Propranolol: Uses, Side Effects, Dosage

Published on: 28 Jun 2023
Clinically Reviewed by Bisma Anwar, LMHC

Propranolol is a medication that’s in the beta-blocker class of drugs. It works by relaxing blood vessels to reduce heart rate and blood pressure. Propranolol is used to treat high blood pressure, chest pain, tremors, fast heartbeat, migraine, irregular heartbeat, anxiety disorders, and other health conditions. 

If you’re considering taking Propranolol for anxiety or another condition, keep reading. We’re covering everything you need to know about Propranolol uses, side effects, dosage, and more.

What is Propranolol?

Propranolol is an FDA-approved beta-blocker used to treat hypertension, angina, arrhythmias, and more. It also can be used off-label to treat anxiety and social phobia. Like any medication, Propranolol has possible side effects that range from mild fatigue to depression. It’s important to always seek medical advice from your health care provider before starting a new medication. 

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How does Propranolol work?

This drug interferes with specific receptors that cause elevated heart rate and blood pressure. As Propranolol works, the medicine reduces some of the physical symptoms related to anxiety and panic attacks.

How does Propranolol make you feel?

When taken orally or intravenously (IV), Propranolol can quickly reduce symptoms like racing heart and trembling hands. It’s been found to improve performance when taken before an event or activity that causes nervousness or fear. Propranolol can help people who suffer from stage fright or public speaking phobia by allowing them to feel more relaxed.

Propranolol Uses

What is Propranolol used for? Propranolol is FDA-approved to treat multiple conditions. For example, it’s used for tremors, angina (chest pain), hypertension (high blood pressure), heart rhythm disorders, and other heart or circulatory conditions. Propranolol can ward off a heart attack and decrease the strength and recurrence of migraine headaches. As noted, there are also off-label uses for anxiety. 


Tremors are involuntary muscle contractions that can cause shaking. Propranolol can block certain nerve receptors that control muscle contractions, thus reducing their intensity or stopping them altogether. 


Angina is just another name for chest pain. It can be caused by reduced oxygen supply to the heart from narrowed coronary arteries or increased demand for oxygen from physical activity or stress. By blocking certain receptors on nerves that control blood vessels around the heart, Propranolol helps relax vessels so more oxygen-rich blood can reach them and relieve symptoms like chest tightness or heaviness.


Hypertension is caused by a rise in resistance to blood flow through the major arteries leading away from the heart, resulting in elevated systolic pressure readings. By loosening up muscles around large arteries close to the heart, Propranolol can lower this resistance so that more oxygen-rich blood can reach it and reduce hypertension.  

Cardiovascular function

Propranolol’s action on nerve endings controlling cardiovascular function might improve overall cardiac performance, restoring normal sinus rhythm and preventing further arrhythmia-related episodes.  


A severe migraine headache can cause intense pain that’s often accompanied by light sensitivity, nausea, and vomiting. Studies have found evidence showing that daily use of low-dose Propranolol can reduce the frequency and severity of migraine attacks. It’s not fully understood why or how this works, but the ability to modulate vascular response and inflammation around the brain stem area, where most migraines originate, seems to play a part. 

Off-label uses for mental health

Off-label Propranolol uses can treat some types of anxiety disorder and panic disorder. It’s important to note that Propranolol doesn’t actually address the underlying causes of anxiety. What it does do is relieve some of the symptoms by blocking the action of hormones that cause increased heart rate and lead to feelings of stress.

“While effective towards symptomatology for heart disease, it’s also shown efficacy in addressing anxiety symptoms including rapid heartbeat, shaking, and other physical symptoms.”

Talkspace therapist Elizabeth Keohan, LCSW-C, LICSW, LICSW

Pros & Cons of Propranolol

Pros of PropranololCons of Propranolol
Treats several conditions, including hypertension, anxiety disorders, & migrainesFatigue & dizziness
Reduces symptoms & prevents future episodes of certain conditionsCold hands or feet
Low risk of adverse reactions compared to other drugsCan cause heart failure in some people

Side Effects of Propranolol

Some of the known side effects of Propranolol include:

  • Lightheadedness or dizziness
  • Drowsiness
  • Nausea or stomach pain
  • Decreased sex drive
  • Diarrhea or constipation
  • Hair thinning or loss

Less common, but potentially severe, side effects to be aware of include:

  • Hallucinations 
  • Memory loss
  • Muscle weakness or cramping
  • Blood sugar changes
  • Shakiness
  • Fluid retention 
  • Insomnia and nightmares 
  • Allergic reaction
  • Cold hands or feet

If you do take Propranolol and want to stop because of side effects, seek medical advice from your health care provider first before stopping. Propranolol withdrawal symptoms can also bring discomfort and sometimes be severe if you take the medication for a long time and suddenly stop.

