Propranolol can, in certain patients, be used alone or as an initial agent in patients in whom, in the judgment of the physician, treatment should be started with a beta-blocker rather than a diuretic. Propranolol may increase oxygen requirements by increasing left ventricular fiber length, end diastolic pressure, and the velocity and extent of myocardial contraction. Propranolol is a competitive antagonist which specifically competes with beta-adrenergic receptor stimulating agents for available beta-receptor sites. Care should be taken if adrenaline is given with Propranolol, as this combination can cause severely high blood pressure and slow heart rate, low blood pressure and heart failure. Possible deleterious effects from long-term use of Propranolol have not yet been adequately appraised. This medicine suddenly, particularly if you have ischemic heart disease. The heart rate, low blood pressure and heart failure. If you have ischemic heart disease. If Propranolol is taken in combination with other drugs, particularly a thiazide diuretic.
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