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Non-selective β-blocker

Propranolol hydrochloride

Brand names: Inderal

Used in: Liver Disease & Cirrhosis Headache & Migraine

Propranolol is a non-selective beta-blocker used for arrhythmias, angina, hypertension, migraine prophylaxis, essential tremor, performance/somatic anxiety, and symptom control in thyrotoxicosis.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

US labelling (FDA)

Reference — US labelling, may differ from UK

DOSAGE AND ADMINISTRATION General Because of the variable bioavailability of propranolol, the dose should be individualized based on response. Hypertension The usual initial dosage is 40 mg propranolol hydrochloride twice daily, whether used alone or added to a diuretic. Dosage may be increased gradually until adequate blood pressure control is achieved. The usual maintenance dosage is 120 mg/day to 240 mg per day. In some instances a dosage of 640 mg a day may be required. The time needed for full antihypertensive response to a given dosage is variable and may range from a few days to several weeks. While twice-daily dosing is effective and can maintain a reduction in blood pressure …

Source: US FDA prescribing information (openFDA / DailyMed), label dated 2024-08-09. Accessed 2026-06-12. US dosing and indications can differ from UK practice — use UK sources for prescribing decisions.

Clinical monograph

How it works

It blocks both β1 and β2 adrenoceptors, reducing heart rate and contractility and blunting the effects of circulating catecholamines.

Prescribing in practice

  • Avoid in asthma — being non-selective it can cause severe bronchospasm.
  • Do not stop abruptly in ischaemic heart disease (rebound), and be aware it can mask the warning signs of hypoglycaemia.
  • It is used at different doses for its different indications.

Monitoring

Monitor heart rate and blood pressure and review the response for the specific indication.

Counselling the patient

  • Do not stop it suddenly.
  • Report wheeze, a very slow pulse, or dizziness.
  • Tiredness or cold hands can occur, especially early on.

Evidence & guidelines

Used across cardiac and non-cardiac indications, including migraine prophylaxis (NICE NG150).

Reference: NICE NG136/CG150/NG217; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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