Is It Safe To Take Propranolol During Pregnancy?

The drug is usually prescribed to pregnant women only if the benefits outweigh the risks.

Medically reviewed by Dr. Arpita Chakraborty, MS Dr. Arpita Chakraborty Dr. Arpita ChakrabortyMS MomJunction on FacebookFollow MomJunction on Instagram Specialty: Obstetrics and Gynaecology Experience: 8 years
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Is It Safe To Take Propranolol During Pregnancy

Propranolol is a beta-blocker drug prescribed for the treatment of cardiac issues such as irregular heart rate and hypertension. Propranolol during pregnancy is seldom prescribed since beta-blockersiA class of drugs that help protect the heart by blocking some hormone effects and reducing heart activity. may pose a risk to the developing fetus. The drug may be prescribed as a last resort when other medicines yield no results.

You must consult your doctor before consuming propranolol or other beta-blockers to minimize possible side effects. Read on to know about the medication safety of using propranolol during pregnancy, the dosage instructions, side effects, and dosage precautions that should be kept in mind.

In This Article

Key Pointers

  • Propranolol is a beta-blocker drug used for treating abnormal heart rhythms, high blood pressure, anxiety, and migraines.
  • It is not commonly prescribed during pregnancy as it can be risky for the fetus.
  • Common side effects include slow heart rate, low blood pressure, dizziness, blurred vision, tiredness, weakness, and sleeping problems.
  • If any side effects occur, stop taking the drug and consult a doctor.
  • Propranolol should only be taken if the potential benefits are greater than the risks.

What Is Propranolol?

Propranolol (Innopran XL) is a beta-blocker that is used to treat high blood pressure, anxiety, and migraines (1)

.

Propranolol can especially help in:

  • Treating irregular heartbeats
  • Preventing future heart attacks, and cardiovascular diseases such as strokes
  • Preventing chest pain due to angina

It also helps in reducing symptoms of excessive thyroid hormone in the body. It is available in tablet, capsule, and liquid form.

Is It Safe To Take Propranolol During Pregnancy?

Propranolol should be taken only under the doctor's advice

Image: Shutterstock

The US Food and Drug Administration has categorized propranolol under “pregnancy category C.” This means animal studies have shown that the drug has adverse effects on the fetus, and there are no well-controlled studies in pregnant women (2). Therefore, the existing research considers propranolol to be among the medications to avoid during pregnancy.

While gestational hypertension and cardiac issues can make pregnancy risky, taking medication that can harm your baby is not a good idea. As there are no well-controlled studies in pregnant women and the available studies suggest adverse effects of propranolol on the developing fetus, this drug should be taken during pregnancy only if the potential maternal health benefits outweigh the risks and strictly under the guidance of your physician.

How Does Propranolol Affect Pregnant Women?

An animal study on rats found that oral administration of propranolol through pregnancy led to reduced neonatal weight and litter size. In humans, the observations could be interpreted to the increased muscle tone of the uterus, and instability in blood flow (3).

Mothers who were given propranolol Hcl at the time of labor showed signs of bradycardia (slow heart rate), hypoglycemia, and/or respiratory depression (2). Talk to your doctor and discuss if there are any safer alternatives to propranolol.

Recommended Dosage

The healthcare provider will determine the appropriate dosage

Image: Shutterstock

The US FDA recommends the following doses for each condition (4). However, your doctor will decide the dosage after considering your requirements.

  • The recommended dosage for hypertension is 40mg twice a day, and it is not known to cause any adverse effects during pregnancy (5).
  • Although the FDA recommends 80mg-320 mg for angina pectorisiFeeling squeezing, heaviness, pressure, or tightness in the chest due to reduced blood supply to the heart. , studies proved that a dosage of more than 160 mg could cause adverse effects on the fetus. So, professional advice is needed (5).
  • 1mg to 30mg three or four times daily for atrial fibrillationiAn irregular heart rhythm that initiates in the upper chambers of the heart.
  • The initial dosage for myocardial infarctioniInterrupted blood flow to cardiac muscles, widely known as heart attack.  is 40mg, and after one month, it can be 60mg to 80mg.
  • Initial dosage for migraine is 80mg, but the effective dose range is 160mg or 240mg per day; it should be taken after consulting a medical professional.

protip_icon Quick tip
Since the first dose of propranolol can make you dizzy, you may take it at night (1).

