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Propranolol

Prescription
Non-Selective Beta-Adrenergic Blocker
Last reviewed 21 Apr 2026 · PetCare.AI Editorial Team
Species
Dog, Cat
Brands
1 available
Interactions
17 documented
Formulations
4

Mechanism of action

Non-selective beta-1 and beta-2 antagonist that reduces heart rate, contractility, AV conduction velocity, and renin secretion (beta-1) while causing bronchial smooth muscle constriction and blocking tremor suppression (beta-2). Highly lipophilic — crosses BBB.

At a glance

Class
Non-Selective Beta-Adrenergic Blocker
Schedule
Prescription
Storage
Store at room temperature, protect from light and moisture

Dosing

🐕

Dog

Used for supraventricular tachyarrhythmias, hypertrophic cardiomyopathy (rare in
Dose
0.2–1 mg/kg
Route
PO, IV
Frequency
q8h (PO); as needed (IV)
🐈

Cat

Used for feline hypertrophic cardiomyopathy (HCM) — reduces heart rate, dynamic
Dose
2.5–5 mg/cat
Route
PO, IV
Frequency
q8–12h (PO)

Formulations

💊

Other — 4

Strength
—
Strength
—
Strength
—
Strength
—

Storage

Store at room temperature, protect from light and moisture

Safety

Monitoring parameters

Heart rateBlood pressureECGRespiratory effort (bronchospasm)Blood glucose (diabetic patients)

Interactions

Contraindicated — 2

Verapamil
contraindicated
IV verapamil + IV beta-blocker: synergistic negative inotropy, chronotropy, and dromotropy causing severe bradycardia, AV block, hypotension, or asystole.
Management: NEVER give IV verapamil and IV beta-blocker together. Oral combination used very cautiously only under cardiologist supervision.
Isoproterenol
contraindicated
Non-selective beta-blocker completely antagonizes isoproterenol's beta-1 and beta-2 effects, rendering it therapeutically useless.
Management: NEVER combine. If patient on propranolol develops complete heart block requiring isoproterenol, propranolol must be discontinued first or glucagon used as bridge.

Major — 9

Diltiazem
major
Additive negative chronotropy and dromotropy: risk of severe bradycardia, AV block, and cardiac arrest.
Management: Use with extreme caution under cardiologist supervision. Do not give both IV. Monitor ECG continuously if combined.
Amiodarone
major
Amiodarone + beta-blocker: additive bradycardia and AV block. Amiodarone also inhibits beta-blocker metabolism.
Management: If combined, use lowest beta-blocker dose and monitor ECG closely.
Pimobendan
major
Pimobendan's positive inotropic effect is partially mediated by calcium sensitization. Beta-blockers (negative inotropes) directly oppose this, potentially precipitating heart failure decompensation.
Management: Generally avoid combining positive inotrope with beta-blocker in decompensated CHF. If used for arrhythmia control, start beta-blocker at very low dose with careful titration.
Clonidine
major
Clonidine withdrawal while on beta-blocker causes severe rebound hypertension (beta-blocker blocks compensatory vasodilation). Also, additive bradycardia during concurrent use.
Management: Never abruptly discontinue clonidine while on beta-blocker. If stopping clonidine, taper beta-blocker first, then taper clonidine slowly.
Adrenaline (Epinephrine)
major
Non-selective beta-blockade leaves epinephrine's alpha-1 vasoconstriction unopposed while blocking beta-2 vasodilation, causing severe hypertension and reflex bradycardia.
Management: Use with extreme caution. In anaphylaxis requiring epinephrine while on propranolol: higher epinephrine doses may be needed; consider glucagon as adjunct.
Dopamine
major
Beta-blockers antagonize dopamine's beta-1 cardiac stimulatory effects (inotropy, chronotropy), leaving only alpha-mediated vasoconstriction at higher doses.
Management: If vasopressor needed in patient on beta-blocker, consider norepinephrine or phenylephrine (pure alpha) instead of dopamine. Higher dopamine doses may worsen hypertension without improving cardiac output.
Terbutaline
major
Non-selective beta-blocker completely antagonizes terbutaline's beta-2 bronchodilatory effect, rendering it ineffective and potentially causing bronchospasm.
Management: NEVER use non-selective beta-blocker in patients requiring bronchodilators. Use cardioselective beta-1 blocker (atenolol) if beta-blocker needed.
Ephedrine
major
Non-selective beta-blocker blocks ephedrine's beta-mediated effects leaving alpha vasoconstriction unopposed, causing severe hypertension and reflex bradycardia.
Management: Avoid. If both pressor and beta-blocker needed, use phenylephrine (pure alpha) which has predictable response with beta-blockade.
Albuterol (Salbutamol)
major
Non-selective beta-blocker completely blocks albuterol's beta-2 bronchodilatory effect, causing bronchospasm. Also blocks beta-2 mediated hypokalemia correction.
Management: NEVER use non-selective beta-blocker in patients requiring bronchodilators. If beta-blocker needed, use cardioselective (atenolol) at lowest effective dose.

