Propranolol, reviewed and prescribed online.

Propranolol 20 mg tablets, after a licensed provider's review. Your provider chooses the dose. A US-licensed pharmacy dispenses your order and ships it free.

Propranolol paid once: $149 for 1 month, $402 for 3 months, $760 for 6 months or $1,430 for 12 months. With auto-refill each is 10% off: $134, $361, $684 and $1,287 ($107.25 a month on the 12-month plan). Shipping is free, and the exact total is shown before you pay.

Yes. You complete an online health intake, including your heart, breathing and the medicines you take, and a licensed provider decides whether propranolol is right for you and chooses the dose. Choosing a plan does not guarantee a prescription.

Yes, for other conditions. The label for propranolol hydrochloride tablets lists hypertension, angina pectoris, atrial fibrillation, myocardial infarction, migraine prophylaxis, essential tremor, hypertrophic subaortic stenosis and pheochromocytoma among its indications, and Drugs@FDA lists an original approval for Inderal (propranolol hydrochloride) dated 11/13/1967. Performance anxiety is not among the listed indications. NIMH says health care providers may prescribe beta-blockers off-label to treat short-term anxiety symptoms, even though the medication is not approved for that specific purpose, and an FDA patient page says that if you and your healthcare provider decide to use an approved drug for an unapproved use, FDA has not determined that the drug is safe and effective for the unapproved use.

The label says that when access to beta-receptor sites is blocked by propranolol, the chronotropic, inotropic, and vasodilator responses to beta-adrenergic stimulation are decreased proportionately. A review abstract on catecholamines in anxiety describes the use of beta-adrenergic blocking agents to diminish somatic symptoms attending anxiety-provoking situations, and a study in string players concluded that the beneficial effects of beta blockade in stage fright only involve a peripheral site of action. These are proposals, not proof of how it works in a particular person.

The sources are mixed. In a randomized crossover study of 5 ophthalmology residents, propranolol 40 mg decreased the residents' own ratings of anxiety and tremor before microsurgery, and it is unknown whether surgical outcome improved. In a double-blind pilot for fear of public speaking, propranolol 40 mg did not reliably outperform placebo. A study of speakers reported that propranolol impaired recall of difficult items in anxious subjects. Trials in musicians often tested other beta blockers, such as oxprenolol, atenolol or nadolol. A systematic review and meta-analysis concluded that the quality of evidence for propranolol is insufficient to support routine use in any of the anxiety disorders, and another states that evidence for beta-blockers in treating performance anxiety was lacking. NIMH says beta-blockers are commonly the medication of choice for the performance anxiety type of social anxiety disorder.

The label lists adverse events by body system, including bradycardia, hypotension, light-headedness, mental depression manifested by insomnia, lassitude, weakness and fatigue, vivid dreams, nausea, vomiting and diarrhea, and says that for immediate-release formulations fatigue, lethargy and vivid dreams appear dose-related. It gives no percentages in the passages we reviewed. A general FDA consumer page on managing the benefits and risks of medicines says to know what to do if you experience side effects and when to notify your doctor.

The label says propranolol is contraindicated in cardiogenic shock; sinus bradycardia and greater than first degree block; bronchial asthma; and in patients with known hypersensitivity to propranolol hydrochloride.

The label's Angina Pectoris warning says there have been reports of exacerbation of angina and, in some cases, myocardial infarction, following abrupt discontinuance of propranolol therapy, and that when discontinuance is planned the dosage should be gradually reduced over at least a few weeks. A general FDA consumer page on managing the benefits and risks of medicines says that if you stop the medicine or want to use the medicine differently than directed, you should consult with your health care professional. These statements do not say how they apply to occasional use.

The label says beta-adrenergic blockade may prevent the appearance of certain premonitory signs and symptoms (pulse rate and pressure changes) of acute hypoglycemia, especially in labile insulin-dependent diabetics. It says alcohol, when used concomitantly with propranolol, may increase plasma levels of propranolol. The label also lists interactions with drugs that affect CYP2D6, 1A2 or 2C19 pathways, verapamil, clonidine, NSAIDs and warfarin.

The label states that there are no adequate and well-controlled studies in pregnant women, that intrauterine growth retardation, small placentas, and congenital abnormalities have been reported in neonates whose mothers received propranolol during pregnancy, and that propranolol should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. It says propranolol is excreted in human milk and caution should be exercised when it is administered to a nursing woman.

A MedlinePlus health topic on poisoning says that if you suspect someone has been poisoned, you should call your local poison control center at 1-800-222-1222 right away, and NIMH says that in life-threatening situations you should call 911. An observational review of UK poison centre enquiries about intentional propranolol overdoses states that propranolol poisoning can be serious, difficult to treat and potentially fatal. If you or someone you know is struggling or having thoughts of suicide, NIMH says you can call or text the 988 Suicide & Crisis Lifeline at 988.

NIMH says cognitive behavioral therapy (CBT), a research-supported type of psychotherapy, is commonly used to treat social anxiety disorder, and NCCIH says anxiety disorders are generally treated with psychotherapy, medication, or both. NIMH also says that with benzodiazepines some people build up a tolerance and need increasing doses to get the same effect, and that some people even become dependent on them.

No. You can pay once for 1, 3, 6 or 12 months, or turn on auto-refill and take 10% off. You can change or cancel refills anytime.