Inderal Tapering Guide
propranolol
Overview
Propranolol is a non-selective beta-blocker used for performance anxiety, akathisia, essential tremor, migraine prevention, and PTSD-related hyperarousal. It dampens the peripheral physical symptoms of anxiety (racing heart, tremor, sweating) without affecting cognitive symptoms.
10mg, 20mg, 40mg, 60mg, 80mg tablets; 60mg, 80mg, 120mg, 160mg LA capsules; oral solution
Tablets IR: 10mg, 20mg, 40mg, 60mg, 80mg; LA capsules: 60mg, 80mg, 120mg, 160mg; Oral solution: 4mg/mL, 8mg/mL
Category C
Mechanism of Action
Non-selective antagonist at beta-1 and beta-2 adrenergic receptors. Blocks the peripheral sympathetic response.
Taper Notes
Slow taper — abrupt discontinuation in cardiac patients can precipitate angina or arrhythmia. Step down by 25% per week.
Hyperbolic Tapering Guidance
For purely as-needed performance anxiety use, no taper is required. For daily use over months, a planned step-down avoids cardiovascular rebound.
Summary written by TaperCommunity, informed by the Maudsley Deprescribing Guidelines (Horowitz & Taylor) and related literature — see Sources & References below. Not affiliated with or endorsed by the Maudsley.
Withdrawal Timeline
1-3 days
5-10 days
2-4 weeks
Cardiovascular rebound usually resolves within 2 weeks
Common Withdrawal Symptoms
Interactions & Safety
Drug Interactions
- Other negative chronotropes/inotropes (verapamil, diltiazem) — additive
- CYP2D6 inhibitors — increase exposure
- NSAIDs — reduce antihypertensive effect
Contraindications
- Asthma
- Sinus bradycardia, AV block
- Cardiogenic shock
Toxicity
Bradycardia, hypotension, bronchospasm (especially in asthma), fatigue, cold extremities, sleep disturbance, vivid dreams. Masks hypoglycemia in diabetes.
Pharmacokinetics
ADME Profile
Hepatic, primarily via CYP2D6 and CYP1A2.
~90%
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Other Drug Profiles
Sources & References
Inderal (propranolol) information on this page is sourced from peer-reviewed research, regulatory bodies, clinical guidelines, and patient-advocacy organizations.
Encyclopedic & chemical databases
Neutral, high-authority entity references.
Regulatory sources
Official prescribing information and safety notices.
Peer-reviewed research
Primary literature cited in this taper guide.
Clinical guidelines
Evidence-based deprescribing and prescribing standards.
Deprescribing-specific resources
Clinician-facing references on tapering protocols.
- Deprescribing.org — Evidence-based deprescribing algorithms from the Bruyère Research Institute
- Royal College of Psychiatrists — Stopping antidepressants — UK clinical guidance on safely discontinuing antidepressants
Patient-advocacy & lived-experience
Long-running communities documenting withdrawal experience.
- Surviving Antidepressants — tapering forum — Long-running community archive of antidepressant taper experiences
- Inner Compass Initiative — Withdrawal Project — Peer-led resources for psychiatric drug withdrawal
- Mad in America — antidepressant withdrawal archive — Journalism and personal narratives on SSRI/SNRI discontinuation
- RxISK — adverse drug reaction reporting — Independent database of patient-reported adverse effects
TaperCommunity does not provide medical advice. Always consult a qualified prescriber before adjusting psychiatric medication.