Propranolol Side Effects: What To Expect From the Anxiety Medication

Scott McDougallMPharmDirector & Registered Manager

Reviewed on 8 Sep 2022

Using an anxiety medicine such as Propranolol to treat the physical symptoms of social or performance anxiety can help to make you feel much better. But are there any Propranolol side effects that you need to know about?

Although they are usually rare and mild, if you’re thinking about using this medicine, it is important to find out more about the possible Propranolol side effects that you may experience.

In this article, we’ll be looking at the possible side effects of this medication, including more common side effects, more serious effects and allergic reactions. We will also cover anything else you need to know, including Propranolol weight gain, Propranolol withdrawal, and Propranolol and pregnancy.

Head over to our dedicated ‘Propranolol for anxiety’ page for more general information on Propranolol.

What does Propranolol do?

Propranolol is a beta-blocker; a type of medicine used to treat a number of different health conditions, including heart problems, anxiety, migraines and high blood pressure.

Propranolol 10 mg tablets have many uses. It can be prescribed to treat the physical symptoms and effects of social and situational anxiety, such as sweating, flushing, trembling and a fast heartbeat.

Propranolol slows down your heart rate, making it easier for your heart to pump blood around your body.

There are different strength dosages and different forms of Propranolol (such as tablets, capsules, or a liquid you can swallow). Depending on the health condition that needs treating, you will be prescribed a certain course of treatment by your doctor or pharmacist.

Summary list of Propranolol side effects

Not everyone will experience side effects when they take Propranolol tablets.

The majority of users won’t experience any negative side effects of Propranolol at all — most people who use the medication have an overwhelmingly positive experience.

However, as with any medicine, there is still a chance that side effects may occur. That is why it’s a good idea to stay informed of the potential side effects that you might experience before starting a new course of medication or medical treatment.

Below is a summary list of the known Propranolol side effects:

Fatigue or drowsiness
Dizziness
Lightheadedness
Feeling weak
Slow or irregular heartbeat
Insomnia or other sleeping problems
Nightmares
Cold fingers and toes
Raynaud’s syndrome
Difficulty breathing or breathlessness
Wheezing
Tightness in chest
Cough producing mucus
General congestion
Feeling sick (nausea)
Being sick (vomiting)
Digestive problems like constipation or diarrhoea
Weight gain
Fluid retention
Headache
Dry eyes
Conjunctivitis
Visual disturbances like double vision or disturbed colour perception
Hair loss (Alopecia)
Dry skin (including cracked or peeling skin)
Muscle weakness and cramps
Joint pain
Low blood sugar levels
Excessive sweating
Confusion
Memory loss
Mood changes
Psychosis or hallucinations (disturbances of the mind)
Changes in sex drive or sexual performance (such as erectile dysfunction)
Skin rashes or exacerbation of exciting skin conditions like psoriasis
Disturbance to liver function and jaundice
Heart failure or worsening of heart problems

As you can see, the possible side effects of Propranolol vary from the mild to the more serious symptoms.

The likelihood of experiencing any of the side effects will depend on the individual; however, the more serious Propranolol side effects are very unusual, affecting less than one in 10,000 patients.

This is particularly true with the low doses you would take for treating performance anxiety. At such a low dose of Propranolol, any side effects will be very mild.

If you are concerned about any of the side effects listed above, or you are worried that you are experiencing any severe, persistent or painful side effects due to this medicine, you should consult your doctor for further guidance straight away.

It is also worth noting that this list is not definitive. If you are concerned that you are experiencing a potential Propranolol side effect that is not mentioned above, speak to your GP.

What are the most common side effects of Propranolol?

Below we have listed the more common side effects and symptoms that may occur as a result of taking Propranolol tablets for social anxiety.

The more common Propranolol 10 mg side effects (which may affect up to 1 in 10 people) include:

Fatigue
Disturbed sleep (insomnia)
Nightmares
Breathlessness
Cold fingers and toes
A slow or irregular heartbeat
Raynaud’s syndrome (a common condition which affects your blood circulation, characterised by white/blue/yellow finger or toes, numbness and spasms)

These symptoms will tend to go away as you continue taking the medicine and your body gets used to it. These more common Propranolol side effects do not usually need medical attention.

These side effects will also be very mild at low doses like the ones used for situational anxiety.

If you are concerned at all, speak to your doctor or pharmacist for advice.

Serious side effects and symptoms

Serious side effects of Propranolol are very unusual.

However, despite it being rare, it is possible for some users to experience serious side effects when taking Propranolol. That’s why it is a good idea to be aware of the symptoms to look out for, should these side effects occur.

Serious side effects and their symptoms include:

Disturbance in liver function and jaundice — signs of this are yellowing of your skin or the whites of your eyes
Heart problems — symptoms of this are chest pain, an irregular heartbeat, shortness of breath, a cough which gets worse when you exert yourself, swollen ankles or legs
Lung or breathing problems — symptoms include shortness of breath, wheezing, tightness in your chest

If you notice any signs or symptoms of the above serious side effects, you should seek medical attention and tell your doctor straight away.

