Propranolol: Difference between revisions
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Latest revision as of 21:56, 20 March 2026
General
- Type: Beta blockers, nonselective
- Dosage Forms:
- IV: 1mg/mL
- PO conventional: 10, 20, 40, 60, 80mg
- PO extended release: 60, 80, 120, 160mg
- Common Trade Names: Inderal
Adult Dosing
- Thyroid storm
- 1-2mg IV over 10 min; if tolerates then 1-2mg boluses q15 minutes until HR <100
- May follow with drip @ dose required for HR control (ie 3-5mg/hr)
- Alternate 60-80mg PO q4h
- Variceal bleed ppx
- 20mg BID titrated up to max tolerated dose
- Migraine ppx
- Starting dose 80mg daily as either XL or divided q6-8hr. Max 160-240mg/day
- Essential tremor
- 40mg BID starting dose
- HOCM
- 80-160mg daily as either XL or divided q6-8 hr
- Akathisia
- 10mg bid-tid starting dose. Max 120mg / day
Pediatric Dosing
Special Populations
- Pregnancy Rating: Category C; risk of IUGR, neonatal hypoglycemia/bradycardia/respiratory depression. Still preferred agent for thyrotoxicosis
- Lactation: Enters breast milk
- Renal Dosing: N/A
- Hepatic Dosing: N/A
Contraindications
- Allergy to class/drug
- Decompensated heart failure, except high output failure secondary to tachyarrhythmia
- Bradycardia / high degree heart block
Adverse Reactions
Serious
- Rebound symptoms with abrupt withdrawal of treatment
- Heart failure
- Agranulocytosis, thrombocytopenia
- Bronchospasm
- SJS/TEN
Common
- Bradycardia
- Orthostasis
Pharmacology
- Half-life: 3-6 hrs, 8-10 hrs extended release
- Metabolism: Hepatic
- Excretion: Urine
- Mechanism of Action: Nonselective β-blocker
Indications by Condition
The following table is automatically generated from disease/condition pages across WikEM.
| Indication | Dose | Context | Route | Population |
|---|---|---|---|---|
| Congenital heart disease | 0.2mg/kg IV | Tet spell (TOF), relieves infundibular spasm | IV | Pediatric |
| Electrical storm | 1mg IV q5min up to 0.15mg/kg | Sympathetic blockade | IV | Adult |
| Thyroid storm | 60-80 mg PO q4h; or 1-2 mg IV over 10 min, then 1-2 mg IV q15min until HR <100, then 3-5 mg/hr drip | Beta-blocker (1st line, also blocks T4→T3) | PO/IV | Adult |
See Also
References
Lexicomp