Propranolol 40mg Tablets (28 tablets)

Generic

Prescription-only medicine (POM)

Non-selective beta-blocker for cardiovascular, migraine and anxiety-related indications

UK MHRA Licensed prescription Only medicine (various PL numbers, e.g. PL 20395/0082 for Propranolol 40mg Tablets x 28).
Manufactured in accordance with EU/UK Good Manufacturing Practice (GMP) standards for medicinal products.
Listed in NHS dm+d as an Actual Medicinal Product (AMP) for Propranolol 40mg tablets, confirming UK licensing status.

UK MHRA Licensed prescription Only medicine (various PL numbers, e.g. PL 20395/0082 for Propranolol 40mg Tablets x 28).
Manufactured in accordance with EU/UK Good Manufacturing Practice (GMP) standards for medicinal products.
Listed in NHS dm+d as an Actual Medicinal Product (AMP) for Propranolol 40mg tablets, confirming UK licensing status.

Non-selective beta-blocker for cardiovascular, migraine and anxiety-related indications

Description

Propranolol 40mg tablets are a prescription-only, immediate-release, non-selective beta-blocker that slows the heart rate, reduces myocardial workload and lowers blood pressure to help manage hypertension, angina, cardiac arrhythmias and to protect the heart after myocardial infarction. They are also used for migraine prophylaxis, essential tremor, relief of the physical symptoms of anxiety (such as palpitations and tremor), and certain thyroid-related conditions such as thyrotoxicosis. The 40mg strength is taken orally, usually in divided doses, and therapy must be initiated and adjusted by a prescriber; treatment should not be stopped abruptly due to the risk of rebound tachycardia, hypertension or exacerbation of angina.

Bnefits

Reduces heart rate and myocardial oxygen demand, helping control high blood pressure and angina symptoms.
Helps stabilise certain types of cardiac arrhythmias by blocking beta-adrenergic stimulation of the heart.
Effective for prevention of migraine attacks when taken regularly as prescribed.
Relieves physical symptoms of anxiety such as palpitations, tremor and sweating, which can improve performance-related or situational anxiety.
Used in essential tremor and certain thyroid conditions (e.g. thyrotoxicosis) to moderate adrenergic symptoms.
Long clinical history and multiple MHRA-licensed presentations in the UK, supporting well-characterised safety and efficacy.

Indications

Hypertension (high blood pressure).
Angina pectoris (chest pain due to coronary artery disease).
Certain cardiac arrhythmias (including supraventricular arrhythmias).
Secondary prevention after myocardial infarction (post-MI cardioprotection).
Migraine prophylaxis.
Essential tremor.
Relief of physical symptoms of anxiety (e.g. palpitations, tremor, tachycardia).
Adjunctive treatment in thyrotoxicosis / hyperthyroidism to control adrenergic symptoms.
Hypertrophic cardiomyopathy (where a beta-blocker is appropriate).
Phaeochromocytoma (only in combination with an alpha-blocker and under specialist supervision).

Composition

Active ingredient: Propranolol hydrochloride 40 mg per tablet.
Core excipients (may vary slightly by MA holder, e.g. Relonchem/Accord/Milpharm): lactose monohydrate, maize starch or pregelatinised starch, microcrystalline cellulose, povidone, talc, magnesium stearate.
Film-coat excipients (for film-coated presentations): hypromellose and other standard coating excipients such as titanium dioxide and plasticisers (e.g. propylene glycol), depending on brand.

Formulation

Immediate-release, film-coated oral tablets containing 40 mg propranolol hydrochloride.

Packaging

Blister packs of 28 tablets (Propranolol 40mg Tablets x 28; typical UK POM pack).
Supplied in cartons labelled with strength, batch number, expiry date, PL number and storage instructions.

Usage

For oral use only; swallow tablets whole with water, with or without food, but in a consistent manner each day.
Dose, frequency and titration must be determined by the prescribing clinician based on indication, age, comorbidities and response; common regimens involve divided doses (e.g. 2–3 times daily) for immediate-release tablets.
Take doses at the same times each day to maintain consistent beta-blockade.
Do not stop taking propranolol suddenly; dose should be tapered gradually under medical supervision to avoid rebound effects such as worsening angina, arrhythmia or hypertension.
If a dose is missed, follow the advice in the patient information leaflet (usually take it as soon as remembered unless it is nearly time for the next dose; never double up).
Use with caution in diabetics, patients with peripheral vascular disease or those on other antihypertensives; regular monitoring is advised.

Contraindications

Hypersensitivity to propranolol hydrochloride or any excipient.
History of bronchospasm, asthma or severe chronic obstructive pulmonary disease (COPD) where beta-blockade may precipitate bronchospasm.
Second- or third-degree atrioventricular (AV) block, sick sinus syndrome, or severe bradycardia (unless a functioning pacemaker is present).
Uncontrolled heart failure, cardiogenic shock or hypotension.
Metabolic acidosis.
Severe peripheral arterial circulatory disturbances, including severe Raynaud’s phenomenon.
Untreated phaeochromocytoma (propranolol should only be used in combination with an alpha-blocker under specialist supervision).
History of severe depression associated with beta-blocker use (relative/brand-specific contraindication per SmPC).
Severe bradycardia-related hypotension or cardiogenic shock.
Use in pregnancy and breastfeeding is generally not recommended unless clearly necessary and under specialist advice.

Adverse Effects

Very common / common: fatigue, dizziness, cold extremities, bradycardia, gastrointestinal upset (nausea, vomiting, diarrhoea), sleep disturbances including vivid dreams.
Cardiovascular: bradycardia, orthostatic hypotension, worsening of heart failure in susceptible patients, precipitation of AV block.
Respiratory: bronchospasm or shortness of breath, particularly in patients with asthma or underlying airway disease.
Central nervous system: dizziness, headache, fatigue, sleep disturbances, nightmares, rarely depression or confusion.
Metabolic: masking of hypoglycaemia symptoms in diabetics, possible alterations in lipid profile.
Peripheral vascular: exacerbation of peripheral arterial disease or Raynaud’s phenomenon (cold, pale or blue fingers and toes).
Hypersensitivity: skin reactions such as rash or pruritus, and very rarely more severe reactions; angioedema is rare.

Storage Conditions

Store below 25°C (or as specified on the outer carton), in the original package to protect from moisture and light.
Keep out of the sight and reach of children.
Do not use after the expiry date shown on the blister and carton; return any unused or expired medicine to a pharmacy for safe disposal.

Duration

Treatment duration is indication-dependent and determined by the prescriber: for chronic conditions such as hypertension, angina or arrhythmia, therapy is often long-term; for migraine prophylaxis or anxiety, treatment may continue for months or years and should be reviewed periodically.

Onset

For cardiovascular indications, clinically meaningful effects on heart rate and blood pressure can appear within hours of dosing, but full antihypertensive benefit may take up to about one week or longer; for migraine prophylaxis, several weeks of regular treatment may be needed; physical anxiety symptoms may improve within a few hours of a dose.