What Factors Affect Propranolol Dosage?

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  • Written By: wiseGEEK Writer
  • Edited By: Jessica Seminara
  • Last Modified Date: 29 April 2019
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Propranolol dosage varies considerably and most depends on the patient’s condition and response. Other factors, such as the presence of certain medical conditions or use of other medications, are also influential. It’s usually the case that the drug has an initiation dose, which is slowly increased until the desired effect is achieved. Generally, children receive much lower amounts of propranolol, even though its safety has not been fully established in this population.

As a beta blocker, propranolol can treat hypertension, certain arrythmias, and angina. The drug also addresses migraines, might be taken for pheochromocytoma, and may reduce mortality after a heart attack. Sometimes this medication is used to minimize essential tremor or to improve heart function in patients with aortic stenosis. A number of off-label indications exist for the medicine, too.

For high blood pressure, most patients begin propranolol dosage at 40 milligrams (mg) a day and may increase to up to six times this starting amount. Additions to the initiation dose are determined by a patient’s reduction in hypertension. Treatment after a heart attack is similar, starting with 40 mg and climbing to as much as 240 mg daily.


In aortic stenosis, the initiation dosage is 60-80 mg with a maximum of 160 mg per day, and migraine treatment typically begins with 80 mg and may rise to between 160-240 mg to provide relief. Conversely, propranolol dosage for essential tremor begins with 40 mg, but may climb to 320 mg each day. Again, the amount depends on the patient’s response, and usually the lowest effective dose is preferred.

It’s also worth noting that treatment isn’t always conducted over a long period of time. This is the case for conditions like pheochromocytoma. Propranolol dosage initiates three days before surgery, consists of 60 mg per day, and is usually discontinued right after surgery.

Other factors, like medical conditions, influence propranolol dosage. People with liver disease may need to take smaller amounts of the drug. Those with asthma or serious breathing conditions are completely advised against using this medication, and there are no studies confirming its safety in pregnant women. Certain medications may also raise or lower the strength of propranolol and could necessitate changes.

Studies of the drug in the pediatric population don’t point to its efficacy or safety. Nevertheless, there are propranolol dosage recommendations for children with some conditions. Therapy often begins at 0.5 to 1.0 mg daily with a maximum of 8.0 mg. Older teens, though, may take amounts similar to adults.



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