Propranolol-Associated Hypotension

Clinical Guidelines and Recommendations

• The American College of Cardiology, American Heart Association, and Heart Rhythm Society recommend that patients with preexisting hypotension should avoid propranolol or use it with extreme caution 1, 2
• The American College of Cardiology, American Heart Association, and Heart Rhythm Society identify hypotension as a potential adverse effect of propranolol in oral continuous therapy 1, 2
• The American Academy of Pediatrics recommends that physicians evaluate and educate caregivers about clinically symptomatic hypotension as a potential adverse effect of propranolol in the treatment of infantile hemangiomas 3

Patient Monitoring and Management

• Regularly monitor blood pressure in patients initiating propranolol, especially those with borderline blood pressure or taking concomitant medications that affect blood pressure 1, 2
• Avoid using propranolol in patients with preexisting hypotension 1, 2
• In cases of symptomatic hypotension, consider dose reduction or switching to another agent 3
• Exercise caution when combining propranolol with other medications that have SA and/or AV nodal blocking properties 1, 2