Likewise, if your symptoms feel dangerous or life-threatening in any way, or you experience sudden chest pain or difficulty breathing, you should call emergency services.

Allergic reactions

A serious allergic reaction (anaphylaxis) to Propranolol tablets is very rare, but it can happen.

You should seek medical attention immediately if you notice any of the below symptoms and signs of a serious allergic reaction:

Any skin rashes including itchy, red, swollen, blistered or peeling skin
Tightness in the chest or throat
Trouble breathing such as breathlessness or wheezing
Swelling, particularly of the face, mouth, lips, tongue or throat
Trouble talking
Severe dizziness

These signs indicate a serious allergic reaction to Propranolol, and this must be treated as an emergency. Get emergency medical attention immediately by calling 999 or going to A&E.

Propranolol withdrawal

If you are going to stop taking Propranolol, it is a good idea to wean yourself off your normal course of treatment gradually.

This is because you may experience Propranolol withdrawal symptoms if you come off this medicine too quickly. These can include an irregular heart rate, sweating and shaking.

Stopping Propranolol suddenly without weaning yourself off it may also make your health problem worse.

It is best to gradually reduce your Propranolol dosage over the course of around two to four weeks. This will help your body to adjust to the changing levels of Propranolol in your system.

Once you do stop, it will take around one to two days for it to be completely out of your body.

If you are worried about Propranolol withdrawal or Propranolol withdrawal symptoms at all, then speak to your doctor or pharmacist about a plan to steadily decrease your use of the medicine.

Propanolol withdrawal is most likely to occur in those who take larger doses every day for long periods. Taking 10mg - 40mg occasionally to treat the physical symptoms of situational anxiety is very unlikely to lead to withdrawal.

Propranolol and weight gain

Certain beta-blockers like Propranolol can sometimes cause weight gain. However, this is unusual.

Propranolol weight gain is down to two reasons. Firstly, Propranolol very slightly reduces the body’s ability to burn fat. Secondly, Propranolol causes your body to retain more fluid than normal, leading to an increase in your body weight.

This weight gain isn’t usually noticeable (around a few pounds is average), and it is also far less likely at the dose used for anxiety treatment (the 10mg tablets).

If you are worried about Propranolol and weight gain, there are a few things you can do. A healthy and balanced diet, as well as keeping up a regular exercise regime will help to maintain your weight. Lifestyle changes like this will also help to manage your anxiety too, so there are multiple benefits.

Propranolol and pregnancy

It is thought that Propranolol isn't harmful during pregnancy to either the mother or baby.

However, it isn’t possible to be certain; not enough research has been done into the effects of Propranolol during pregnancy to be sure.

If you are pregnant or planning to get pregnant, then you should speak to your doctor about using Propranolol. They will be able to tell you more about the benefits and possible harms of taking Propranolol during pregnancy and might suggest taking it only if the benefits outweigh the potential risk.

There may also be other medicines that are safer for you.

Propranolol and asthma

Sometimes, existing health conditions can affect whether a medicine is suitable for you.

If you have asthma or a history of asthma, then you should tell your doctor about this when you are looking into treatments for social anxiety.

People with breathing disorders, such as asthma, bronchitis or emphysema, are generally told not to take Propranolol. This is because it can mean that your inhaler is less effective when you need it.

Propranolol can cause the airways to narrow and become more sensitive, making asthma worse, which can be dangerous and even life-threatening.

Does Propranolol make you tired?

Tiredness is one of the more common side effects of Propranolol. You may experience this as drowsiness or fatigue. Some users also experience insomnia and other sleeping problems, which exacerbates the tiredness.

If you feel tired or dizzy after taking Propranolol, you should lie or sit down until you feel better.

If you are taking Propranolol for the very first time, you may feel dizzy and tired, so your doctor will probably suggest taking it just before bedtime. As your body gets used to Propranolol, this side effect (and others) should start to wear off.

You should also avoid combining Propranolol and alcohol as this will exacerbate any tiredness or dizziness you are feeling and make you feel worse.

Summary

Propranolol is a type of prescription-only medicine that is used to treat a range of different health conditions, including anxiety, heart problems and migraines.

Low-dose Propranolol tablets can be used to help quickly alleviate the physical symptoms of performance or situational anxiety such as flushing, shaking, sweating and a high heart rate.

Most people who use Propranolol will not experience any negative side effects and will have a very positive experience with this medicine. This is particularly the case with the low strength dosage prescribed for treating social anxiety.

However, there are possible Propranolol side effects to be aware of. More common side effects (affecting over one in 10 users) include fatigue, insomnia, cold extremities, Raynaud’s syndrome, nightmares, and a slow or irregular heartbeat. These symptoms tend to go away as you continue taking the medicine and generally don’t need medical attention.

If you encounter any severe or distressing Propranolol tablets side effects, you should contact your doctor or pharmacist for advice on how to proceed.