5 Foods to Avoid When Taking Carvedilol (and Other Beta Blockers)
Beta blockers treat hypertension. When taking a beta blocker like carvedilol, it’s best to avoid foods that may counteract or interfere with the medication.
propranolol
Used for Adrenal Cancer, Angina, Atrial Fibrillation, Essential Tremor, Heart Attack, Hypertension, Migraine
Used for Adrenal Cancer, Angina, Atrial Fibrillation, Essential Tremor, Heart Attack, Hypertension, Migraine
Propranolol is a non-selective beta blocker. It can treat several health problems, such as high blood pressure and tremors. It can also help prevent migraines. Sometimes, it's used off-label to help with performance anxiety. Propranolol comes as immediate-release (IR) tablets and an oral solution. It also comes as extended-release (ER) capsules. The medication is taken by mouth, but IR and ER forms have different uses and dosing schedules. Common side effects include dizziness, tiredness, and weakness.
What is Propranolol?
What is Propranolol used for?
- High blood pressure - propranolol IR and all ER capsules
- Chronic chest pain (angina) - propranolol IR and Inderal LA
- Hypertrophic subaortic stenosis - propranolol IR and Inderal LA
- Atrial fibrillation (AFib) - propranolol IR only
- Heart protection after a heart attack - propranolol IR only
- Migraine prevention - propranolol IR and Inderal LA
- Tremors - propranolol IR only
- Pheochromocytoma (a rare tumor of the adrenal gland) - propranolol IR only
How Propranolol works
Propranolol is a non-selective beta blocker. It blocks beta receptors in your body, including those found on your heart. This blocks the effects of certain stress hormones, such as adrenaline. This helps slow your heart rate, lower your blood pressure, and reduce shaking (tremors).
Drug facts
| Common Brands | Inderal LA, Inderal XL, InnoPran XL |
|---|---|
| Drug Class | Beta blocker |
| Controlled Substance Classification | Not a controlled medication |
| Generic Status | Lower-cost generic available |
| Availability | Prescription only |
More on Propranolol essentials
Side effects of Propranolol
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Dizziness or lightheadedness
- Tiredness
- Weakness
Less Common Side Effects
- Slow heart rate (bradycardia)
- Nausea or vomiting
- Constipation
- Diarrhea
- Stomach cramps
- Dry eyes
- Trouble sleeping
Propranolol serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Heart problems: chest pain; trouble breathing; feeling very tired; swelling in the legs, ankles, or feet
- Sudden tightening in the lungs: trouble breathing, trouble catching your breath, wheezing, cough, dizziness
- Allergic reaction: hives; trouble breathing; swelling of the lips, throat, or face
- Severe skin reaction: rash, blistering or peeling skin, skin pain, fever
When do Propranolol possible side effects begin and end?
Time passed since treatment started:
M
H
D
W
M
Dizziness
Tiredness
Feeling weak
Constipation
Trouble sleeping
Trouble breathing
Seek immediate medical care if you experience this side effect.
If a line continues to the right, you'll likely keep experiencing this side effect once it starts.
More on Propranolol side effects
The following Propranolol side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
Incidence not known
Abdominal or stomach pain and tenderness
black, tarry stools
blistering, peeling, or loosening of the skin
blood in the urine
bloody nose
bloody stools
blurred or loss of vision
body aches or pain
burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
chest pain or discomfort
confusion about identity, place, and time
congestion
cracks in the skin
crying
decreased awareness or responsiveness
decreased urine output
depersonalization
difficulty with swallowing
dilated neck veins
disturbed color perception
dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
double vision
dryness or soreness of the throat
dysphoria
euphoria
extreme fatigue
fast, pounding, slow, or irregular heartbeat
fever and chills
general feeling of discomfort, illness, or weakness
halos around lights
headaches
heavier menstrual periods
hoarseness
irregular breathing
lightheadedness, dizziness, or fainting
loss of heat from the body
mental depression
mimicry of speech or movements
muscle or joint pain
mutism
negativism
night blindness
noisy breathing
overbright appearance of lights
paleness or cold feeling in the fingertips and toes
paranoia
peculiar postures or movements, mannerisms, or grimacing
pinpoint red or purple spots on the skin
puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
quick to react or overreact emotionally
rapidly changing moods
rectal bleeding
red skin lesions, often with a purple center
red, irritated eyes
red, swollen skin
reddening of the skin, especially around the ears
seeing, hearing, or feeling things that are not there
severe sleepiness
short-term memory loss
skin irritation or rash, including rash that looks like psoriasis
sores, ulcers, or white spots in the mouth or on the lips
sweating
swelling of the eyes, face, fingers, feet, or lower legs
swollen glands
tender, swollen glands in the neck
tightness in the chest
tingling or pain in fingers or toes when exposed to cold
tunnel vision
unusual bleeding or bruising
unusual tiredness or weakness
voice changes
vomiting
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
in children
hyperventilation
irritability
restlessness
shaking
sleepiness or unusual drowsiness
trouble sleeping
unusual dreams
Less common
in children
Decreased appetite
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Pros and cons of Propranolol
Pros
- Helps with many conditions, including high blood pressure and migraine prevention
- IR version also comes as an oral solution for people who have trouble swallowing pills
- Long-acting (ER) version only needs to be taken once a day
Cons
- Not safe for people with asthma or certain serious heart conditions
- Can hide signs of low blood sugar, like a fast heartbeat
- Stopping suddenly can raise your risk of chest pain or heart attack
Pharmacist tips for Propranolol
- Take propranolol as prescribed, around the same time(s) each day. Immediate-release (IR) propranolol is usually taken a few times a day. Extended-release (ER) propranolol is taken once a day. Follow your prescriber's instructions for when to take each dose.
- For brand-name Inderal XL or InnoPran XL capsules: Take your dose once a day at bedtime. Take it the same way each day, either with food or on an empty stomach.
- For propranolol liquid: Measure each dose with a dosing cup or oral syringe from the pharmacy. Don't use kitchen spoons because you might get the wrong dose. Store the liquid at room temperature.
- Propranolol can make you feel dizzy or lightheaded. This usually happens when you first start taking it or when your dose goes up. These side effects tend to go away over time. But to help, get up slowly after sitting or lying down. If you feel dizzy, sit or lie down until you feel better. Don't drive or use heavy machines until you know how propranolol affects you.
- If you have diabetes, check your blood sugar as your care team tells you to. Propranolol can hide some signs of low blood sugar, such as a fast heartbeat or shaking. This can make it harder to know when your blood sugar is too low.
- Tell your prescriber and pharmacist about all the medications you take. Propranolol can interact with some medications. For example, verapamil and diltiazem (Cardizem) can slow your heart rate too much when taken with propranolol. It can also make rescue inhalers like albuterol (Ventolin) work less well. Your care team can check if your medications are safe to take together.
- Don't stop taking propranolol suddenly without talking to your prescriber. Stopping too quickly can cause your blood pressure to rise. It can also sometimes lead to serious heart problems, like chest pain. Your prescriber can help you lower your dose slowly if you need to stop treatment.
- If you're pregnant or plan to become pregnant: Tell your prescriber. Taking propranolol late in pregnancy can sometimes cause a slow heartbeat or low blood sugar in newborn babies. Your prescriber can explain the risks and benefits and help find the right option for you.
- If you're breastfeeding or plan to breastfeed: Let your prescriber know. Propranolol passes into breast milk in small amounts. Your prescriber can help you decide if propranolol is right for you.
Risks and warnings for Propranolol
Propranolol can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Risks of stopping propranolol suddenly
- Risk factors: Coronary artery disease
If you're been taking propranolol for a long time, don’t suddenly stop taking it without talking to your prescriber. Stopping suddenly can lead to serious problems. This can include worsening chest pain or abnormal heart rhythm. In some cases, a heart attack has happened.
If you need to stop propranolol, your prescriber will usually lower your dose slowly over 1 to 2 weeks. Tell your care team right away if you have new or worsening chest pain while lowering your dose or after stopping propranolol. Get medical help right away if you notice chest pain that spreads to arms and neck, shortness of breath, lightheadedness, or fatigue. These could be signs of a heart attack.
Risk of heart failure
- Risk factors: Heart failure
Beta blockers like propranolol can make your heart pump less strongly. In some people, this can lead to or worsen heart failure.
Before taking propranolol, tell your prescriber if you have heart failure. It's usually best to avoid propranolol if your heart failure isn't well controlled. But you might still be able to take it if your condition is stable and your care team watches you closely. Your prescriber can make sure propranolol is safe for you.
Tell your care team right away if you notice new or worsening signs of heart failure. These include swelling in your legs, ankles, or feet. Other signs are trouble breathing or feeling very tired. Your prescriber might need to lower your propranolol dose or stop the medication.
Risk of trouble breathing
- Risk factors: Asthma | Chronic obstructive pulmonary disease (COPD) | Other lung problems
Beta blockers like propranolol are generally not recommended for people with conditions that can cause breathing problems, such as asthma or COPD. Beta blockers can block beta receptors in the lungs. This can cause the vessels in your lungs to tighten and make it harder to breathe.
Tell your prescriber if you have asthma or another lung condition before taking propranolol. They can check that the medication is right for you.
