Propranolol tablets BP 40 mg – patient leaflet, side effects, dosage

What Propranolol tablets are and what they are used for

Propranolol is one of a group of medicines called beta-blockers. It has effects on the heart and

circulation and also on other parts of the body.

Propranolol can be used for many conditions including:

• hypertension (high blood pressure)
• angina pectoris (chest pain)

• some arrhythmias (disorders of heart rhythm)

  • protection of the heart after a

    myocardial infarction (heart attack)

  • prevention of migraine
  • essential tremor, anxiety

  • certain thyroid conditions (such as

    thyrotoxicosis, which is caused by

    an overactive thyroid gland)

  • hypertrophic cardiomyopathy

    (thickened heart muscle)

  • phaeochromocytoma (high blood

    pressure due to a tumour usually

    near the kidney)

  • bleeding in the oesophagus or

    stomach caused by high blood

    pressure in the liver.

What you need to know before you take Propranolol tablets

Do not take Propranolol tablets and

tell your doctor if you:

• are allergic to Propranolol or any

  of the other ingredients of this

  medicine (listed in section 6)

• have untreated/uncontrolled

  heart failure or are in shock

  caused by heart problems

• suffer with heart conduction or

  rhythm problems (second or third

  degree heart block or sick sinus syndrome)

  • have a slow heart rate
  • have low blood pressure
  • suffer from severe blood circulation problems (which may cause your fingers and toes to tingle or turn pale or blue)
  • suffer from diabetes mellitus (low blood sugar levels may be hidden by this medicine) or increased acidity of the blood (metabolic acidosis)

  • are on a strict fasting diet

    • suffer from a tight, painful feeling in the chest in periods of rest (Prinzmetal’s angina)
    • suffer from asthma or any other breathing difficulties
    • suffer from untreated phaeochromocytoma (high blood pressure due to a tumour near the kidney).

Warnings and precautions

Talk to your doctor or pharmacist before taking Propranolol tablets if you:

• have heart failure (please also see “Do not take” section above)
• suffer from blood circulation problems (which may cause your fingers and toes to tingle or turn pale or blue)
• have a heart weakness or first degree heart block

• have diabetes. Propranolol may change your normal response to low blood sugar, which usually involves an increase in heart rate. Propranolol may cause low blood sugar levels even in patients who

  are not diabetic (please see section

  4 “Possible side effects”)

  • have kidney or liver problems

    (including cirrhosis of the liver)

  • have thyrotoxicosis. Propranolol

    may hide the symptoms of

    thyrotoxicosis

  • have a phaeochromocytoma (a

    tumour near the kidney) (please

    also see “Do not take” section

    above)

  • have a history of allergic reactions.

    Other medicines and Propranolol tablets

    Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines. Propranolol can interfere with the action of some other medicines and some medicines can have an effect on propranolol tablets. The medicines which can cause some problems when taken together with propranolol tablets are:

    • insulin (to treat diabetes)

    • ergotamine, dihydroergotamine

      or rizatriptan (for migraine)

      • disopyramide, quinidine,

        amiodarone, propafenone (to treat

        irregular heartbeat (arrhythmia))

      • digitalis glycosides (digoxin) (to

        treat heart conditions)

      • verapamil, diltiazem, nifedipine,

        nisoldipine, nicardipine, isradipine,

        lacidipine and dihydropyridine (to

        treat heart diseases)

      • adrenaline (used in anaphylactic

        shock)

      • lidocaine (to treat irregular

        heartbeat or as a local anaesthetic)

        • cimetidine (to treat stomach ulcers)
        • hydralazine (to treat high blood pressure)

        • clonidine (for hypertension or migraine). If you are taking clonidine and propranolol together, you must not stop taking clonidine unless your doctor tells you to do so. If it becomes necessary for you to stop taking clonidine, your doctor will give you careful instructions on how to do it.

