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Propranolol

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From £19.95

Includes FREE Private Prescription.

* This treatment requires an online consultation for review by our prescribing team. The decision to supply the specific treatment and quantity requested will be based on whether our medical team are satisfied that it will be safe, appropriate, and effective. Please note that you must be 18 years of age or older to request this treatment.

Place your order by 1pm to receive delivery as soon as the next day!

 

First-line treatment for Essential Tremor

Beta-blocker

Reduces tremor severity

 

What is Propranolol and how does it work?

Propranolol is a non-selective beta-adrenergic receptor antagonist, known more commonly as a beta-blocker.

Propranolol is a first-line treatment option for Essential Tremor (ET) and is successful in reducing tremor intensity and amplitude in up to 70% of patients. It should, however, be noted that complete suppression of ET is very rare.

Propranolol works best for alleviating tremors in the hands and arms, it is less effective for head and voice tremors. Patients with ET that take Propranolol may see marked improvement in their ability to control their tremor and carry out basic tasks such as drinking from a cup or using food utensils. More specialised motor functions, such as threading a needle, may still be too difficult.

The exact mechanism of action of Propranolol for treating tremors is not fully understood, although it is thought that it may work by blocking nerve impulses to the affected muscles.

Treatment is usually started at a low dose and gradually increased until the tremor improves. The risk of side effects grows with increased dosage.

Additional Information

How should I take Propranolol?

Before taking Propranolol, you should read the manufacturer’s printed Patient Information Leaflet (PIL) from inside the pack. It will give you more information about Propranolol and provide you with a full list of the side effects which you may experience from taking it.

In most cases, Propranolol is used for daily maintenance and suppression of Essential Tremor. It can also be used as and when needed to prevent or treat exacerbations of tremor during social situations or planned events.

The recommended starting dose for Essential Tremor using standard release tablets is 40mg taken two or three times daily. Dosage may be increased according to response up to four 40mg tablets (160mg) per day. Tablets should be swallowed with a drink of water.

Patients that are taking Propranolol as a daily maintenance dose may prefer the convenience of a long acting preparation that is only taken once daily. The usual recommended starting dose is one 80mg modified release capsule daily. The dose may be increased to 160mg, and then if necessary up to a maximum of 240mg daily. Capsules may be taken in the morning or evening but should be taken at the same time each day.

If you forget to take a dose, take it as soon as you remember and then 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.

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.

Along with their useful effects, most medicines can cause unwanted side effects although not everyone experiences them. The unwanted effects often improve as your body adjusts to the new medicine, but please speak with your doctor or pharmacist if they continue or become troublesome. You will find a full list of possible side effects in the Patient Information Leaflet (PIL) supplied with your medicine.

Stop taking Propranolol if you experience any of the following reactions, and seek medical help immediately:

  • Allergic reactions: swelling of the face, throat, or tongue, difficulty breathing or dizziness
  • Difficulty in breathing. This is more likely if you have asthma or a history of asthmatic problems

 

Common side effects (may affect up to 1 in 10 people)

  • Cold hands and feet
  • Weakness
  • Tiredness (fatigue)
  • Difficulty in sleeping (insomnia)
  • Nightmares
  • Slow heartbeat (bradycardia)
  • Poor blood circulation which makes the toes and fingers numb and pale (Raynaud’s syndrome)

Please tell the prescriber if you are taking, have recently taken, or might take any other medicines, including medicines obtained without a prescription. This is because Propranolol can affect the way some medicines work, and some medicines can have an effect on Propranolol. In the event of a medical emergency, you should tell your doctor, pharmacist or nurse that you have taken Propranolol and when you did. Do not take Propranolol with other medicines unless your doctor tells you that you can.

