Precautions and Warnings With Propranolol XL

Specific Propranolol XL Warnings and Precautions

Some warnings and precautions to be aware of prior to taking propranolol XL include the following:
  • As with all beta blockers, you should not abruptly stop taking propranolol XL, as serious problems (including heart attacks) may result. Your healthcare provider will advise you on how to safely stop taking this medication. It is usually recommended to slowly reduce the dose over a period of one to two weeks, with careful monitoring. It is best to minimize physical activity during this time. Let your healthcare provider know if you develop chest pain or any other problems while stopping propranolol XL.
  • Like all beta blockers, propranolol XL can worsen heart failure in some situations. However, beta blockers are also useful for the treatment of heart failure. If you have heart failure, your healthcare provider may need to monitor you very closely while you take propranolol XL. Let your healthcare provider know immediately if your heart failure symptoms seem to worsen.
  • Beta blockers can worsen breathing problems like asthma or COPD. If you have breathing problems, check with your healthcare provider before taking propranolol XL.
  • If you will be having surgery, make sure your surgeon and anesthesiologist know you take propranolol XL, as it may affect the choice of medications used during the surgery.
  • Beta blockers can mask some of the symptoms of low blood sugar (hypoglycemia), particularly the "racing heart" feeling. This can cause serious problems for people with diabetes, who need to be able to sense that they have low blood sugar (in order to correct it before it becomes life-threatening). Propranolol XL may also increase the risk of hypoglycemia.  


  • Beta blockers can mask some of the symptoms of an overactive thyroid (hyperthyroidism). Stopping propranolol XL suddenly could cause a "thyroid storm" (a sudden and severe worsening of hyperthyroidism symptoms).
  • Propranolol XL can potentially interact with many other medications (see Drug Interactions With Propranolol XL).
  • The kidneys and liver help remove propranolol XL from the body. If you have kidney or liver disease, your healthcare provider may need to monitor your response to propranolol XL more closely (and a lower propranolol XL dosage may be recommended).
  • If you have an anaphylactic allergy (the type that affects the entire body and often interferes with breathing), propranolol XL may make you more sensitive to the allergen and may make the usual treatments (such as epinephrine or an EpiPen®) less effective.
  • Propranolol XL is considered a pregnancy Category C medication. This means that it may not be safe for use during pregnancy, although the full risks are not currently known (see InnoPran XL and Pregnancy).
  • Propranolol XL passes through breast milk in humans. Therefore, if you are breastfeeding or plan to start breastfeeding, discuss this with your healthcare provider prior to taking the drug (see InnoPran XL and Breastfeeding).
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Propranolol XL Drug Information

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