Propranolol

[Chimerka]

Hi, I am taking propranolol 40mg a day as migraine prevention (my blood pressure is ok ). I read from many women who continue to take it in pregnancy, but my doctor said I should stop take it when I got pregnant .I stopped taking it, but I was extremely stressed, got permanent migraine and almost lost my job. In the end I miscarried 6th week . I know some women take even 160mg in pregnancy. Is it really so bad to take it, at least first trimester ? I can't function without it and stress might give me another miscarriage .
​​​
​​

[Sandra]

Chimerka,

Propranolol is rated a P3-unknown-risk to the fetus cannot be ruled out. "Propranolol is not a known teratogen, but neonatal adverse outcomes cannot be ruled out at this time. Further studies are necessary. Caution: This drug is a non-selective beta blocker and should be used with caution, if at all, in asthma patients. Quick Note: Propranolol is a nonselective B-adrenergic blocking agent used in the treatment of hypertension. [1] This drug has also been used in the treatment of maternal hyperthyroidism, dysfunctional labor, and cardiac disease. [1] Use of this drug during pregnancy has led to reports of adverse fetal outcomes. These include bradycardia, hypoglycemia, IUGR, hyperbilirubinemia, prolonged labor, polycythemia, and respiratory depression at birth.[2] It is important to note that these effects can not be solely linked to propranolol as they could have been caused by the use of other drugs taken at the same time or by maternal illness.[1] In conclusion, propranolol is not a known teratogen, but neonatal adverse outcomes cannot be ruled out at this time. Further studies are necessary. Caution: This drug is a non-selective beta blocker and should be used with caution, if at all, in asthma patients." (Medications and Mothers' Milk database, Dr Thomas Hale PhD).

1.##Briggs G, Freeman R, Yaffe S. A Reference Guide to Fetal and Neonatal Risk: Drugs in Pregnancy and Lactation. Vol 1. Seventh Edition ed. Philadelphia, PA: Lippincott Williams & Williams; 2005.
2.##Pruyn SC, Phelan JP, Buchanan GC. Long-term propranolol therapy in pregnancy: maternal and fetal outcome. Am J Obstet Gynecol. Oct 15 1979;135(4):485-489.

Sandra Lovato R.N.
InfantRisk Center