Propranolol (Inderal)

Question:  My neurologist put me on 80 mg propranolol ER a few years back for essential tremors. I still have tremors and don't feel it's doing me any good, except I'm more tired. I finally said I want to wean off this med. The PA sent in a script for 60 mg and told me after 7 days to stop it completely. They did tell me to keep an eye on my blood pressure. I am so concerned about the after effects of going off this so rapidly.

Dr. Bruno’s Response:

  • First, propranolol often causes fatigue in polio survivors and will decrease blood pressure. It’s one of the drugs polio survivors should have a conversation about and understand the side effects from their physician when prescribed.

  • Second, stopping quickly can cause a spike in blood pressure and heart rate.

With any drug, weaning isn’t “take less and after 7 days stop it completely.” That’s cold turkey. The drug company’s recommendations are “when discontinuation of [propranolol ER] is planned…the dosage should be gradually reduced over a period of at least two weeks and the patient should be carefully monitored."

I recommend you let the physician wean medications, not the physician assistant. I would call the doctor’s office and ask for a prescription that allows you to taper slowly over the course of two weeks as the manufacturer of the drug recommends.

Richard L. Bruno, HD, PhD

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