Tell your doctor or pharmacist if you are taking any of the following medicines:

  • Cimetidine, for stomach ulcers and indigestion
  • Hydralazine, for high blood pressure
  • Fluvoxamine, used to treat depression and Obsessive-Compulsive Disorder (OCD)
  • Adrenaline, for emergency treatment of allergic reaction (anaphylaxis) and cardiac arrest
  • Medicines for heart failure such as Digoxin
  • Ergotamine, for migraines
  • Indometacin, for arthritis and other prostaglandin inhibiting drugs, such as Ibuprofen
  • Medicines for irregular heartbeat, such as Disopyramide and Amiodarone
  • Lidocaine, used as a local anaesthetic or for an irregular heartbeat
  • Medicines known as MAOIs for depression, such as Moclobemide
  • Nifedipine, for high blood pressure and chest pains (angina)
  • Medicines known as tricyclic antidepressants for depression, such as Amitriptyline
  • Medicines for sleeping difficulties, such as Amobarbital (barbiturates)
  • Other medicines for high blood pressure such as ACE inhibitors
  • Chlorpromazine for anxiety, nausea, vomiting or mental disorders and other Phenothiazines, such as Trifluoperazine
  • Rizatriptan, used to treat migraine headaches
  • Angiotensin-II Antagonists, used to treat high blood pressure e.g. Losartan
  • Aldesleukin, to treat some cancers
  • Alprostadil, for sexual problems
  • Corticosteroids
  • Moxisylyte, to treat poor circulation
  • Muscle relaxants, used to treat multiple sclerosis
  • The contraceptive pill
  • Parasympathomimetics e.g. Pyridostigmine used to treat myasthenia gravis
  • Clonidine, for high blood pressure and migraine
  • Verapamil or Diltiazem, medicines for high blood pressure or angina
  • Medicines for the treatment of diabetes, such as Insulin and Metformin.
  • Propafenone, for irregular heartbeat
  • Rifampicin, an antibiotic used for various infections, in particular tuberculosis
  • Theophylline, for asthma
  • Warfarin, for thinning the blood
  • Calcium channel blockers for high blood pressure or chest pain, such as Nicardipine and Lacidipine
  • Thyroxine, for certain thyroid disorders

Do not take Propranolol:

  • If you are allergic (hypersensitive) to Propranolol, other beta-blockers, or any of the ingredients listed in the Patient Information Leaflet supplied with your medication
  • If you have a history of breathing difficulties, wheezing, or asthma
  • If you have heart failure or heart problems
  • If you have a very slow heart rate (bradycardia) or an irregular heartbeat
  • If you have very low blood pressure (hypotension)
  • If you have severe circulation problems
  • If you are fasting or have been fasting recently
  • If you have an untreated tumour near your kidneys (phaeochromocytoma)
  • If you have more acid than normal in your blood (metabolic acidosis)
  • If you have chest pains when at rest (Prinzmetal’s angina)

 

Warnings & Precautions

  • Abrupt withdrawal of beta-blockers is to be avoided. The dosage should be withdrawn gradually over a period of 7 to 14 days
  • Propranolol with food, drink and alcohol – alcohol may affect how Propranolol works
  • Operations – If you go into hospital to have an operation, you should tell the anaesthetist or the medical staff that you are taking Propranolol

 

You should tell the prescriber if you have or have ever had any of the following problems or conditions before you start using Propranolol:

  • Allergic reactions to such things as insect bites/stings
  • 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
  • Unstable angina (non-exercise induced sharp chest pain)
  • Thyrotoxicosis – Propranolol may hide the symptoms
  • Kidney or liver problems (including cirrhosis of the liver). You may need to have some check-ups during treatment
  • Any other health problems such as circulation disorders, heart problems, breathlessness, or swollen ankles

 

Pregnancy, Breastfeeding, & Fertility

Propranolol is not recommended for use during pregnancy or when breastfeeding and should only be used if deemed essential by an appropriate healthcare professional.

 

Driving and using machinery

Propranolol is unlikely to affect your ability to drive or to operate machinery. However, some people may occasionally feel dizzy or tired when taking Propranolol. If you are adversely affected, you should not drive or operate hazardous machinery.

 

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You can be confident that your treatment will be 100% genuine, safe, and effective as we only use medications procured from licensed manufacturers and trusted UK wholesalers.

Rest assured that your treatment will be delivered in plain packaging for complete discretion.

Step 2 - Complete a Short Medical Questionnaire

A straightforward medical questionnaire acts as a replacement to the conventional face-to-face appointment. This type of consultation process is quick and should only take around five minutes to complete.

The questionnaire consists of simple questions regarding your general health and the specific condition selected. Questions are easy to understand and similar to those that you would be asked during a GP appointment.

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