Hiding symptoms of low blood sugar
- Risk factors: Diabetes | Fasting before surgery | Not eating regularly | Vomiting often
Propranolol can make it harder to notice early signs of low blood sugar. It can hide symptoms like a fast heartbeat or tremors. This is especially important if you use insulin or take diabetes medications, like glipizide. These medications can lower your blood sugar.
If you have diabetes, tell your prescriber. Ask them when and how often to check your blood sugar while taking propranolol. This can help you catch low blood sugar even if you don't notice the usual symptoms. Keep in mind that sweating might still happen even when other symptoms are hidden. Get emergency mdical help if you have severe low blood sugar.
Effects on hyperthyroidism
Propranolol can hide signs of hyperthyroidism, such as a fast heartbeat. If you have hyperthyroidism, don't suddenly stop taking propranolol. This can make your thyroid symptoms worse. Rarely, it can cause a serious condition called a thyroid storm. Talk to your prescriber before stopping the medication.
Effects during anesthesia and surgery
- Risk factors: Major surgery requiring anesthesia
Before any major surgery, tell your surgery care team that you take propranolol. This medication can affect how your heart responds to the effects of anesthesia and surgery. Your care team might need to watch your heart rate and blood pressure closely. Don't stop propranolol before surgery unless your care team tells you to.
Allergic reactions and skin reactions
In rare cases, propranolol can cause serious allergic reactions, like anaphylaxis. Get emergency medical help if you have hives, swelling of your face or throat, or trouble breathing.
Propranolol can also rarely cause serious skin reactions. Call for urgent medical help if you notice a severe rash, skin blisters, or peeling skin.
Severe allergic reactions might be harder to treat
- Risk factors: History of severe allergic reaction
If you've had a severe allergic reaction in the past, tell your prescriber before taking propranolol. Beta blockers like propranolol might make a future allergic reaction more severe. They can also make the usual dose of epinephrine used to treat a severe allergic reaction work less well. Talk to your care team about what to do if you have an allergic reaction.
Propranolol dosage
The average cost for 60 tablets of 10mg of Propranolol is $13.00 with a free GoodRx coupon. This is 15.86% off the average retail price of $15.45.
Typical dosage for Propranolol
-
Immediate-release propranolol - generic tablets and oral solution
- High blood pressure: The typical starting dose is 40 mg by mouth twice a day. The typical maintenance dose ranges from 120 mg to 240 mg per day.
- Chronic angina: The typical dose ranges from 80 mg to 320 mg by mouth per day. The daily dose is split into smaller doses taken 2 to 4 times a day.
- Atrial fibrillation (AFib): The typical dose ranges from 10 mg to 30 mg by mouth 3 or 4 times a day before meals and at bedtime.
- Heart protection after a heart attack: The typical starting dose is 40 mg by mouth 3 times a day. The typical maintenance dose ranges from 60 mg to 80 mg 3 times a day.
- Hypertrophic subaortic stenosis: The typical dose ranges from 20 mg to 40 mg by mouth 3 or 4 times a day before meals and at bedtime.
- Migraine prevention: The typical starting dose is 80 mg by mouth per day, split up into smaller doses throughout the day. The typical maintenance dose ranges from 160 mg to 240 mg by mouth per day, split into smaller doses.
- Tremors: The typical starting dose is 40 mg by mouth twice a day. The typical maintenance dose is 120 mg per day, split into smaller doses.
- Pheochromocytoma: The typical dose is 60 mg by mouth per day, split into smaller doses for 3 days before surgery. If surgery isn't possible, the typical dose is 30 mg by mouth per day, split into smaller doses.
-
Propranolol extended-release - generic capsules and Inderal LA
- High blood pressure: The typical starting dose is 80 mg by mouth once a day. The typical maintenance dose ranges from 120 mg to 160 mg once a day.
- Chronic angina: The typical starting dose is 80 mg by mouth once a day. The typical maintenance dose is 160 mg once a day.
- Hypertrophic subaortic stenosis: The typical dose ranges from 80 mg to 160 mg by mouth once a day.
- Migraine prevention: The typical starting dose is 80 mg by mouth once a day. The typical maintenance dose ranges from 160 mg to 240 mg once a day.
-
Propranolol extended-release - Inderal XL and Innopran XL
- High blood pressure: The typical starting dose is 80 mg by mouth once a day at bedtime. The maximum dose is 120 mg once a day at bedtime.
More on Propranolol dosage
Interactions between Propranolol and other drugs
Propranolol may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with Propranolol. Please note that only the generic name of each medication is listed below.
