Propranolol

Originally introduced in 1962, propranolol remains among the top 50 prescribed drugs. This beta blocker treats a variety of ailments ranging from exercise induced chest pain or angina pectoris to high blood pressure. It additionally controls heart rate in atrial fibrillation. Propranolol may improve essential tremor and prevent recurrent attacks of migraine headache.

If begun within a week or so after a heart attack, propranolol offers the potential of avoiding another cardiovascular event. It also slows the heart rate in those with an overactive thyroid gland, steadies the hand in sporting activities including archery and reduces the likelihood of esophageal bleeding among individuals with cirrhosis.

Bronchial asthma, heart failure and an already slow heart rate generally suggest avoidance of propranolol. It may mask early symptoms of hypoglycemia in diabetics and may actually precipitate chest pain or a heart attack if abruptly discontinued.

Over the decades since propranolol won FDA approval, several other beta blockers have significantly eroded its market share. Other more popular drugs in the same family include metoprolol, carvedilol and atenolol.

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