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911DOC
911DOC, Board Certified Dr.
Category: Medical
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Experience:  Emergency Medicine Physician
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I have been on propranolol for 2.5 years (5mg twice daily every

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I have been on propranolol for 2.5 years (5mg twice daily every 10-12 hours). (My pulse races with anxiety attacks and heart dr was originally telling me to take 2-4 days a week when I went somewhere ( that's when my heart races) but when I didn't take it my heart felt the missed dose and I just kept taking it on routine, it actually got used to it after a day or 2) I also have a history of pvcs and sometimes a min or two of SVT. I fell asleep and missed my dose I was suppose to take about 12-2am (I was going to take it at 10 hour at midnight) its 5 am and I take anti anxiety meds and had to take it. This is the first time I have ever missed. I have taken it 3x a day a few times (dr said I could take more as needed) now I'm afraid about missing the dose if I should take it now or if I miss completely if I would have to refrain from getting my heart rate up like going somewhere, having anxiety attack, and worry of SVT. Any suggestions? I'm not sure what I do?
You can take it now. There is a very wide therapeutic window with propranolol, and missing a dose is no big deal especially as with the way you are taking it.

The only mistake would be in 'doubling up' on your dose to catch up... no need to do that and you could cause problems if you do.

Thank you so much for your question. It was a pleasure talking with you. If this answer has been helpful to you please consider leaving positive feedback. Should you require my assistance in the future simply start your question with ‘for 911doc’, and I am usually on the site most days.

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Customer: replied 3 years ago.
Thanks so much I was really worried because I started taking it basically because once I started taking it a couple days later at just taking a dose in e morning my heart felt like rebounding it would race worse until I just regulaly took it. (The dr first prescribed it this way then I said I didn't want to be on meds all the time and he just gave it to me when I needed it but then I got a thyroid problem on top or that and my heart raced worse so that's how it all began- my family dr told me I should take it even more than twice, but I've only taken in a few times 3x a day, never have missed a dose so it really scared me. Thought maybe it would induce palps or SVT. SVT scares me really bad, though as of now it hasn't went over a couple minutes so far. I'm not sure what I'd/I'll do of it ever does? I take meds doe anxiety too, needless to say I never miss a dose of anything. It's a benzo, and I really need to take Benadryl but haven't taken real dose since beginning propranolol because I'm afraid it will slow my heart too much because my heart rate is in the 52-56 range at bedtime. (It actually did that sometimes before propranolol). Have any suggestions? Oh and can I do normal activities? I know it says when you come off a heart pill to take it easy, not sure it applies here. And another thing besides the missed dose, can you exercise with SVT? I can't seem to get a straight answer from anyone they just say walk outside when its cool, so that makes me want to imply things myself.
your one question has changed into three.

you do not need to worry about your heart rate unless you have symptoms of dizziness or faintness. you need to talk to your doctor about dosing.

you can do normal activities.

you can exercise with SVT but if you have this recurrently you should have it ablated by an EP cardiologist and be done with it.

best