PROPRANOLOL is used for treating high blood pressure or atrial fibrillation. It is used in patients with angina to decrease angina frequency and increase exercise tolerance. It is used to decrease the risk of heart death in certain patients who have survived a heart attack. It is used to manage certain types of tremors, a heart condition called hypertrophic subaortic stenosis, or certain symptoms of pheochromocytoma (an adrenal tumor). It is used to prevent migraine headaches. It may also be used for other conditions as determined by your doctor.

Inderal is a beta-blocker. It works by slowing down the heart and decreasing the amount of blood it pumps out. This helps to decrease blood pressure, helps the heart pump more efficiently, and reduces the workload on the heart. Exactly how Inderal works to treat migraines or tremors is not known.

What should I tell my health care providers before I take this medicine?

They need to know if you have any of these conditions:

• circulation problems or blood vessel disease
• diabetes
• asthma or Raynaud syndrome
• history of heart attack or heart disease, vasospastic angina
• kidney disease
• liver disease
• lung or breathing disease, like asthma or emphysema
• pheochromocytoma
• slow heart rate
• thyroid disease
• an unusual or allergic reaction to propranolol, other beta-blockers, medicines, foods, dyes, or preservatives
• pregnant or trying to get pregnant
• breast-feeding

How should I use this medicine?

Take this medicine by mouth with a glass of water. Follow the directions on the prescription label. Take your doses at regular intervals. Do not take your medicine more often than directed. Do not stop taking except on your the advice of your doctor or health care professional.

What if I miss a dose?

If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses.

What may interact with this medicine?

Do not take this medicine with any of the following:

• feverfew
• phenothiazines
• mibefradil
• sotalol

This medicine may also interact with the following:

• aluminum hydroxide gel
• antipyrine
• barbiturates like phenobarbital
• cimetidine
• ciprofloxacin
• diazepam
• fluconazole
• haloperidol
• isoniazid
• medicines for cholesterol like cholestyramine or colestipol
• medicines to control heart rhythm
• medicines for high blood pressure
• medicines for HIV
• medicines for mental depression
• medicines for migraine headache like almotriptan, eletriptan, frovatriptan, naratriptan, rizatriptan, sumatriptan, zolmitriptan
• NSAIDs, medicines for pain and inflammation, like ibuprofen or naproxen
• phenytoin
• rifampin
• teniposide
• theophylline
• thyroid medicines
• tolbutamide
• warfarin
• zileuton

This list may not describe all possible interactions. Give your health care providers a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What side effects may I notice from this medicine?

Side effects that you should report to your doctor or health care professional as soon as possible:

• allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue
• breathing problems
• changes in blood sugar
• chest pain
• cold hands or feet
• difficulty sleeping, nightmares
• dry peeling skin
• fever with aching and sore throat
• hallucinations
• memory loss
• mental or mood changes
• muscle cramps or weakness
• persistent or severe vision changes
• red, swollen, blistered, or peeling skin
• slow heart rate
• shortness of breath or wheezing
• swelling of the mouth, face, lips, legs or ankles
• vomiting

Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):

• change in sex drive or performance
• diarrhea
• dry sore eyes
• fatigue
• hair loss
• lightheadedness
• nausea
• stomach upset or cramping
• trouble sleeping
• vomiting
• weak or tired

This list may not describe all possible side effects.

What should I watch for while using this medicine?

Visit your doctor or health care professional for regular check ups. Check your blood pressure and pulse rate regularly. Ask your health care professional what your blood pressure and pulse rate should be, and when you should contact them.

You may get drowsy or dizzy. Do not drive, use machinery, or do anything that needs mental alertness until you know how this drug affects you. Do not stand or sit up quickly, especially if you are an older patient. This reduces the risk of dizzy or fainting spells. Alcohol can make you more drowsy and dizzy. Avoid alcoholic drinks.

This medicine can affect blood sugar levels. If you have diabetes, check with your doctor or health care professional before you change your diet or the dose of your diabetic medicine.

Do not treat yourself for coughs, colds, or pain while you are taking this medicine without asking your doctor or health care professional for advice. Some ingredients may increase your blood pressure.

Do not suddenly stop taking Inderal . Sharp chest pain, irregular heartbeat, and sometimes heart attack may occur if you suddenly stop Inderal . The risk may be greater if you have certain types of heart disease. Your doctor should slowly lower your dose over several weeks if you need to stop taking it. This should be done even if you only take Inderal for high blood pressure. Heart disease is common and you may not know you have it. Limit physical activity while you are lowering your dose. If new or worsened chest pain or other heart problems occur, contact your doctor right away. You may need to start taking Inderal again.

Where should I keep this medicine?

Store between 68 and 77 degrees F (20 and 25 degrees C). Brief storage at temperatures between 59 and 86 degrees F (15 and 30 degrees C) is permitted. Store away from heat, moisture, and light. Do not store in the bathroom. Keep out of the reach of children and away from pets.