Whether taken in the prescribed dosages or otherwise, propranolol can have certain side effects in the patients.

Side Effects Of Propranolol During Pregnancy

Propranolol may cause low blood pressure during pregnancy

Image: Shutterstock

Propranolol has some common side effects on the mother (6).

  • If the mother has an intolerance to propranolol tablets, then she could experience a slow heart rate, low blood pressure, dizziness, light-headedness, blurred vision.
  • A few common side effects include tiredness, weakness, cold extremities, difficulty in sleeping, irregular heartbeat, Raynaud’s syndromeiA medical condition characterized by blood vessel spasms due to cold temperatures or emotional stress. , and nightmares.

If you do take propranolol during pregnancy and experience any of these symptoms, then stop taking the medication and contact your obstetric specialist or gynecologist immediately.

Frequently Asked Questions

1. Is it okay to take propranolol occasionally during pregnancy?

Do not take propranolol occasionally, as the withdrawal of the medicine from your system should be gradual, over 10 to 14 days. You may experience unpleasant side effects such as sweating, shaking, worsening of angina, irregular or fast heartbeat, heart attack, or even death in some cases (6).

Also, medications for hypertension and anxiety need to be taken continuously for a certain period. So always discuss with your doctor before starting or stopping the medication and stick to the prescribed dosage.

2. What if I have already taken propranolol during pregnancy?

So, if you are already under medication, and found out that you are pregnant, then talk to your doctor to decide the best course of action, as abruptly stopping the drug is not safe.

3. Can propranolol cause miscarriage?

Several studies did not include miscarriage as an adverse effect of propranolol (7). However, the lack of well-controlled studies makes it difficult to determine if propranolol causes miscarriage.

4. Can taking propranolol during pregnancy cause stillbirth?

A study conducted based on the data from the Danish Fertility Database, the Danish National Hospital Register, and the National Prescription Register found that a higher rate of perinatal mortality was found among women exposed to beta-blockers (8). So, there is a chance of stillbirthiWhen a fetus passes away in the uterus or is born dead after 20 weeks of pregnancy. upon the usage of propranolol during pregnancy.

5. Can taking propranolol during pregnancy cause any birth defects?

A paper published in The Journal of Pediatrics states that infants born to mothers who received continuous propranolol therapy during pregnancy reported a small placentaiA temporary organ that develops during pregnancy and provides the fetus with oxygen and nutrients. , fetal growth restriction or intrauterine growth retardation, fetal depression at birth, neonatal hypoglycemia, and bradycardia (4). (9).

6. What is the safest beta blocker in pregnancy?

The beta blocker, labetalol, is usually prescribed for the treatment of gestational hypertension, while metoprolol is the most commonly used for arrhythmias, cardiomyopathies, and aortopathies. Your doctor will decide the best medicine for you based on your overall health and medical requirements (10).

7. Does propranolol cross the placenta?

Yes, beta blockers such as propranolol are known to cross the placenta (11).

8. Can Propranolol interact with other medications during pregnancy?

Yes, it may interact with OTC medicines, such as antacids that contain aluminum, cimetidine, and NSAIDs, such as naproxen and ibuprofen (12). Do not start any new medications while on Propranolol without first consulting your healthcare provider.

9. Are there specific health conditions that could complicate Propranolol use in pregnancy?

Propranolol use during pregnancy requires careful medical supervision as Propranolol use can be complicated by pre-existing conditions such as asthma, cardiac conditions such as irregular heartbeat and heart failure, and lung disease (12).

Propranolol is a beta-blocker usually prescribed for conditions such as high blood pressure, migraine, and anxiety. The doctor may perform a risk assessment and prescribe it to you if they find that the benefits outweigh the risks. However, there are not enough studies done on humans to establish the safety of propranolol in expecting mothers for treatment of the pregnancy problems such as preeclampsia. In addition, research on animals has shown adverse effects on the fetus, and therefore you should not take propranolol during pregnancy without your doctor’s consent.

