Do not initiate propranolol for people with Generalised Anxiety Disorder (GAD) or panic disorder. Propranolol is not included in NICE guidance (NICE CG113).

All other indications:

• Only prescribe following a full risk-benefit discussion, including toxicity risks.
• Avoid prescribing to people at risk of self-harm or overdose, including where co-morbidities increase this risk.
• For short-term management of physical symptoms of situational anxiety (e.g. palpitations, tremor):
  • Prescribe limited quantities
  • Consider maximum 7 days’ supply
  • Be mindful of stockpiling.

5mg/10ml injection

50mg/10ml and 100mg/20ml

Injection: 5mg/5ml 

• 5mg & 10mg tablets.
• 1.25mg, 2.5mg, 3.75mg & 7.5mg tablets - for use in the treatment of heart failure only. The 5mg and 10mg tablets should be used where possible - cheaper than other strengths.

• For use in the treatment of heart failure only.

• Tablets: 50mg, 100mg, 200mg, 400mg

• Tablets: 50mg, 100mg
• SR Tablets: 200mg 

• Treatment should only be intiated on the advice of a cardiologist. 

300 mg powder for solution for infusion

Refractory atrial tachydysrhythmias with reduced LV systolic dysfunction, and or hypotension.

Second line option where esmolol is not appropriate. The decision to initiate landiolol requires consultant intensivist approval and should be documented in the patient’s medical records. There is limited experience of infusions beyond 24 hours. If treatment goals are not achieved at 24 hours then consultant review is required and alternatives considered.

• For specialist use in the treatment of patients who cannot tolerate other beta-blockers. Treatment should only be intiated on the advice of a cardiologist. 

• Limited to use by cardiologists in patients with long QT syndrome/idiopathic ventricular fibrillation.
• Liquid formulations (unlicensed) can be obtained for use in children if necessary. Treatment should only be on the advice of a cardiologist.

• For specialist use in the treatment of patients who cannot tolerate other beta-blockers. Treatment should only be on the advice of a cardiologist.