Asthmanefrin, Auvi-Q, EpiPen)
• Erectile dysfunction medicines such as avanafil (Stendra), sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra, Staxyn)
• Ergot medicines such as dihydroergotamine (D.H.E. 45, Migranal), ergotamine (Ergomar), and methylergonovine
• Fingolimod (Gilenya)
• Heart or blood pressure medicines such as amiodarone (Cordarone, Pacerone), digoxin (Lanoxin), diltiazem (Cardizem, Cartia, Tiazac), disopyramide (Norpace), dofetilide (Tikosyn), dronedarone (Multaq), felodipine, flecainide, hydralazine, isradipine (DynaCirc), ivabradine (Corlanor), nicardipine (Cardene), nifedipine (Adalat CC, Procardia), prazosin (Minipress), procainamide, propafenone (Rythmol), quinidine, reserpine, terazosin, and verapamil (Calan, Covera, Verelan)
• HIV medicines such as atazanavir (Reyataz), darunavir (Prezista), delavirdine (Rescriptor), efavirenz (Sustiva), elvitegravir/cobicistat/emtricitabine/tenofovir (Stribild), fosamprenavir (Lexiva), indinavir (Crixivan), lopinavir/ritonavir (Kaletra), nelfinavir (Viracept), nevirapine (Viramune), ritonavir (Norvir), saquinavir (Invirase), and tipranavir (Aptivus)
• Levothyroxine (Levo-T, Levothroid, Levoxyl, Synthroid, Unithroid)
• Lorcaserin (Belviq)
• Malaria medicines such as artemether/lumefantrine (Coartem), chloroquine, mefloquine, primaquine, and quinine
• MAO inhibitors such as isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl, Emsam, Zelapar), and tranylcypromine (Parnate) (Do not take this medicine and an MAO inhibitor within 14 days of each other.)
• Medicines to treat breathing or lung problems such as albuterol (ProAir, Proventil, Ventolin), aminophylline, arformoterol (Brovana), formoterol (Perforomist), indacaterol (Arcapta), metaproterenol, salmeterol (Serevent), terbutaline, theophylline, and zileuton (Zyflo)
• Methadone (Dolophine, Methadose)
• Methoxsalen (8-MOP, Oxsoralen Ultra, Uvadex)
• Migraine medicines such as rizatriptan (Maxalt) and zolmitriptan (Zomig)
• Mirabegron (Myrbetriq)
• Natural remedies such as bayberry, black cohosh, blue cohosh, California poppy, cayenne, dong quai, ephedra, garlic, ginger, ginseng, goldenseal, hawthorn, kola, licorice, ma huang, shepherd's purse, St. John's wort, and yohimbe
• Nitrate medicines such as isosorbide (Dilatrate, Isordil, Monoket) and nitroglycerin (Minitran, Nitro-Dur, Nitrostat)
• Nonsteroidal anti-inflammatory medicines (NSAIDs) such as celecoxib (Celebrex), diclofenac (Cambia, Voltaren, Zipsor), ibuprofen (Advil, Motrin), indomethacin (Indocin), ketoprofen, ketorolac, nabumetone (Relafen), naproxen (Aleve, Anaprox, Naprelan), oxaprozin (Daypro), piroxicam (Feldene), and sulindac (Clinoril)
• Paroxetine (Brisdelle, Paxil, Pexeva)
• Stimulants such as amphetamine/dextroamphetamine (Adderall), dextroamphetamine (Dexedrine), and methamphetamine (Desoxyn)

Do not drink alcohol while you are taking this medicine unless your healthcare provider approves.

If you are not sure if your medicines might interact, ask your pharmacist or healthcare provider. Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

How should I store this medicine?

Store this medicine at room temperature. Keep the container tightly closed. Protect it from heat, high humidity, and bright light.

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This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Ask your pharmacist for the best way to dispose of outdated medicine or medicine you have not used. Do not throw medicine in the trash.

Keep all medicines out of the reach of children.

Do not share medicines with other people.