More on Propranolol interactions
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Abametapir
- Albuterol
- Bupivacaine
- Bupivacaine Liposome
- Bupropion
- Capmatinib
- Ceritinib
- Clonidine
- Crizotinib
- Darunavir
- Diatrizoate
- Diltiazem
- Dronedarone
- Epinephrine
- Eslicarbazepine Acetate
- Fenoldopam
- Fingolimod
- Fluoxetine
- Formoterol
- Haloperidol
- Indacaterol
- Iobenguane I 131
- Iohexol
- Lacosamide
- Lercanidipine
- Levalbuterol
- Lidocaine
- Mefloquine
- Mepivacaine
- Olodaterol
- Oxymetazoline
- Peginterferon Alfa-2b
- Pixantrone
- Ponesimod
- Prilocaine
- Rivastigmine
- Salmeterol
- Simeprevir
- Siponimod
- Terbutaline
- Verapamil
- Vilanterol
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Acarbose
- Aceclofenac
- Acemetacin
- Acetyldigoxin
- Albiglutide
- Alfuzosin
- Alogliptin
- Aluminum Carbonate, Basic
- Aluminum Hydroxide
- Aluminum Phosphate
- Amtolmetin Guacil
- Arbutamine
- Aspirin
- Bromfenac
- Bufexamac
- Bunazosin
- Calcium Carbonate
- Canagliflozin
- Celecoxib
- Chlorpromazine
- Chlorpropamide
- Cholestyramine
- Choline Salicylate
- Cimetidine
- Clonixin
- Dapagliflozin
- Deslanoside
- Dexibuprofen
- Dexketoprofen
- Diclofenac
- Diflunisal
- Digitoxin
- Digoxin
- Dihydroergotamine
- Dihydroxyaluminum Aminoacetate
- Dihydroxyaluminum Sodium Carbonate
- Dipyrone
- Disopyramide
- Doxazosin
- Droxicam
- Dulaglutide
- Empagliflozin
- Ergotamine
- Ertugliflozin
- Etodolac
- Etofenamate
- Etoricoxib
- Exenatide
- Felbinac
- Fenoprofen
- Fepradinol
- Feprazone
- Flecainide
- Floctafenine
- Flufenamic Acid
- Flurbiprofen
- Fluvoxamine
- Glimepiride
- Glipizide
- Glyburide
- Guggul
- Ibuprofen
- Indomethacin
- Insulin Aspart, Recombinant
- Insulin Degludec
- Insulin Detemir
- Insulin Glargine, Recombinant
- Insulin Glulisine
- Insulin Human Inhaled
- Insulin Human Isophane (NPH)
- Insulin Human Regular
- Insulin Lispro, Recombinant
- Ketoprofen
- Ketorolac
- Linagliptin
- Liraglutide
- Lixisenatide
- Lornoxicam
- Loxoprofen
- Lumiracoxib
- Magaldrate
- Meclofenamate
- Mefenamic Acid
- Meloxicam
- Metformin
- Metildigoxin
- Mibefradil
- Miglitol
- Morniflumate
- Moxisylyte
- Nabumetone
- Naproxen
- Nateglinide
- Nepafenac
- Niflumic Acid
- Nimesulide
- Nimesulide Beta Cyclodextrin
- Oxaprozin
- Oxyphenbutazone
- Parecoxib
- Phenoxybenzamine
- Phentolamine
- Phenylbutazone
- Phenylephrine
- Piketoprofen
- Pioglitazone
- Piperine
- Piroxicam
- Pramlintide
- Pranoprofen
- Prazosin
- Proglumetacin
- Propoxyphene
- Propyphenazone
- Proquazone
- Quinidine
- Repaglinide
- Rifapentine
- Rizatriptan
- Rofecoxib
- Rosiglitazone
- Salicylic Acid
- Salsalate
- Saxagliptin
- Sertraline
- Sitagliptin
- Sodium Salicylate
- St John's Wort
- Sulindac
- Tamsulosin
- Tenoxicam
- Terazosin
- Tiaprofenic Acid
- Tolazamide
- Tolbutamide
- Tolfenamic Acid
- Tolmetin
- Trimazosin
- Tubocurarine
- Urapidil
- Valdecoxib
- Vildagliptin
- Zileuton
How much does Propranolol cost?
To access savings, use a GoodRx coupon and pay just a fraction of the retail price.
Propranolol (generic)
$11.62
Propranolol contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Propranolol will not be safe for you to take.
- Cardiogenic shock
- Low heart rate (bradycardia) and greater than a first-degree heart block
- Asthma
What are alternatives to Propranolol?
There are a number of medications that your doctor can prescribe in place of Propranolol. Compare a few possible alternatives below.
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Propranolol images
