Propranolol During Pregnancy – Is It Safe?

Propranolol is not just available in tablet form; you can consume it in any form of your choice, such as syrup, tablets, or even capsules.

Is It Safe To Take Propranolol While Pregnant?

Propranolol is in “Pregnancy Category C” according to the US Food and Drug Administration. Research studies show mixed results for the safety of the mother and fetus during pregnancy. But at times, the need for this medication may supersede the side effects to save the life of the mother.

There are situations, such as cardiac arrest or extreme hypertension, during the pregnancy period where using the drug becomes extremely important. The doctor will weigh the pros and cons and take a call regarding the usage of the medication and the safe dosage.

 What Are The Benefits of Propranolol During Pregnancy?

The main benefits of using propranolol during pregnancy are for treating high blood pressure, stress, and anxiety. It is also used as adjunctive therapy in women with thyroid and migraines.

1. Treating High Blood Pressure

High BP is a common problem during pregnancy and if untreated, it may lead to complications like preeclampsia. Beta-blockers like propranolol can be used to treat high blood pressure in pregnant women when given under medical supervision.

2. Stress and Anxiety Issues

Few pregnant women may experience unexplained stress and anxiety during pregnancy. Also, pregnant women with known cases of cardiac issues may experience an increase in heart rates, etc. To help these patients feel calm and manage their stress and anxiety, doctors may recommend using propranolol.

3. Thyroid Condition

A low dose of propranolol may be recommended for pregnant women who have hyperthyroidism to control a few symptoms caused by the condition, which is again a common concern during pregnancy in most women.  The dose and dosage should be followed strictly by the suggestions of the doctors.

4. Migraines

Migraines can become worse during pregnancy for a few women. Along with other medicines that control symptoms Propranolol is usually given as preventive care to chronic migraine patients.

What Are The Side Effects Of Propranolol During Pregnancy?

No medication is devoid of side effects. Let us take a quick look at the side effects of taking propranolol during pregnancy.

• Consumption of propranolol might cause side effects such as blurry vision, loss of vision, sudden drop in blood pressure, slow heart rate, etc. Reported complications of propranolol administration during pregnancy and labor include: intrauterine growth retardation, fetal depression at birth, prolonged labor, and postnatal hypoglycemia and bradycardia [1].
• If you consume propranolol during pregnancy, there are chances that you might experience feelings of extreme tiredness, lack of energy, weakness, fatigue, etc.
• Other effects include a shift or a change in your sleeping patterns, which might prove to be unhealthy for pregnant women. Sleep is the utmost necessity during pregnancy and pregnant women just cannot give up on it.
• Propranolol may also cause shivering and sweating in pregnant women, and this might get worse if not treated promptly.
• Growth retardation is one significant side effect in most cases where propranolol had been administered [2].

Always talk to your doctor about the possible side effects you can expect and the warning signals you should look out for when taking propranolol during pregnancy. In cases of extreme uneasiness, don’t hesitate to rush to your doctor.

How Much Propranolol Is Safe To Take During Pregnancy?

The US FDA has already justified the recommended dosage of propranolol during pregnancy. However, it may change as per the person’s medical history and immunity level. Your doctor will consider several factors, such as your age, medical history, and health issues, before recommending your dosage.

• The ideal dosage for a condition like hypertension is 40 mg or 60 mg, twice a day. This dosage is safe and doesn’t cause any major side effects during pregnancy [3].
• For conditions such as angina pectoris, a dosage of 80–320 mg can be given. However, studies have proved that a dosage of more than 160 mg might prove to be dangerous. So, you should consult your doctor on an immediate basis.
• For conditions such as atrial fibrillation, a dosage of 1–30 mg is sufficient.

What Are The Alternatives to Propranolol During Pregnancy

If we consider the same class of beta blockers, labetalol is the most widely recommended antihypertensive medicine for pregnancy and the best alternative to propranolol.

According to the studies, labetalol during pregnancy does not cause as much fetal growth restriction in fetuses as other beta blockers and is considered the safest among beta blockers.

However, labetalol is contraindicated in pregnant women who have both cardiac issues and certain lung conditions. Your healthcare provider will suggest what is best for your condition.

Another safer alternative to propranolol is another set of antihypertensive medicines called Calcium channel blockers like Nifedipine. nifedipine has high effectiveness in treating preeclampsia and eclampsia, without impacting gestational diabetes or low birth weight.

FAQ’s

1. What Does Propranolol Do To A Fetus?

Propranolol does not harm your baby in any manner. It keeps the fetus safe by protecting the mother’s health. But it might affect your baby’s growth in later pregnancy. It is a wise idea to discuss all your doubts and questions before starting to consume this medication, especially what to do when you miss a dose or take a double dose by mistake.

2. Can Propranolol Be Taken Occasionally?

It is not safe to consume propranolol occasionally as the withdrawal of the medication must be around 10-14 days and must be gradual. If you do consume propranolol occasionally, you will start witnessing unpleasant side effects such as vomiting, sweating, shivering, fast heartbeat, shaking, heart attack, and even death in some cases. Hence, keep your medication on a regular level or do not consume it at all.

3. What to Do If I Have Already Consumed Propranolol During My Pregnancy?

Talk to your doctor if you are taking propranolol and are pregnant. They will analyze your situation and decide whether you can continue or must stop taking it. Also, they will give you the right schedule to taper the drug.

4. Can Propranolol Cause Miscarriage?

Propranolol does not pose any kind of risk such as preterm deliveries or miscarriages. It is a safe class of beta-blocker drugs that can help reduce hypertension and other heart-related issues. The resulting miscarriage or birth defects are due to any previous or other underlying causes that do not contribute to Propranolol usage.

References –

1. Effects on the neonate of propranolol administered during pregnancy 
   https://d1wqtxts1xzle7.cloudfront.net/67484130/s0022-3476_2877_2981048-220210601-8679-1snhzy7-libre.pdf?1622569742
2. Long-term propranolol therapy in pregnancy: Maternal and fetal outcome
   https://www.sciencedirect.com/science/article/abs/pii/0002937879904368
3. Pharmacokinetics of propranolol during pregnancy
   https://link.springer.com/article/10.1007/BF00556896