          • ibuprofen and indometacin (for pain and inflammation)
          • chlorpromazine and thioridazine (for psychiatric illness)
          • anaesthetics
          • warfarin (to thin the blood)
          • rifampicin (to treat infection)
          • theophylline (treating asthma)

Propranolol tablets with alcohol

You are advised to avoid alcohol whilst taking this medicine.

Pregnancy, breast-feeding and fertility

Propranolol tablets are not recommended during pregnancy or breast-feeding. If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, ask your doctor or pharmacist for advice before taking this medicine.

Driving and using machines

Your medicine is unlikely to affect your ability to drive or to operate

machinery. However, some people may occasionally feel dizzy or tired when taking propranolol tablets. If this happens to you, ask your doctor for advice.

Anaesthetics or tests

If you are going to have an anaesthetic or any blood or urine tests, please tell your doctor or dentist that you are taking

Propranolol tablets. If you see another doctor or go into hospital, let them know what medicines you are taking.

Propranolol tablets contain Lactose

If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicinal product.

Propranolol tablets contain Carmoisine (E122)

Propranolol tablets contain carmoisine (E122) which may cause allergic reactions.

How to take Propranolol tablets

Always take this medicine exactly as your doctor or pharmacist has told you. Check with your doctor or pharmacist if you are not sure. Propranolol tablets should be swallowed with a drink of water, before meals. Your doctor will have decided how many propranolol tablets you need to take each day depending on your condition. Follow your doctor’s instructions about when and how to take your tablets. Please read the label on the

carton. This will also tell you how many tablets to take and when you should take them. Ask your doctor or pharmacist if you are not sure.

The following table shows the recommended total daily dosages for an adult:

Hypertension (high blood pressure)

160 mg to 320 mg

Angina (chest pains)

120 mg to 240 mg

Arrythmias (disorders of heart rhythm)

30 mg to 160 mg

Protection of the heart after a heart attack

160 mg

Prevention of migraine

80 mg to 160 mg

Essential tremor

80 mg to 160 mg

Anxiety

40 mg to 120 mg

Certain thyroid conditions (such as thyrotoxicosis)

30 mg to 160 mg

Hypertrophic cardiomyopathy

(thickened heart muscle)

30 mg to 160 mg

Phaeochromocytoma

30 mg to 60 mg

Bleeding in the oesophagus caused

by high blood pressure in the liver

80 mg to 160 mg

Elderly people may be started on a

lower dose.

Children and Adolescents:

Under some circumstances,

propranolol tablets can be used to

treat children with the following conditions:

irregular heartbeats,

phaeochromocytoma,

thyrotoxicosis, Fallot's tetralogy, migraine.

The dosage will be adjusted by the doctor according to the child’s age or weight.

If you take more Propranolol tablets than you should

Propranolol is severely toxic if used in overdose. If you have accidently

taken more than the prescribed dose or are experiencing symptoms of overdose, you should urgently seek medical attention. Overdose causes difficulty breathing, low blood pressure, drowsiness, fits, dilated pupils, an excessively slowed heart beat with symptoms such as

dizziness, sickness, confusion, hallucinations, body spasms,

breathlessness on exertion, fainting or coma. Overdose could result in heart attack.

If you forget to take Propranolol tablets

If you forget to take a dose, take it as soon as you remember, unless it is nearly time for your next dose. Take your next dose at the usual time. Don’t take two doses at the same time. If you are worried, ask your doctor or pharmacist for advice.

If you stop taking Propranolol tablets

Do not stop taking your medicine without talking to your doctor first.

In some cases, it may be

necessary to stop taking the

medicine gradually. If you have any

further questions on the use of this

medicine, ask your doctor or

pharmacist.

Possible side effects

Like all medicines, this medicine can

cause side effects, although not

everybody gets them.

