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propranolol

✓ Approved

Bausch + Lomb Corporation · ADRB1 · Small Molecule

What is propranolol?

propranolol is a small molecule developed by Bausch + Lomb Corporation. It is approved for therapeutic indications via oral (po).

Drug Profile

CompanyBausch + Lomb Corporation
Drug ClassSmall Molecule
Molecular TargetADRB1, ADRB2
RouteOral (PO)
StatusApproved
Sources: ClinicalTrials.gov, Bausch + Lomb Corporation

Mechanism of Action

Molecular Targets

propranolol acts on 2 molecular targets:

ADRB1adrenoceptor beta 1 (B1AR, RHR)
ADRB2adrenoceptor beta 2 (B2AR, ADRBR)
Want deeper analysis?Noah AI can explain complex mechanisms and compare to similar drugs.

Therapeutic Indications

propranolol is developed for 1 unique indication across 1 therapeutic area.

Therapeutic AreaConditionPhase
Vascular disordersHypertension✓ Approved

Related Research Articles

PubMedExperimental & molecular medicine2026-10-15

Decreased circulating dopamine β-hydroxylase is associated with medication-related osteonecrosis of the jaw and implicates sympathetic dysregulation.

Lee Kyeongho K, Cho Hana H, Kim June Yeon JY, Hwang Hyun H et al.

Medication-related osteonecrosis of the jaw (MRONJ) is a severe complication of antiresorptive therapy, yet no reliable circulating biomarker exists for risk stratification. Using an unbiased serum proteomics approach in a multicentre framework, we identified dopamine β-hydroxylase (DBH) as a differentially expressed protein with significantly lower levels in patients with MRONJ. This finding was validated in an independent clinical cohort and further supported in the UK Biobank population. Circulating DBH levels were positively associated with blood-pressure traits, consistent with its role as a surrogate marker of sympathetic nervous system activity, and suggesting that reduced DBH levels in MRONJ may reflect altered sympathetic regulation. In a mouse model, pharmacological sympathetic inhibition with propranolol exacerbated jaw osteonecrosis and further suppressed osteoclast activity in the presence of zoledronic acid. Osteoblast-osteoclast co-culture experiments demonstrated additive inhibitory effects on osteoclast differentiation under β-adrenergic blockade. Together, these findings support an association between reduced circulating DBH levels and MRONJ and suggest that sympathetic dysregulation may contribute to disease pathogenesis. Circulating DBH may serve as a candidate biomarker for risk assessment and disease monitoring in patients receiving antiresorptive therapy.

PMID 42875482
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PubMedJournal of the Chinese Medical Association : JCMA2026-10-14

Nonselective beta-blockers and hepatic encephalopathy in liver cirrhosis:A meta-analysis of randomized controlled trials.

Kuo Tai-Hui TH, Chen Yu-Jen YJ, Lee Pei-Chang PC, Yang Tsung-Chieh TC et al.

Liver cirrhosis leads to portal hypertension and related complications, including ascites, esophageal varices, and hepatic encephalopathy (HE). Non-selective beta blockers (NSBBs) decrease portal pressure, but it is not yet clear whether they contribute to HE development. Therefore, we examined the association between NSBB therapy and HE in randomized controlled trials (RCTs) involving patients with cirrhosis. We systematically searched PubMed, Web of Science, ScienceDirect, and the Cochrane Library (from inception to December 31, 2024) for RCTs comparing NSBBs with a placebo, endoscopic band ligation, or injection sclerotherapy for variceal bleeding prevention in relation to HE. The risk ratios (RRs) and 95% confidence intervals (CIs) were pooled using a random-effects model. Subgroups were defined according to the comparator, NSBB type, and hepatic function status (weighted mean Child-Pugh score ≤6 vs. >6). The risk of bias was assessed using the revised Cochrane risk-of-bias tool for randomized trials (RoB 2). There were 12 relevant studies, which included 775 NSBB-treated and 771 comparator patients (54 and 57 HE events). NSBB therapy was not associated with a statistically significant change in HE risk (RR 1.04, 95% CI 0.73-1.47; p = 0.84; I² = 0%). Estimates were consistent across all subgroups of hepatic function statuses (compensation, RR 1.18, 0.44-3.14; decompensation, RR 1.02, 0.70-1.48; p = 0.79), comparators (placebo, RR 1.19, 0.79-1.80; endoscopic therapy, RR 0.72, 0.38-1.39; p = 0.20), and NSBB types (propranolol/timolol, RR 1.06, 0.72-1.55; carvedilol, RR 0.95, 0.42-2.15; p = 0.82). Current evidence does not indicate a statistically significant association between NSBB therapy and HE development in patients with cirrhosis, regardless of disease severity.

