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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Tightness In Chest And Irregular Heart Beats After Quitting Propranolol?

Hi. Just wanted to ask I was put on propranolol six weeks ago for sinus migraines. I m taking 2x10mg dose twice daily. I ve taken 3 x 10 dose some days, I don t want to take these mess anymore, I ve not taken them for 2 days, I feel my chest is tight and having irregular heartbeats?is that withdrawal symptoms?
Thu, 2 Feb 2017
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General & Family Physician,  's  Response
Hello,

I understand your concern, and yes, you are right, what you are experiencing are indeed withdrawal symptoms. Propranolol slows the heart rate and decreases the oxygen demand of the heart musle. After abruptly quitting propranolol after long term use, there is an overshoot in the heart rate which exceeds the rate before treatment causing the oxygen demand of the heart muscle to increase, hence the chest tightness feeling. This can be dangerous and cessation needs to be gradual. Initially halving the dosage for 2 days and then going down to one fourth of the daily dosage for another few days is the best way to do it.

Wishing you all the best.
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What Causes Tightness In Chest And Irregular Heart Beats After Quitting Propranolol?

Hello, I understand your concern, and yes, you are right, what you are experiencing are indeed withdrawal symptoms. Propranolol slows the heart rate and decreases the oxygen demand of the heart musle. After abruptly quitting propranolol after long term use, there is an overshoot in the heart rate which exceeds the rate before treatment causing the oxygen demand of the heart muscle to increase, hence the chest tightness feeling. This can be dangerous and cessation needs to be gradual. Initially halving the dosage for 2 days and then going down to one fourth of the daily dosage for another few days is the best way to do it. Wishing you all the best.