Do NOT use Propranolol if:

• you are allergic to any ingredient in Propranolol
• you have moderate to severe heart block, sick sinus syndrome, or a very slow heartbeat and you do not have a permanent pacemaker
• you have uncontrolled heart failure, shock caused by serious heart problems, or very low blood pressure after a heart attack
• you have asthma
• the patient is a child with diabetes or heart failure
• you are taking mibefradil.

Contact your doctor or health care provider right away if any of these apply to you.

Some medical conditions may interact with Propranolol. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

• if you are pregnant, planning to become pregnant, or are breast-feeding
• if you are taking any prescription or nonprescription medicine (eg, medicines to treat colds or congestion), herbal preparation, or dietary supplement
• if you have allergies to medicines, foods, or other substances, or are taking medicine for allergies
• if you have a history of other heart problems (eg, angina, congestive heart failure, slow heartbeat)
• if you have a history of liver or kidney problems, blood vessel disease, lung or breathing problems (eg, chronic bronchitis, emphysema, chronic obstructive pulmonary disease [COPD]), diabetes, low blood sugar, overactive thyroid, or glaucoma
• if you have Wolff-Parkinson-White syndrome, Down syndrome, Raynaud syndrome, or an adrenal gland tumor (pheochromocytoma)
• if you smoke or drink alcohol.

Some medicines may interact with Propranolol. Tell your health care provider if you are taking any other medicines, especially any of the following:

• Mibefradil because the risk of serious heart side effects may be increased
• Many prescription and nonprescription medicines (eg, used for infections, inflammation, aches and pains, high blood pressure, heart problems, irregular heartbeat, diabetes, prostate problems, blood thinning, thyroid problems, depression, mental or mood problems, immune system suppression, allergic reactions, asthma, high cholesterol, seizures, local anesthesia), multivitamin products, and herbal or dietary supplements (eg, herbal teas, coenzyme Q10, garlic, ginseng, ginkgo, St. John's wort) may interact with Propranolol, increasing the risk of side effects

This may not be a complete list of all interactions that may occur. Ask your health care provider if Propranolol may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

Important safety information:

• Propranolol may cause drowsiness, dizziness, lightheadedness, or vision changes. These effects may be worse if you use it with alcohol or certain medicines. Use Propranolol with caution. Do not drive or perform other possible unsafe tasks until you know how you react to it.
• Check with your doctor before you drink alcohol while you are using Propranolol; it may increase the risk of Propranolol's side effects.
• Do NOT use more than the recommended dose without checking with your doctor.
• Patients who take medicine for high blood pressure often feel tired or run down for a few weeks after starting treatment. Be sure to take your medicine even if you may not feel "normal." Tell your doctor if you develop any new symptoms.
• Tell your doctor or dentist that you use Propranolol before you receive any medical or dental care, emergency care, or surgery.
• If you have a history of any severe allergic reaction, talk with your doctor. You may be at risk of an even more severe allergic reaction if you come into contact with the substance that caused your allergy. Some medicines used to treat severe allergies may also not work as well while you are using Propranolol.
• Propranolol may lower your blood sugar levels. This is most likely to happen in infants and children, or in patients who have diabetes or kidney problems. It may also occur after prolonged physical activity or during fasting. Low blood sugar may make you anxious, sweaty, weak, dizzy, drowsy, or faint. It may also make your heart beat faster; make your vision change; give you a headache, chills, or tremors; or make you more hungry. If this occurs, you should eat or drink a quick source of sugar like table sugar, honey, candy, orange juice, or non-diet soda. This will raise your blood sugar level quickly. Tell your doctor right away if this happens.
• Diabetes patients - Propranolol may hide signs of low blood sugar, such as a rapid heartbeat. Be sure to watch for other signs of low blood sugar. Check blood sugar levels closely. Ask your doctor before you change the dose of your diabetes medicine.
• Propranolol may interfere with certain lab tests, including glaucoma screening and dobutamine stress echocardiography. Be sure your doctor and lab personnel know you are using Propranolol.
• Lab tests, including blood pressure and heart function, may be performed while you use Propranolol. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
• Use Propranolol with caution in the elderly; they may be more sensitive to its effects.
• Propranolol should not be used in children; safety and effectiveness in children have not been confirmed.
• Pregnancy and breast-feeding: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Propranolol while you are pregnant. Propranolol is found in breast milk. If you are or will be breast-feeding while you use Propranolol, check with your doctor. Discuss any possible risks to your baby.

If you stop taking Propranolol suddenly, you may have withdrawal symptoms. These may include worsening chest pain along with possible heart attack.

All medicines may cause side effects, but many people have no, or minor, side effects.

Check with your doctor if any of these most common side effects persist or become bothersome:

Constipation; diarrhea; dizziness; drowsiness; fatigue; lightheadedness; mild pain, swelling, or redness at the injection site; nausea; stomach upset or cramping; trouble sleeping; vomiting; weakness.

Seek medical attention right away if any of these severe side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); chest pain; disorientation; fever with aching and sore throat; hallucinations; memory loss; mental or mood changes; numbness or tingling of the hands; persistent or severe vision changes; red, swollen, blistered, or peeling skin; severe dizziness; shortness of breath or wheezing; sudden, unusual weight gain; swelling of the hands, ankles, or feet; unusual bruising; unusually slow heartbeat; very cold or blue fingers or toes.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider.