P-Nolol SR
P-Nolol SR is propranolol 80 mg sustained-release tablets — once-daily dosing with smoother 24-hour plasma levels than IR. For hypertension, migraine prevention, angina, essential tremor. Do not crush or chew. Standard 80-160 mg once daily. Safe in pregnancy.
✓ Medically reviewed by Morgan Ellis — Pharmacy Researcher · 8 years experience · Last reviewed: May 2026
⚡ Quick Answer — What is P-Nolol SR?
P-Nolol SR is a 80 mg propranolol sustained-release tablet from a WHO-GMP certified manufacturer — non-selective (blocks beta-1 AND beta-2). Primary use is hypertension; also used for angina, arrhythmia control, post-myocardial-infarction secondary prevention, migraine prevention, essential tremor, thyrotoxicosis, and performance anxiety. Typical hypertension dose: IR: 40-80 mg twice or thrice daily (80-160 mg/day). LA: 80-160 mg once daily. Contraindicated in asthma, severe bradycardia, second/third-degree heart block, acute decompensated heart failure, and phaeochromocytoma without prior alpha-blockade. Do NOT stop abruptly — taper over 1-2 weeks to avoid rebound tachycardia / angina / MI.
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What Is P-Nolol SR?
P-Nolol SR is an oral sustained-release tablet containing propranolol 80 mg from a WHO-GMP certified manufacturer, supplied in 30-180 tablets. Propranolol is a non-selective (blocks beta-1 AND beta-2). The original beta-blocker (Sir James Black, 1964; Nobel Prize 1988). Still the reference non-selective beta-blocker and arguably the most-prescribed cardiovascular drug in history.
How Propranolol Lowers Blood Pressure
Beta-blockers reduce blood pressure through four mechanisms:
- Reduction of cardiac output — beta-1 blockade in the sinoatrial node reduces heart rate, and blockade in ventricular myocardium reduces contractility. Lower cardiac output = lower blood pressure.
- Renin-angiotensin suppression — beta-1 blockade in juxtaglomerular cells reduces renin release, lowering angiotensin II and aldosterone over 2-4 weeks. This accounts for much of the long-term BP effect.
- Central sympathetic reduction — lipophilic beta-blockers cross the blood-brain barrier and reduce central sympathetic outflow.
Beta-blockers are lipophilic — crosses the blood-brain barrier; this explains its efficacy in migraine, tremor, and performance anxiety but also the CNS side effects (vivid dreams, sleep disturbance). Plasma half-life of propranolol is 3-6 hours (IR), 8-11 hours (LA/SR).
Approved and Evidence-Based Uses
- Hypertension (primary indication)
- Angina pectoris — 80-240 mg/day
- Atrial fibrillation rate control
- Migraine prophylaxis — first-line preventive; 80-160 mg/day
- Essential tremor — 40-240 mg/day
- Thyrotoxicosis — symptom control (tremor, tachycardia, anxiety)
- Performance anxiety — situational low-dose (10-40 mg)
- Infantile haemangioma — first-line since 2008
- Portal hypertension / varices prophylaxis
P-Nolol SR Dosage
Adult hypertension dose: IR: 40-80 mg twice or thrice daily (80-160 mg/day). LA: 80-160 mg once daily.
Start low, titrate upward over 2-4 weeks to target BP (typically <140/90 in uncomplicated hypertension; <130/80 in diabetes, chronic kidney disease, or established cardiovascular disease). Check resting pulse before each dose-increase — do not titrate if <55 bpm.
Monitoring:
- Resting pulse and BP at 2, 4, and 8 weeks after starting or dose change
- Baseline ECG if any cardiac history; periodic ECG if symptoms change
Administration: swallow whole with water. Sustained/extended-release formulations must NOT be crushed, chewed, or split — doing so delivers an IR dose with risk of bradycardia / hypotension.
Discontinuation: NEVER stop abruptly. Taper over 1-2 weeks (reduce by 25-50% every 3-5 days). Abrupt discontinuation causes rebound tachycardia, worsened angina, and — in patients with coronary disease — can precipitate myocardial infarction. This is one of the most important safety points for beta-blockers.
Side Effects
Common (>5%):
- Fatigue, lethargy — often adapts over 2-4 weeks
- Cold hands and feet (peripheral vasoconstriction)
- Bradycardia (check pulse; stop if <50 bpm)
- Exercise intolerance — maximum heart rate is blunted by beta blockade
- Dizziness, postural hypotension
- Sleep disturbance, vivid dreams / nightmares (lipophilic beta-blockers cross the blood-brain barrier)
- Reduced libido, erectile dysfunction (mostly at higher doses)
Less common: depression, reduced libido / erectile dysfunction, gastrointestinal upset, Raynaud-like cold intolerance, bronchospasm (more common with non-selective agents).
Important but uncommon:
- Masked hypoglycaemia in diabetics — beta-blockers blunt the tachycardia / tremor warning signs of low blood sugar. Monitor glucose more carefully; prefer nebivolol or bisoprolol in insulin-treated diabetes.
- Bronchospasm — can be severe in asthma / COPD. Absolute contraindication for non-selective agents; relative for cardioselective.
- Heart block or worsening heart failure — in susceptible patients. Start low, titrate slowly.
Contraindications & Cautions
- Asthma / severe COPD / any bronchospastic disorder — absolute contraindication (non-selective beta blockade)
- Second or third-degree atrioventricular block (without pacemaker)
- Sinus bradycardia <50 bpm
- Cardiogenic shock, decompensated heart failure requiring inotropes
- Severe peripheral arterial disease, Raynaud’s syndrome (relative)
- Phaeochromocytoma without prior alpha-blockade — paradoxical hypertensive crisis (never use a beta-blocker before alpha-blocker)
- Severe hepatic impairment (for extensively hepatic-metabolised agents: propranolol, metoprolol, carvedilol, labetalol)
- Severe renal impairment — dose adjustment needed for renal-excreted agents (atenolol, nadolol)
- Hypersensitivity to propranolol
Pregnancy: Category C but with extensive reassuring real-world data; preferred beta-blocker in pregnant migraine patients.
Breastfeeding: compatible (low milk transfer).
Drug Interactions
- Verapamil, diltiazem (non-dihydropyridine CCBs) — additive bradycardia, heart block, and negative inotropy; generally avoid combination. Dihydropyridine CCBs (amlodipine, nifedipine) are safer to combine with beta-blockers.
- Other beta-blockers — do not combine; additive bradycardia
- Clonidine — if stopping clonidine, stop the beta-blocker first (several days before) to avoid rebound hypertensive crisis
- Insulin and sulphonylureas — mask hypoglycaemia warning signs; monitor glucose closely
- NSAIDs — reduce the antihypertensive effect of beta-blockers; avoid chronic combination
- Rizatriptan — propranolol raises rizatriptan plasma levels ~70%; reduce rizatriptan to 5 mg max per dose
- Alcohol — additive hypotension and CNS depression (particularly for lipophilic agents)
Beta-Blocker Class at a Glance
| Beta-blocker | Selectivity | Best for |
|---|---|---|
| Propranolol (Inderal, Ciplar, Beloc) | Non-selective | Migraine, tremor, thyrotoxicosis, performance anxiety, HTN |
| Metoprolol | Cardioselective | Post-MI, HF-REF (succinate ER), angina, AF rate control |
| Carvedilol | Non-selective + α-1 | HF-REF (mortality evidence), post-MI |
| Bisoprolol | Highly cardioselective | HF-REF, HTN, angina, AF rate control |
| Nebivolol | Ultra-selective + NO | Elderly, metabolic syndrome, erectile dysfunction |
| Atenolol | Cardioselective (hydrophilic) | Angina, AF rate control (second-line for HTN) |
| Labetalol | Non-selective + α-1 | Pregnancy hypertension, hypertensive crisis |
Absolute contraindication in asthma / severe COPD (beta-2 blockade causes bronchospasm). Rizatriptan interaction: propranolol raises rizatriptan plasma levels ~70% — reduce rizatriptan to 5 mg max if co-prescribed.
Storage
Store P-Nolol SR below 25°C. Keep out of reach of children — accidental paediatric beta-blocker ingestion can cause life-threatening bradycardia and hypoglycaemia.
Frequently Asked Questions
How long does P-Nolol SR take to lower blood pressure?
You should see some BP reduction within 1-2 days of starting; the full antihypertensive effect takes 2-4 weeks (driven by the gradual renin-angiotensin suppression, not the immediate heart-rate effect). Measure BP at home at the same time each day to track response.
Can I take P-Nolol SR if I have asthma?
No — Propranolol is non-selective and can cause severe bronchospasm in asthmatics. Absolute contraindication. For asthmatic patients needing a beta-blocker, nebivolol or bisoprolol (highly cardioselective) are safer alternatives — though no beta-blocker is completely safe in asthma.
Why should I never stop P-Nolol SR abruptly?
Abrupt discontinuation causes rebound tachycardia and worsened angina within 24-48 hours, driven by up-regulation of beta receptors during chronic blockade. In patients with coronary artery disease, this can precipitate myocardial infarction or unstable angina. Always taper over 1-2 weeks when stopping.
Will P-Nolol SR affect my exercise performance?
Yes — beta blockade blunts the heart-rate response to exercise, so your maximum pulse is lower and you fatigue faster at high intensities. For recreational exercise most people adapt; for competitive endurance athletes, beta-blockers can meaningfully impair performance and are banned in precision sports (shooting, archery — where they reduce physiological tremor).
Will P-Nolol SR affect my blood sugar if I have diabetes?
Beta-blockers mask the tachycardia / tremor / palpitation warning signs of hypoglycaemia, making low blood sugar harder to detect. They can also blunt the counter-regulatory glucose response. Monitor glucose more frequently on a beta-blocker, particularly if on insulin or sulphonylureas. Nebivolol and bisoprolol have the best metabolic profile.
Can I drink alcohol on P-Nolol SR?
Moderate alcohol is generally acceptable but alcohol potentiates the hypotensive and CNS-depressant effects. Stand up slowly after drinking. Alcohol is also an independent BP-raiser; reducing intake can improve BP control independent of P-Nolol SR.
Does P-Nolol SR cause weight gain?
Older beta-blockers (propranolol, atenolol, metoprolol) are associated with modest weight gain (1-3 kg) and worsening of insulin sensitivity over time. Nebivolol and carvedilol are weight-neutral or slightly weight-favourable due to their vasodilator components. For patients with metabolic syndrome, nebivolol is the preferred beta-blocker when one is needed.
Is P-Nolol SR safe in pregnancy?
Reasonable — propranolol has extensive reassuring data in pregnancy. Small risk of intrauterine growth restriction and neonatal bradycardia / hypoglycaemia. Usually preferred only for migraine prevention in pregnancy; for BP control in pregnancy, labetalol is the first choice.
Can I take P-Nolol SR with other BP medications?
Yes — beta-blockers combine well with dihydropyridine calcium-channel blockers (amlodipine), ACE inhibitors (ramipril, lisinopril), ARBs (losartan, telmisartan, olmesartan), and thiazide diuretics (HCTZ). Avoid combination with non-dihydropyridine CCBs (verapamil, diltiazem) — additive bradycardia and heart-block risk.
Where can I buy P-Nolol SR online?
You can buy P-Nolol SR (propranolol 80 mg sustained-release tablet, 30-180 tablets) from MedsBase with discreet packaging and worldwide shipping.
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| Strength | 80 mg |
|---|---|
| Quantity | 30 Tablet/s, 60 Tablet/s, 90 Tablet/s, 180 Tablet/s |
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