Propranolol

This information from Lexicomp® explains what you need to know about this medication, including what it’s used for, how to take it, its side effects, and when to call your healthcare provider.

Brand Names: US

Hemangeol; Inderal LA; Inderal XL; InnoPran XL

Brand Names: Canada

APO-Propranolol [DSC]; Hemangiol; Inderal LA [DSC]; LUPIN-Propranolol LA; TEVA-Propranolol

What is this drug used for?

Hemangeol:

  • It is used to treat proliferating infantile hemangioma.

Products other than Hemangeol:

  • It is used to treat high blood pressure.
  • It may be given to your child for other reasons. Talk with the doctor.

What do I need to tell the doctor BEFORE my child takes this drug?

All products:

  • If your child is allergic to this drug; any part of this drug; or any other drugs, foods, or substances. Tell the doctor about the allergy and what signs your child had.

Hemangeol:

  • If your child was born premature and has not reached the corrected age of 5 weeks.
  • If your child weighs less than 4 ½ pounds (2 kilograms).
  • If your child has asthma or has had breathing problems.
  • If your child has any of these health problems: Certain heart problems, a slow heartbeat, or very low blood pressure.
  • If your child has high blood pressure caused by a tumor of the adrenal gland (pheochromocytoma).

Products other than Hemangeol:

  • If your child has any of these health problems: Certain types of abnormal heartbeats called heart block or sick-sinus syndrome, heart failure (weak heart), low blood pressure, poor blood flow to the arms or legs, shock caused by heart problems, or a slow heartbeat.
  • If your child has any of these health problems: Asthma or other breathing problems like COPD (chronic obstructive pulmonary disease).

This is not a list of all drugs or health problems that interact with this drug.

Tell the doctor and pharmacist about all of your child’s drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe to give this drug with all of your child’s other drugs and health problems. Do not start, stop, or change the dose of any drug your child takes without checking with the doctor.

What are some things I need to know or do while my child takes this drug?

All products:

  • Tell all of your child’s health care providers that your child is taking this drug. This includes your child’s doctors, nurses, pharmacists, and dentists.
  • Have your child’s blood pressure and heart rate checked often.
  • This drug may prevent some signs of low blood sugar like fast heartbeat. This may raise the risk of severe or long-lasting low blood sugar, especially in people with diabetes, children, and people who are fasting. This includes people who are having surgery, are not eating like normal, or are throwing up. If you have questions, talk with the doctor.
  • If your child has high blood sugar (diabetes), you will need to watch your child’s blood sugar closely.
  • If your child has had a very bad allergic reaction, talk with the doctor. Your child may have a chance of an even worse reaction if your child comes into contact with what caused the allergy. If your child uses epinephrine to treat very bad allergic reactions, talk with the doctor. Epinephrine may not work as well while your child is taking this drug.

Hemangeol:

  • This drug may raise the chance of stroke in some children who have very bad problems with the blood vessels in their brain. The risk is higher in children with a large hemangioma that affects the face or head. Talk with the doctor.
  • If you are breast-feeding your child, tell the doctor about all the drugs you are taking. Certain drugs may pass to your child through breast milk and may interact with this drug.

All liquid products:

  • Make sure you have the right liquid; there is more than one strength.

Products other than Hemangeol:

  • Have your child avoid tasks or actions that call for alertness until you see how this drug affects your child. These are things like riding a bike, playing sports, or using items such as scissors, lawnmowers, electric scooters, toy cars, or motorized vehicles.
  • To lower the chance of feeling dizzy or passing out, have your child rise slowly if your child has been sitting or lying down. Have your child be careful going up and down stairs.
  • This drug may affect certain lab tests. Tell all of your child’s health care providers and lab workers that your child takes this drug.
  • Alcohol may interact with this drug. Be sure your child does not drink alcohol.
  • If your child smokes, talk with the doctor.
  • Do not stop giving this drug to your child all of a sudden. If you do, chest pain that is worse and in some cases heart attack may occur. The chance may be higher if your child has certain types of heart disease. To avoid side effects, you will want to slowly stop this drug as ordered by the doctor. Call the doctor right away if your child has new or worse chest pain or if other heart problems happen.
  • This drug may make it harder to tell if your child has signs of an overactive thyroid like fast heartbeat. If your child has an overactive thyroid and stops taking this drug all of a sudden, it may get worse and could be life-threatening. Talk with the doctor.
  • If your child is taking this drug and has high blood pressure, talk with the doctor before giving OTC products that may raise blood pressure. These include cough or cold drugs, diet pills, stimulants, non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen, and some natural products or aids.