Infographic: Side Effects Of Propranolol During Pregnancy

Your doctor may have advised taking propranolol when pregnant for a medical reason; though the drug may not harm your fetus, it could cause certain discomfort to you. This infographic discusses the possible side effects of propranolol during pregnancy. Make a note and inform your doctor if you notice any of these symptoms.

side effects of propranolol during pregnancy (infographic)

Illustration: Momjunction Design Team

This post is for informational purposes only and is not a replacement for a doctor’s consultation. Do not use any medication without talking to your doctor.


Get informed about propranolol usage, proper dosage, and possible adverse effects from a physician. Acquire the necessary knowledge to make well-informed choices regarding your health.

References

MomJunction's articles are written after analyzing the research works of expert authors and institutions. Our references consist of resources established by authorities in their respective fields. You can learn more about the authenticity of the information we present in our editorial policy.

1. Propranolol; NHS
2. Prescribing Information-Innopran XL; The US Food and Drug Administration
3. N. Shoenfeld et al.; Effects of Propranolol during Pregnancy and Development of Rats. I. Adverse Effects during Pregnancy; Tel Aviv University
4. Gwendolyn R. Gladstone M.D,Gwendolyn R M.D, Gladstonea,b, M.D. Allan Hordofa,b, Welton M. Gersonya,b M.D; Propranolol administration during pregnancy: Effects on the fetus; The Journal of Pediatrics
5. Inderal Tablets; The US Food and Drug Administration
6. E.A. Taylor, P. Turner; Anti-hypertensive therapy with propranolol during pregnancy and lactation; British Medical Journal
7. Package leaflet: Information for the patient; The Electronic Medicines Compendium (EMC)
8. Mohammed Y Yakoob et al.; The Risk of Congenital Malformations Associated With Exposure To Beta-Blockers Early In Pregnancy: A Meta- Analysis; NCBI (2013)
9. Kasper Meidahl Petersen et al.; β-Blocker treatment during pregnancy and adverse pregnancy outcomes: a nationwide population-based cohort study; British Medical Journal
10. Beta-Blockers in Pregnancy and Congenital Malformation Risk American College of Cardiology
11. Lewei Duan et al.; (2017); β-Blocker Exposure in Pregnancy and Risk of Fetal Cardiac Anomalies.
12. Propranolol

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Dr. Arpita Chakraborty
Dr. Arpita ChakrabortyMS
Dr. Arpita Chakraborty practices at Bombay Hospital, Mumbai and has eight years of experience in the field of ob/gyn. She has passed her medical training with distinction and bagged gold medals in various subjects. Dr. Chakraborty trained in advanced laparoscopy at Bombay Hospital and did FOGSI Certified Course in Obstetrics Ultrasonography.

Read full bio of Dr. Arpita Chakraborty
shreeja pillai
shreeja pillaiMSc
Shreeja holds a postgraduate degree in Chemistry and diploma in Drug Regulatory Affairs from the University of Mumbai. Before joining MomJunction, she worked as a research analyst with a leading multinational pharmaceutical company.

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Rebecca Malachi
Rebecca MalachiBSc
Rebecca is a pregnancy writer and editor with a passion for delivering research-based and engaging content in areas of fertility, pregnancy, birth, and post-pregnancy. She did her graduation in Biotechnology and Genetics from Loyola Academy, Osmania University and obtained a certification in ‘Nutrition and Lifestyle in Pregnancy’ from Ludwig Maximilian University of Munich (LMU).

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Dr. Joyani Das
Dr. Joyani DasM.Pharm, PhD
Dr. Joyani Das did her post-graduation from Birla Institute of Technology, Mesra and PhD in Pharmacology. Previously, she worked as an associate professor, faculty of Pharmacology, for two years. With her research background in preclinical studies and a zeal for scientific writing, she joined MomJunction as a health writer.

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