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Propranolol...is this a high dose?


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I think it depends on the person ... ie, I am allowed to take 10 mg 4x/day as needed, while I have read others here on CB say how they are on +/- 120 mg/day.  Some take it PRN, others take it on a regular basis.

Being a beta blocker, IMO it should help both the anxiety and blood pressure ... on a cautious note though, personally I would still watch your blood pressure though to make sure it doesn't go too low.  Because everyone metabolizes meds differently, it IMO depends on the person in terms of how much they can tolerate.  YMMV.

I also really helped me with the tremors.  I take it as needed, so when I take one, the tremors do lessen.

Edited by melissaw72
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I can understand your uncertainty about taking such a dose of propranolol starting out. I agree with @melissaw72, I think it depends on the person. I think it depends on your blood pressure too. The thing to watch out for is since it's a hepatically metabolized beta-blocker is drug-drug interactions which can increase the concentration of propranolol, effectively increasing the dose in your system.

For what it's worth, this is what Epocrates has to say about initiating propranolol for hypertension:
Start: 40 mg by mouth twice a day, increase dose every 3-7 days; Max: 640 mg/day; Alt: start 80 mg ER by mouth every day, increase dose every 3-7 days to 120-160 mg ER by mouth every day; Info: taper dose gradually to D/C
The rest of the indications seem to all start at a max of 80 mg/day.

So if you're uncomfortable starting at 120 mg/day, if it's the instant release version, you could split the 60 mg tablet in half and take 30 mg twice a day for a few days to a week then go up to either 90 mg for another few days/a week then go up to 120 mg/day, or just go straight from there to 120 mg/day. Or you could try the full 120 mg/day at first and if you get side effects, reduce the dose slightly until you get used to it and then raise it back up once you're used to that dose. Keep in mind I'm not telling you how to take your medicine by any means, this is just a suggestion on what you could do.

Good luck, hope it works well for you!

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It's not the highest dose possible, but it is not a low dose either. If your doctor thinks you need 120 mg and prescribed it, then I am sure it is safe. It's an old drug that is generally considered safe.

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4 hours ago, notloki said:

People take twice and 3 times that much to control blood pressure but honestly what is this about being unsafe ? Don't you think your doc is competent to prescribe a little propranolol ?

Of course I think she's competent. She's the best pdoc out there. I was just asking if that dose could cause side effects like low blood pressure. Thats what I meant by saying "is it safe?"

 

I never intended to make it seem like I don't trust my pdoc. I have seen her for over 2 years.

24 minutes ago, mikrw33 said:

I can understand your uncertainty about taking such a dose of propranolol starting out. I agree with @melissaw72, I think it depends on the person. I think it depends on your blood pressure too. The thing to watch out for is since it's a hepatically metabolized beta-blocker is drug-drug interactions which can increase the concentration of propranolol, effectively increasing the dose in your system.

For what it's worth, this is what Epocrates has to say about initiating propranolol for hypertension:
Start: 40 mg by mouth twice a day, increase dose every 3-7 days; Max: 640 mg/day; Alt: start 80 mg ER by mouth every day, increase dose every 3-7 days to 120-160 mg ER by mouth every day; Info: taper dose gradually to D/C
The rest of the indications seem to all start at a max of 80 mg/day.

So if you're uncomfortable starting at 120 mg/day, if it's the instant release version, you could split the 60 mg tablet in half and take 30 mg twice a day for a few days to a week then go up to either 90 mg for another few days/a week then go up to 120 mg/day, or just go straight from there to 120 mg/day. Or you could try the full 120 mg/day at first and if you get side effects, reduce the dose slightly until you get used to it and then raise it back up once you're used to that dose. Keep in mind I'm not telling you how to take your medicine by any means, this is just a suggestion on what you could do.

Good luck, hope it works well for you!

Thank you for your advice. After doing further research I found like you said the max dose is 640. So I am no longer worried. I appreciate your post!

15 minutes ago, jt07 said:

It's not the highest dose possible, but it is not a low dose either. If your doctor thinks you need 120 mg and prescribed it, then I am sure it is safe. It's an old drug that is generally considered safe.

Thank you!

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