If your child is pregnant or breast-feeding a baby:

  • Talk with the doctor if your child is pregnant, becomes pregnant, or is breast-feeding a baby. You will need to talk about the benefits and risks to your child and the baby.

What are some side effects that I need to call my child’s doctor about right away?

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your child’s doctor or get medical help right away if your child has any of the following signs or symptoms that may be related to a very bad side effect:

All products:

  • Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
  • Very bad dizziness or passing out.
  • Shortness of breath, a big weight gain, or swelling in the arms or legs.
  • Slow heartbeat.
  • A heartbeat that does not feel normal.
  • Feeling cold in the arms or legs.
  • Fever, chills, or sore throat.

Hemangeol:

  • Feeling fussy.
  • Change in color of skin.
  • Wheezing or coughing.
  • Pale skin.
  • Feeling very tired or weak.
  • Weakness on 1 side of the body, trouble speaking or thinking, change in balance, drooping on one side of the face, or blurred eyesight.
  • This drug may lower blood sugar levels. Feed your child on a regular basis while giving this drug. Tell the doctor if your child has a poor appetite. Do not give this drug if your child is not eating as much as normal, is throwing up, or is under stress (like if your child has a cold or infection) unless told to do so by the doctor. Call the doctor or get medical help right away if your child has signs of low blood sugar like pale, blue, gray, or purple skin color; sweating; feeling fussy; crying that is not normal; fast heartbeat; a heartbeat that does not feel normal; poor feeding; low body temperature; sleeping more than normal; seizures; or breathing stops for a short time.

Products other than Hemangeol:

  • Signs of low blood sugar like dizziness, headache, feeling sleepy, feeling weak, shaking, a fast heartbeat, confusion, hunger, or sweating.
  • Signs of lupus like a rash on the cheeks or other body parts, sunburn easy, muscle or joint pain, chest pain or shortness of breath, or swelling in the arms or legs.
  • Chest pain that is new or worse.
  • Feeling confused.
  • Hallucinations (seeing or hearing things that are not there).
  • Memory problems or loss.
  • Depression or other mood changes.
  • A burning, numbness, or tingling feeling that is not normal.
  • Change in color of hands, feet, or other areas. Skin may turn pale, blue, gray, purple, or red.
  • Change in eyesight.
  • Any unexplained bruising or bleeding.
  • Severe skin reactions have happened with this drug. These have included Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and other severe skin reactions. Get medical help right away if your child has signs like red, swollen, blistered, or peeling skin; other skin irritation (with or without fever); red or irritated eyes; or sores in the mouth, throat, nose, or eyes.

If your child is or may be sexually active:

  • Not able to get or keep an erection.

What are some other side effects of this drug?

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your child’s doctor or get medical help if any of these side effects or any other side effects bother your child or do not go away:

All products:

  • Diarrhea.
  • Throwing up.
  • Feeling sleepy.
  • Trouble sleeping.

Products other than Hemangeol:

  • Feeling dizzy, tired, or weak.
  • Upset stomach.
  • Stomach pain or cramps.
  • Constipation.
  • Strange or odd dreams.

These are not all of the side effects that may occur. If you have questions about side effects, call your child’s doctor. Call your child’s doctor for medical advice about side effects.

You may report side effects to your national health agency.

How is this drug best given?

Give this drug as ordered by your child’s doctor. Read all information given to you. Follow all instructions closely.

