Generic name: propranolol (pro PRAN oh lol)
Brand name: Hemangeol, Inderal LA, Inderal XL, InnoPran XL, Inderal
Drug class: Group II antiarrhythmics, Non-cardioselective beta blockers
Propranolol is a beta-blocker. Beta-blockers affect the heart and circulation (blood flow through arteries and veins).
Propranolol is used to treat tremors, angina (chest pain), hypertension (high blood pressure), heart rhythm disorders, and other heart or circulatory conditions. It is also used to treat or prevent heart attack, and to reduce the severity and frequency of migraine headaches.
Hemangeol (propranolol oral liquid 4.28 milligrams) is given to infants who are at least 5 weeks old to treat a genetic condition called infantile hemangiomas. Hemangiomas are caused by blood vessels grouping together in an abnormal way. These blood vessels form benign (non-cancerous) growths that can develop into ulcers or red marks on the skin. Hemangiomas can also cause more serious complications inside the body (in the liver, brain, or digestive system).
Propranolol may also be used for purposes not listed in this medication guide.
Warnings
You should not use this medicine if you have asthma, very slow heart beats, or a serious heart condition such as "sick sinus syndrome" or "AV block" (unless you have a pacemaker).
Babies who weigh less than 4.5 pounds should not be given Hemangeol oral liquid.
Before taking this medicine
You should not use propranolol if you are allergic to it, or if you have:
- asthma;
- very slow heart beats that have caused you to faint; or
- a serious heart condition such as "sick sinus syndrome" or "AV block" (unless you have a pacemaker).
Babies who weigh less than 4.5 pounds should not be given Hemangeol oral liquid.
To make sure propranolol is safe for you, tell your doctor if you have:
- a muscle disorder;
- bronchitis, emphysema, or other breathing disorders;
- low blood sugar, or diabetes (propranolol can make it harder for you to tell when you have low blood sugar);
- slow heartbeats, low blood pressure;
- congestive heart failure;
- depression;
- liver or kidney disease;
- a thyroid disorder;
- pheochromocytoma (tumor of the adrenal gland); or
- problems with circulation (such as Raynaud's syndrome).
It is not known whether propranolol will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using propranolol.
Propranolol can pass into breast milk and may harm a nursing baby. Tell your doctor if you are breast-feeding a baby.
How should I take propranolol?
Take propranolol exactly as prescribed by your doctor. Follow all directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results. Do not take this medicine in larger or smaller amounts or for longer than recommended.
Adults may take propranolol with or without food, but take it the same way each time.
Take propranolol at the same time each day.
Do not crush, chew, break, or open an extended-release capsule. Swallow it whole.
Hemangeol must be given to an infant during or just after a feeding. Doses should be spaced at least 9 hours apart. Make sure your child gets fed regularly while taking this medicine. Tell your doctor when the child has any changes in weight. Hemangeol doses are based on weight in children, and any changes may affect your child's dose.
Call your doctor if a child taking Hemangeol is sick with vomiting, or has any loss of appetite.
Measure liquid medicine with the dosing syringe provided, or with a special dose-measuring spoon or medicine cup. If you do not have a dose-measuring device, ask your pharmacist for one.
Do not shake Hemangeol liquid.
Your blood pressure will need to be checked often.
If you need surgery, tell the surgeon ahead of time that you are using propranolol. You may need to stop using the medicine for a short time.
Do not skip doses or stop using propranolol suddenly. Stopping suddenly may make your condition worse. Follow your doctor's instructions about tapering your dose.
This medicine can cause unusual results with certain medical tests. Tell any doctor who treats you that you are using propranolol.
If you are being treated for high blood pressure, keep using propranolol even if you feel well. High blood pressure often has no symptoms. You may need to use blood pressure medicine for the rest of your life.
Propranolol is only part of a complete program of treatment for hypertension that may also include diet, exercise, and weight control. Follow your diet, medication, and exercise routines very closely if you are being treated for hypertension.
Store at room temperature away from moisture and heat. Do not allow liquid medicine to freeze. Throw away any unused Hemangeol 2 months after you first opened the bottle.
What happens if I miss a dose?
For regular (short-acting) propranolol: Take the missed dose as soon as you remember. Skip the missed dose if your next dose is less than 4 hours away.
For extended-release propranolol (Inderal LA, InnoPran XL and others): Take the missed dose as soon as you remember. Skip the missed dose if your next dose is less than 8 hours away.
Do not take extra medicine to make up the missed dose.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.
Overdose symptoms may include slow or uneven heartbeats, dizziness, weakness, or fainting.
What to avoid
Avoid drinking alcohol. It may increase your blood levels of propranolol.
Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Get up slowly and steady yourself to prevent a fall.
Propranolol side effects
Get emergency medical help if you have any signs of an allergic reaction to propranolol: hives; difficult breathing; swelling of your face, lips, tongue, or throat.
Call your doctor at once if you have:
- slow or uneven heartbeats;
- a light-headed feeling, like you might pass out;
- wheezing or trouble breathing;
- shortness of breath (even with mild exertion), swelling, rapid weight gain;
- sudden weakness, vision problems, or loss of coordination (especially in a child with hemangioma that affects the face or head);
- cold feeling in your hands and feet;
- depression, confusion, hallucinations;
- liver problems - nausea, upper stomach pain, itching, tired feeling, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);
- low blood sugar - headache, hunger, weakness, sweating, confusion, irritability, dizziness, fast heart rate, or feeling jittery;
- low blood sugar in a baby - pale skin, blue or purple skin, sweating, fussiness, crying, not wanting to eat, feeling cold, drowsiness, weak or shallow breathing (breathing may stop for short periods), seizure (convulsions), or loss of consciousness; or
- severe skin reaction - fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.
Common propranolol side effects may include:
- nausea, vomiting, diarrhea, constipation, stomach cramps;
- decreased sex drive, impotence, or difficulty having an orgasm;
- sleep problems (insomnia); or
- tired feeling.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
What other drugs will affect propranolol?
Tell your doctor about all medicines you use, and those you start or stop using during your treatment with propranolol, especially:
- a blood thinner - warfarin, Coumadin, Jantoven;
- an antidepressant - amitriptyline, clomipramine, desipramine, imipramine, and others;
- drugs to treat high blood pressure or a prostate disorder - doxazosin, prazosin, terazosin;
- heart or blood pressure medicine - amiodarone, diltiazem, propafenone, quinidine, verapamil, and others;
- NSAIDs (nonsteroidal anti-inflammatory drugs) - aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac, indomethacin, meloxicam, and others; or
- steroid medicine - prednisone and others.
This list is not complete. Other drugs may interact with propranolol, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.