Propranolol INDIA

Propranolol: A Non-Selective Beta Blocker for Cardiovascular, Neurological, and Stress-Related Disorders

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🩺 What is Propranolol?

Propranolol is a first-generation, non-selective beta-adrenergic receptor blocker used to treat a wide range of conditions including hypertension, angina, arrhythmias, anxiety, and migraine prophylaxis. It was the first beta blocker developed and remains a foundational agent in cardiovascular and neuropsychiatric medicine.

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⚙️ Mechanism of Action

Propranolol blocks both β1 and β2-adrenergic receptors:

• β1 blockade (heart): Decreases heart rate, contractility, and cardiac output → reduces blood pressure and oxygen demand.
• β2 blockade (lungs, vasculature): May cause bronchoconstriction, peripheral vasoconstriction, and metabolic effects (e.g., decreased glycogenolysis).

Its lipophilic nature also allows it to cross the blood-brain barrier, contributing to central nervous system effects like anxiolysis and tremor control.

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📋 Indications

Cardiovascular:

• Hypertension (alone or in combination)
• Angina pectoris
• Supraventricular arrhythmias (e.g., atrial fibrillation)
• Post-myocardial infarction (MI) secondary prevention
• Hypertrophic subaortic stenosis

Neurological & Psychiatric:

• Migraine prophylaxis
• Essential tremor
• Anxiety (especially performance anxiety)
• PTSD-related symptoms (off-label)

Other Uses:

• Hyperthyroidism (adjunctive)
• Pheochromocytoma (with alpha-blockers)
• Portal hypertension (reduces risk of esophageal variceal bleeding)

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💊 Dosage and Administration

Typical adult dosing regimens:

Indication	Dose Range
Hypertension	40–160 mg BID
Migraine prophylaxis	80–160 mg/day
Anxiety (situational)	10–40 mg 30 mins before event
Essential tremor	40–120 mg/day
Post-MI	180–240 mg/day