Medicinsk godkendt artikel
Propranolol is used as a preventive medicine for migraines.
Propranolol has been developed to treat heart and circulatory disorders, but scientific studies have shown that it can also have an effect on migraines.
It is well known that a drug can act on more than one disease. When we prescribe Propranolol to you, it is not to lower your blood pressure, but to treat your migraines. The preventive effect of Propranolol may be due to the fact that it stabilizes the blood vessels, but the exact mechanism of action is not known.
The most frequent side effects are fatigue, dizziness, drop in blood pressure associated with posture change, nausea, abdominal pain, diarrhoea, constipation, cold hands and feet, slow heart rate, palpitations and difficulty breathing.
Propranolol should not be used in certain types of cardiac disorders, for example in conduction disorders. It should be used with caution or not at all if you suffer from diabetes and asthma. It should also be used with caution if you are taking certain types of other medicines, especially other heart medicines.
Before starting treatment, a cardiac cardiogram (ECG) must be performed and your heart rate and blood pressure measured.
Start by taking 20 mg 2 times a day for 1 week. After this, increase the dose to 40 mg 2 times a day.
In case of insufficient efficacy — and if there are no bothersome side effects after 1 month — increase to 60 mg twice daily for 1 week, and then further to 80 mg twice daily. Stay on the dose at which you find the best balance between effect and side effects — usually between 80 and 160 mg daily. However, you can go as much as 240 mg per day.
In case of lack of effect after 1 month of 160 mg per day, it can be concluded that the preparation does not work for you. You can then step down by 40 mg every 3 to 7 days until you have completely stopped taking the medicine.
Once the correct final dose has been found, it should be taken daily for ½-1 years, after which the dose can often be slowly scaled down in consultation with the doctor. However, some patients need to use propranolol for a longer period of years.
