Propranolol

Propranolol, sold under the brand name Inderal among others, is a medication of the beta blocker class.[1] It is used to treat high blood pressure, a number of types of irregular heart ratethyrotoxicosiscapillary hemangiomasperformance anxiety, and essential tremors.[1][2][3] It is used to prevent migraine headaches, and to prevent further heart problems in those with angina or previous heart attacks.[1] It can be taken by mouth or by injection into a vein.[1] The formulation that is taken by mouth comes in short-acting and long-acting versions.[1] Propranolol appears in the blood after 30 minutes and has a maximum effect between 60 and 90 minutes when taken by mouth.[1][4]

Common side effects include nauseaabdominal pain, and constipation.[1] It should not be used in those with an already slow heart rate and most of those with heart failure.[1] Quickly stopping the medication in those with coronary artery disease may worsen symptoms.[1] It may worsen the symptoms of asthma.[1] Caution is recommended in those with liver or kidney problems.[1] Propranolol may cause harmful effects in the baby if taken during pregnancy.[5] Its use during breastfeeding is probably safe, but the baby should be monitored for side effects.[6] It is a non-selective beta blocker which works by blocking β-adrenergic receptors.[1]

Propranolol was patented in 1962 and approved for medical use in 1964.[7] It is on the World Health Organization’s List of Essential Medicines, the safest and most effective medicines needed in a health system.[8] Propranolol is available as a generic medication.[1] The wholesale cost in the developing world is between US$0.24 and US$2.16 per month as of 2014.[9] In the United States it costs about $15 per month at a typical dose.[1] In 2016 it was the 43rd most prescribed medication in the United States with more than 18 million prescriptions.[10]