PROPRANOLOL HYDROCHLORIDE should not be used in cardiogenic shock (heart unable to pump sufficient blood) and heart failure condition. Do not stop taking PROPRANOLOL HYDROCHLORIDE without talking to your doctor first. Stopping PROPRANOLOL HYDROCHLORIDE may cause changes in your heart rhythm and blood pressure. Your doctor will lower your dose gradually over a period of time to help prevent these symptoms. You should not use PROPRANOLOL HYDROCHLORIDE if you have a very slow heartbeat, asthma, serious heart condition (sick sinus syndrome) or any heart blockage. Before taking PROPRANOLOL HYDROCHLORIDE you should tell the doctor if you have any muscle disorder (myasthenia gravis, rhabdomyolysis), breathing problem (COPD, bronchitis, emphysema), low blood sugar level (hypoglycaemia), low blood pressure (hypotension), depression, previous heart failure, liver/kidney disease, thyroid hormone disorder, adrenal gland cancer or problems with circulation (Raynaud’s syndrome). Intake of PROPRANOLOL HYDROCHLORIDE may mask symptoms of diabetes. So tell your doctor if you have type 1 or type 2 diabetes. It may also worsen your symptoms of congestive heart failure and bradycardia (slow heart rate less than 60). You should regularly monitor your prothrombin time if PROPRANOLOL HYDROCHLORIDE is taken with anti-coagulants like warfarin.

Drug-Drug Interactions: PROPRANOLOL HYDROCHLORIDE may interact with beta-blockers (acebutolol, atenolol, bisoprolol, carteolol, esmolol, metoprolol, nadolol, nebivolol or sotalol), blood pressure-related medicines (lisinopril, enalapril, diltiazem, prazosin, terazosin, doxazosin), asthma medications (theophylline), and pain killers. If you are using these medicines tell your doctor before taking PROPRANOLOL HYDROCHLORIDE.

Drug-Food Interactions: PROPRANOLOL HYDROCHLORIDE may interact with grapefruit and protein-enriched foods. Therefore, avoid consuming grapefruit and its juice while taking PROPRANOLOL HYDROCHLORIDE.

Drug-Disease Interactions: PROPRANOLOL HYDROCHLORIDE may have interaction with disease conditions such as diabetes, thyroid disease, asthma, cardiogenic shock (when the heart fails to pump required blood to the body), heart valve problem (stenosis), low blood pressure (hypotension), coronary heart disease, liver disease or heart failure.

• Do regular physical activity or exercise for at least 150 minutes per week or about 30 minutes most days of the week. Doing this can help lower your raised blood pressure by about 5 mm of Hg.
• Opt for a diet rich in whole grains, fruits, vegetables, and low-fat dairy products.
• Limit intake of sodium chloride (table salt) in your daily diet to 2300 mg per day. Less than 1500 mg is ideal for most adults.
• If you are taking alcohol then only one serving for women and two servings for men is advisable.
• Quitting smoking is the best strategy to lower the risk of heart disease.
• Avoid chronic stress as it can raise your blood pressure. Try to enjoy and spend time with your loved ones to cope with stress and practice mindfulness techniques.
• Monitor your blood pressure daily and if there is too much fluctuation then immediately contact your doctor.
• Try to include heart-healthy omega 3 fatty acid containing food drinks in your daily diet. You can also use low-fat cooking oil like olive oil, soybean oil, canola oil and coconut oil can help in lowering your elevated blood pressure.

• PROPRANOLOL HYDROCHLORIDE may cause low blood sugar levels. Check your blood sugar levels regularly and consult a doctor if you notice any changes.
• Tell a doctor straight away if you have shortness of breath with a cough that gets worse when you exercise (like walking upstairs), swollen ankles or legs, chest pain, or an irregular heartbeat – these are signs of heart problems.