Propranolol Dosage

Propranolol comes in multiple forms, including tablets, capsules, solution, and injections. The dosage of Propranolol varies based on individual factors and the condition being treated. It’s available in pill form with 10mg – 160mg strengths. Liquid Propranolol is available in 5mg, 40mg, or 50mg doses. 

Like any medication, you should talk to your doctor about the best dose for your symptoms and condition. Off-label usage for anxiety disorders or social phobia should be used cautiously and only under the close supervision of an experienced mental health care specialist.  

Propranolol for anxiety: 40mg is typically taken one time per day. Dosage can be increased to 40mg and taken 3 times daily with your doctor’s instructions.

How to take Propranolol

Take Propranolol exactly as directed by your doctor. You should take this drug at or around the same time every day. It can be taken with or without food. Do not crush, chew, or break Propranolol capsules — use water to swallow them whole. 

Liquid Propranolol should be taken using careful measurements with the dosing instrument the pharmacy provided you. Do NOT use a kitchen spoon to dose Propranolol. 

Additional Considerations

When taking Propranolol, it’s important to consult your healthcare provider about any interactions and warnings.  


Propranolol can interact with other medications, supplements, or vitamins you may be taking. Inform your physician of any prescription or over-the-counter drugs you’re already taking before you start Propranolol. 

Do not drink alcohol if you’re on Propranolol — it can increase the medication levels in your blood. 


Tell your doctor if you have a history of any of the following, as it may play a role in how (or if) they prescribe Propranolol:

  • Fainting or slow heart rate
  • Asthma
  • Heart failure
  • A severe heart condition
  • Adrenal gland tumor
  • Raynaud’s syndrome or circulation problems
  • Thyroid disorder or condition
  • Peripheral vascular disease

Propranolol Alternatives

Although Propranolol is effective in treating certain conditions, that doesn’t necessarily mean it’s right for you. Different medications can be better suited for some people. 

  • Atenolol: Atenolol is a beta-blocker that’s similar to Propranolol but with a longer half-life. It works by blocking the body’s adrenaline receptors, which helps reduce blood pressure and prevent heart palpitations. It’s often prescribed for those who have difficulty taking Propranolol due to its shorter duration of action. Studies show that Atenolol was effective for 81% of people who took it for anxiety. Side effects can include fatigue, dizziness, and depression.
  • Metoprolol: Metoprolol is another beta-blocker. It works similarly to Atenolol but has a longer half-life, making it ideal for some people to treat social phobia anxiety. Common adverse reactions include exhaustion, sleeplessness, and dry mouth/eyes.

“Though Propranolol effectively addresses anxiety, it is still important to stay connected with your providers, prescribers, and clinicians, understanding that it can help with symptoms, but not necessarily address the emotional or stress difficulty often accompanied. Medications can be beneficial in managing symptoms, but they still warrant the important work of processing and navigating the role of stressors in our lives and how they trigger or manifest in our behaviors. Talk therapy and medication management support can be the best comprehensive care practice.”

–  Talkspace therapist Elizabeth Keohan, LCSW-C, LICSW, LICSW

Online Propranolol Prescription Through Talkspace Psychiatry

Talkspace provides convenient access to mental healthcare services without having to leave home, giving you more control over your care while still receiving professional guidance from licensed professionals whenever needed. By offering personalized prescriptions for Propranolol online, Talkspace users get reliable information about how best to use this drug safely — ensuring maximum benefit with the least amount of risk.

For anyone looking for an easier way to get Propranolol without leaving home, Talkspace Psychiatry offers online prescriptions with no hassle involved. Reach out today to get started. 


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  3. Pal PK. Guidelines for management of essential tremor. Annals of Indian Academy of Neurology. 2011;14(5):25. doi:10.4103/0972-2327.83097. Accessed March 26, 2023.  
  4. Prichard BN. Propranolol in the treatment of angina: a review. Postgrad Med J. 1976;52 Suppl 4:35-41.
  5. Shahrokhi M, Gupta V. Propranolol – StatPearls – NCBI Bookshelf. Propranolol. Published March 3, 2023. Accessed March 26, 2023. 
  6. Jackson JL, Kuriyama A, Kuwatsuka Y, et al. Beta-blockers for the prevention of headache in adults, a systematic review and meta-analysis. PLOS ONE. 2019;14(3). doi:10.1371/journal.pone.0212785. Accessed March 26, 2023.

Talkspace articles are written by experienced mental health-wellness contributors; they are grounded in scientific research and evidence-based practices. Articles are extensively reviewed by our team of clinical experts (therapists and psychiatrists of various specialties) to ensure content is accurate and on par with current industry standards.

Our goal at Talkspace is to provide the most up-to-date, valuable, and objective information on mental health-related topics in order to help readers make informed decisions.

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