Propranolol for heart conditions

Propranolol belongs to a group of drugs called beta blockers. It can be used to treat a variety of condition; it is often used in patients with heart problems to control high blood pressure or irregular heart beats. Propranolol is also given to control cyanotic (blue) spells in children with Tetralogy of Fallot.

Propranolol acts on the heart muscle to slow the heart rate and prevent the heart working too hard.

Propranolol is also used to treat a variety of other conditions including headaches and birthmarks.

It is usually given three times a day. An oral liquid is available for children who cannot swallow tablets. The strength we use at GOSH is 50mg in 5mL but other strengths are available. Please check the same strength is given if further supplies are needed from your local pharmacy.

Small doses can be given using an oral syringe, which will be given to you with the medicine. For older children and teenagers, tablets are available in the following strengths: 10mg, 40mg, 80mg and 160mg. Your child should not stop taking propranolol suddenly.

Propranolol is usually well tolerated, but possible side effects are:

• low blood pressure or slow heart rate (bradycardia): This may make your child feel dizzy or faint. If this occurs please tell us, so that we can adjust the dose if necessary
• difficult breathing (bronchospasm) or shortness of breath: if this worsens while taking propranolol, please tell us. Some people have shortness of breath because of their condition
• cold hands and feet
• nausea (feeling sick), vomiting, diarrhoea or constipation
• difficulty sleeping and bad dreams
• feeling tired and lethargic
• high or low blood sugar

If you are concerned about any of these side effects, please discuss them with your doctor or pharmacist.

People with the following conditions should discuss taking propranolol with their doctor:

• pregnant, could be pregnant, planning to become pregnant or breast-feeding
• asthma
• diabetes or low blood glucose
• uncontrolled heart failure or heart block
• Raynaud’s disease

Some medicines can interact with Propranolol. Always check with your doctor or pharmacist before giving your child any other medicines, including herbal or complementary medicines. 

The following medicines are known to interact with propranolol:

• Other medicines that slow the heart rate such as digoxin, amiodarone, verapamil and diltiazem. These are sometimes prescribed alongside propranolol but will need careful monitoring.
• Other medicines that reduce blood pressure such as diuretics, ACE inhibitors and calcium channel blockers. These are sometimes prescribed alongside propranolol but will need careful monitoring.
• Selective serotonin inhibitor anti-depressants: These medicines may increase the effect of propranolol.
• Phenothiazine type anti-psychotic medicines: Fluoxetine may have an additional effect on lowering the blood pressure.

• Keep medicines in a safe place where children cannot reach them.
• Keep medicines in a cool, dry place out of direct sunlight and away from heat.
• If your doctor decides to stop treatment with Propranolol, return any unused medicine to the pharmacist. Do not flush down the toilet or throw it away.
• If you forget to give your child a dose, give it as soon as you remember. Do not give a double dose if it is already time to give the next one.
• If you child vomits after taking the medicine, do not give a double dose.
• Your family doctor (GP) will need to give you a repeat prescription for propranolol.
• Some medicines will need to be ordered by your local pharmacist - ask your GP for another prescription with enough time (when you have about 2 weeks of your medicine left) to ensure you do not run out.

For further information please contact:

Medicines Information: 020 829 8608 or via the Medications page on the MyGOSH app (available Monday - Friday, 9am - 5pm)

Cardiology team via GOSH switchboard: 020 7405 9200 or via the MyGOSH app