Stop treatment and contact a doctor at once if you have the

following symptoms of an:

• intolerance to Propranolol

  tablets such as slow heart rate and

  low blood pressure causing

  dizziness, light-headedness,

  fainting or blurred vision

• allergic reaction such as itching,

  difficulty breathing or swelling of

  the face, lips, throat or tongue

Tell your doctor if you notice any of the following side effects or

notice any other effects not listed:

Common (may affect up to 1 in 10 people):

• disturbed sleep/nightmares
• the heart beating more slowly
• cold fingers and toes, numbness and spasm in the fingers which is followed by warmth and pain (Raynaud’s phenomenon)
• fatigue

Uncommon (may affect up to 1 in 100 people):

• feeling or being sick, diarrhoea

  Rare (may affect up to1 in 1,000 people):

  • bruising more easily

    (thrombocytopaenia)

  • mood changes, confusion,

    memory loss, psychosis or

    hallucinations (disturbances of the mind)

  • tingling sensation (pins and

    needles)

  • disturbances of vision, dry eyes

  • breathlessness and/or swollen ankles, if you also have heart

    failure

    • heart block which may cause an

      abnormal heart beat, dizziness,

      tiredness or fainting

    • dizziness, particularly on standing up

    • worsening of your blood

      circulation, if you already suffer

      from poor circulation

    • worsening of breathing difficulties, if you have or have had asthma

    • hair loss, skin rash, including

      worsening of psoriasis, purple

      spots on the skin (purpura)

      Very rare (may affect up to 1 in

      10,000 people)

      • severe muscle weakness

        (myasthenia gravis)

      • there may be changes to some of

        the cells or other parts of your

        blood. It is possible that your

        doctor may occasionally take

        blood samples to check whether

        propranolol has had any effect on

        your blood.

        Not known (frequency cannot be estimated from the available data):

        • Low levels of blood sugar may

          occur in diabetic and non diabetic patients including the newborn,

          toddlers and children, elderly

          patients, patients on artificial

          kidneys (haemodialysis) or patients on medication for diabetes. It may also occur in patients who are

          fasting or have been fasting

          recently or who have a long-term liver disease.

          • Seizure linked to low levels of

            sugar in the blood.

Reporting of side effects

If you get any side effects, talk to

your doctor, pharmacist or nurse.

This includes any possible side

effects not listed in this leaflet. You

can also report side effects directly

via the Yellow Card Scheme at:

www.mhra.gov.uk/yellowcard or

search for MHRA Yellow Card in the

Google Play or Apple App Store.

By reporting side effects, you can

help provide more information on the safety of this medicine.

How to store Propranolol tablets

Keep Propranolol tablets out of the sight and reach of children. Do not store the tablets above 25°C. Do not take the tablets after the expiry date which is stated on the carton. The expiry date is also stated on the back of the strip after ‘Exp’. Do not throw away any medicines via wastewater or household waste. Ask

your pharmacist how to throw away medicines you no longer use. These measures will help protect the

environment.

Contents of the pack and other information

What Propranolol tablets contain

• the active substance (the

  ingredient that makes the tablets work) is propranolol hydrochloride. Each tablet contains either 10mg, 40mg, 80mg or 160mg of the

  active substance.

  • the other ingredients are lactose, magnesium stearate, maize starch, stearic acid, hypromellose (E464).

  • the coating contains polysorbate, carmoisine (E122), titanium dioxide (E171), iron oxide red (E172),

    hypromellose (E464).

What Propranolol tablets look like and contents of the pack

Propranolol tablets 40mg pink

film-coated tablets.

Pack sizes are 28, 56 and 1000

tablets.

Not all pack sizes may be available.

Marketing Authorisation Holder and Manufacturer

Accord, Barnstaple, EX32 8NS, UK

This leaflet was last revised in April 2021

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Component: Label Leaflet

Date Sent: 02/11/21

Technologist: T. Hull

Technically Approved

Propranolol Tablets

40mg x 1000 - UK

JDE No.: 50969004

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