Moderate — 6

Amlodipine
moderate
DHP calcium channel blocker + non-selective beta-blocker: additive BP reduction. Less AV conduction risk than diltiazem+beta-blocker.
Management: Monitor BP and heart rate. Usually well-tolerated.
Bupivacaine
moderate
Propranolol reduces hepatic blood flow (beta-blocker) and inhibits CYP enzymes, reducing bupivacaine clearance and increasing systemic toxicity risk.
Management: Use caution with bupivacaine doses in patients on beta-blockers. Reduce max dose. Ropivacaine may be safer alternative (less cardiotoxic).
Insulin, Glargine
moderate
Non-selective beta-blockers mask hypoglycemia signs (tremor, tachycardia) and prolong hypoglycemic episodes by blocking hepatic glycogenolysis (beta-2 effect).
Management: Monitor glucose more frequently. Educate owners about atypical hypoglycemia signs (lethargy, weakness rather than tremors). Cardioselective beta-blocker (atenolol) preferred in diabetics.
Hydralazine
moderate
Beta-blocker attenuates hydralazine-induced reflex tachycardia. Additive blood pressure reduction.
Management: Intentional combination to control reflex tachycardia. Monitor blood pressure and heart rate closely during titration.
Lidocaine
moderate
Propranolol reduces hepatic blood flow, decreasing lidocaine first-pass clearance and increasing systemic lidocaine levels. Also additive negative cardiac effects.
Management: Reduce lidocaine CRI rate by 25-40% in patients on propranolol. Monitor for lidocaine toxicity (tremors, seizures).
Phenylephrine
moderate
Phenylephrine (pure alpha-1 agonist) causes vasoconstriction and reflex bradycardia. Propranolol blocks compensatory tachycardia, potentially worsening bradycardia.
Management: Monitor heart rate and blood pressure. The combination predictably causes hypertension + bradycardia.

Brands

Other markets

Inderal

FAQs

Frequently asked questions

›What is Propranolol?
Propranolol is a non-selective beta-adrenergic blocker used in pets. Non-selective beta-1 and beta-2 antagonist that reduces heart rate, contractility, AV conduction velocity, and renin secretion (beta-1) while causing bronchial smooth muscle constriction and blocking tremor suppression (beta-2). Highly lipophilic — crosses BBB.
›What is Propranolol used for in pets?
Propranolol is used in veterinary medicine for: Used for supraventricular tachyarrhythmias, hypertrophic cardiomyopathy (rare in; Used for feline hypertrophic cardiomyopathy (HCM) — reduces heart rate, dynamic .
›What is the Propranolol dose for dogs?
For dogs, Propranolol is typically dosed as follows — Used for supraventricular tachyarrhythmias, hypertrophic cardiomyopathy (rare in: 0.2–1 mg/kg PO/IV q8h (PO); as needed (IV). Always consult your veterinarian for a dose tailored to your pet's weight, age, and condition.
›What is the Propranolol dose for cats?
For cats, Propranolol is typically dosed as follows — Used for feline hypertrophic cardiomyopathy (HCM) — reduces heart rate, dynamic : 2.5–5 mg/cat PO/IV q8–12h (PO). Always consult your veterinarian for a dose tailored to your pet's weight, age, and condition.
›Does Propranolol need a prescription?
Yes. Propranolol is a prescription medication and should only be administered under veterinary supervision.

References

References

Textbooks & handbooks

  • Plumb, D.C. Plumb's Veterinary Drug Handbook. 10th ed., Wiley-Blackwell, 2023.
  • Vail, D.M., Thamm, D.H., & Liptak, J.M. (eds.). Withrow & MacEwen's Small Animal Clinical Oncology. 6th ed., Saunders/Elsevier, 2020.
  • Riviere, J.E., & Papich, M.G. (eds.). Veterinary Pharmacology and Therapeutics. 10th ed., Wiley-Blackwell, 2018.
  • National Research Council. Nutrient Requirements of Dogs and Cats. National Academies Press, Washington DC, 2006.
  • The Merck Veterinary Manual. Merck & Co., Online edition. https://www.merckvetmanual.com/

Clinical guidelines & consensus

  • Fletcher, D.J., Boller, M., Brainard, B.M., et al. "RECOVER Evidence and Knowledge Gap Analysis on Veterinary CPR." Journal of Veterinary Emergency and Critical Care, 2012;22(S1):S102–S131.
  • American Animal Hospital Association. 2018 AAHA Diabetes Management Guidelines for Dogs and Cats. AAHA Press.

Journals & peer-reviewed studies

  • Hogan, D.F., Fox, P.R., Jacob, K., et al. "Secondary prevention of cardiogenic arterial thromboembolism in the cat: The FAT CAT study." Journal of Veterinary Cardiology, 2015;17(Suppl 1):S306–S317.
  • Boswood, A., Häggström, J., Gordon, S.G., et al. "Effect of Pimobendan in Dogs with Preclinical Myxomatous Mitral Valve Disease and Cardiomegaly: The EPIC Study — A Randomized Clinical Trial." Journal of Veterinary Internal Medicine, 2016;30(6):1765–1779.
  • ASPCA Animal Poison Control Center. Toxicology and Poison Management Guidelines. American Society for the Prevention of Cruelty to Animals. https://www.aspca.org/pet-care/animal-poison-control

Regulatory & approvals

  • Central Drugs Standard Control Organisation (CDSCO), Government of India. Veterinary Drug Approval Registry, 1969–2026. Directorate General of Health Services. https://cdsco.gov.in/

Databases

  • Washington State University, College of Veterinary Medicine. Veterinary Clinical Pharmacology Laboratory (VCPL) — MDR1 Multidrug Sensitivity Database. https://vcpl.vetmed.wsu.edu/
Educational reference only
This information is provided for educational purposes and is not a substitute for professional veterinary advice, diagnosis, or treatment. Always consult a qualified veterinarian before administering any medication to your pet. Find a vet near you →