Hemangeol:

  • Measure liquid doses carefully. Use the measuring device that comes with this drug. If there is none, ask the pharmacist for a device to measure this drug.
  • Do not shake the solution.
  • Give this drug right into your child’s mouth. If needed, this drug may be mixed with a little bit of milk or fruit juice and given in a baby’s bottle.
  • Give this drug with or right after a feeding.
  • Give doses of this drug at least 9 hours apart.
  • If giving this drug to your child and your child’s weight changes, talk with the doctor. The dose of this drug may need to be changed.
  • If your child spits up a dose or if you are not sure your child got all of the drug, do not give another dose. Wait until your child’s next dose to give again.
  • Keep giving this drug to your child as you have been told by your child’s doctor or other health care provider, even if your child feels well.

Inderal XL and InnoPran XL:

  • Give this drug with or without food but give it the same way each time. Always give with food or always give on an empty stomach.
  • Give at bedtime if your child is taking it once a day.
  • Keep giving this drug to your child as you have been told by your child’s doctor or other health care provider, even if your child feels well.

All other oral products:

  • Some drugs may need to be given with food or on an empty stomach. For some drugs, it does not matter. Check with your pharmacist about how to give this drug to your child.
  • Keep giving this drug to your child as you have been told by your child’s doctor or other health care provider, even if your child feels well.

Oral solution:

  • Measure liquid doses carefully. Use the measuring device that comes with this drug. If there is none, ask the pharmacist for a device to measure this drug.

All long-acting products:

  • Have your child swallow whole. Do not let your child chew, break, or crush.

Injection:

  • It is given as a shot into a vein.

What do I do if my child misses a dose?

All oral products:

  • Give a missed dose as soon as you think about it.
  • If it is close to the time for your child’s next dose, skip the missed dose and go back to your child’s normal time.
  • Do not give 2 doses at the same time or extra doses.

Injection:

  • Call your child’s doctor to find out what to do.

How do I store and/or throw out this drug?

All oral products:

  • Store at room temperature. Do not freeze.
  • Protect from heat, cold, and light.
  • Keep lid tightly closed.
  • Store in a dry place. Do not store in a bathroom.

Hemangeol:

  • Throw away any part of the solution not used after 2 months.

Injection:

  • If you need to store this drug at home, talk with your child’s doctor, nurse, or pharmacist about how to store it.

All products:

  • Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets.
  • Throw away unused or expired drugs. Do not flush down a toilet or pour down a drain unless you are told to do so. Check with your pharmacist if you have questions about the best way to throw out drugs. There may be drug take-back programs in your area.

General drug facts

  • If your child’s symptoms or health problems do not get better or if they become worse, call your child’s doctor.
  • Do not share your child’s drug with others and do not give anyone else’s drug to your child.
  • Some drugs may have another patient information leaflet. If you have any questions about this drug, please talk with your child’s doctor, nurse, pharmacist, or other health care provider.
  • If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.

Consumer Information Use and Disclaimer

This generalized information is a limited summary of diagnosis, treatment, and/or medication information. It is not meant to be comprehensive and should be used as a tool to help the user understand and/or assess potential diagnostic and treatment options. It does NOT include all information about conditions, treatments, medications, side effects, or risks that may apply to a specific patient. It is not intended to be medical advice or a substitute for the medical advice, diagnosis, or treatment of a health care provider based on the health care provider’s examination and assessment of a patient’s specific and unique circumstances. Patients must speak with a health care provider for complete information about their health, medical questions, and treatment options, including any risks or benefits regarding use of medications. This information does not endorse any treatments or medications as safe, effective, or approved for treating a specific patient. UpToDate, Inc. and its affiliates disclaim any warranty or liability relating to this information or the use thereof. The use of this information is governed by the Terms of Use, available at https://www.wolterskluwer.com/en/know/clinical-effectiveness-terms.

Last Reviewed Date

2024-01-03

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Last Updated

Monday, December 12, 2022