PMID 42870342
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PubMedZhonghua wei zhong bing ji jiu yi xue2026-10-14

[Successful treatment of myocardial infarction complicated with thyroid crisis using extracorporeal membrane oxygenation: a case report and literature review].

Zhang Liang L, Piao Yihua Y, Piao Xianji X

Thyroid crisis is caused by an excess of thyroid hormones in the body, leading to a hypermetabolic state and a series of pathological and physiological changes. Clinical manifestations are often non-specific, and in severe cases, it can manifest as multiple organ dysfunction. Acute myocardial infarction combined with thyroid crisis is dangerous and has a high mortality rate. Timely identification and combination of mechanical circulatory support and antithyroid drug treatment are key to improving prognosis. On January 28, 2021, a 49-year-old female patient was admitted to Yanbian University Affiliated Hospital due to "altered mental status for 4 hours, cardiopulmonary during this period". After cardiopulmonary resuscitation, her vital signs were extremely unstable, and electrocardiogram and myocardial enzymes showed acute non-ST-segment elevation myocardial infarction with severe heart function decline (ejection fraction 26%). On the third day of admission, she underwent veno-arterial extracorporeal membrane oxygenation (VA-ECMO) support, and on the sixth day, she underwent percutaneous coronary stent implantation. After surgery, the patient continued to experience recurrent persistent hyperpyrexia and profuse diaphoresis. Screening revealed a significant increase in thyroid hormones and inhibition of thyroid-stimulating hormone. Combined with thyroid ultrasound and Burch-Wartofsky score>45 points, the diagnosis was confirmed to be hyperthyroidism and thyroid crisis. Subsequently, treatment was given with propylthiouracil, propranolol, and hydrocortisone. On the 9th day of admission, extracorporeal membrane oxygenation (ECMO) was successfully withdrawn, cardiac function recovered (ejection fraction of 60%), consciousness improved, and finally the patient was weaned off the ventilator and transferred to a primary hospital for rehabilitation. After 3 months of follow-up, normal life and work were resumed. This case study suggests that early application of ECMO combined with antithyroid therapy can significantly improve the prognosis of patients with refractory cardiogenic shock and thyroid crisis. Even without a clear history of hyperthyroidism, acute coronary events may trigger crisis, and clinical vigilance should be maintained.

PMID 42875246
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PubMedAME case reports2026-10-14

Thyroid storm revealing suspected evolving autoimmune polyglandular syndrome type 2 with steroid-limited assessment of autoimmune adrenal insufficiency: a case report.

Salgueiro Ruben R, Salgueiro Fábio Rêgo FR, Lopes Gonçalo G, Tenreiro Patricia P et al.

Autoimmune polyglandular syndrome type 2 (APS-2) is a rare autoimmune disorder characterized by the coexistence of autoimmune adrenal insufficiency with autoimmune thyroid disease and/or type 1 diabetes mellitus. Its heterogeneous and progressive presentation frequently delays diagnosis, particularly during acute endocrine emergencies where one dominant manifestation may obscure concurrent glandular dysfunction. Recognition of evolving autoimmune disease before overt adrenal insufficiency develops remains particularly challenging, especially when emergency corticosteroid therapy is initiated before endocrine evaluation. We report the case of a 53-year-old woman admitted with severe thyrotoxicosis presenting with marked weight loss, persistent vomiting, generalized weakness, and sinus tachycardia. Laboratory evaluation demonstrated suppressed thyroid-stimulating hormone and markedly elevated free thyroxine levels, fulfilling the clinical criteria for suspected thyroid storm, prompting immediate treatment with hydrocortisone, propranolol, thiamazole, and intravenous fluids resulted in rapid clinical improvement. Further investigation confirmed Graves' disease with positive anti-thyroid antibodies and diffuse uptake on thyroid scintigraphy. Additional studies revealed hypercalcemia with suppressed parathyroid hormone levels, vitamin B12 deficiency, positive anti-parietal cell antibodies, and autoimmune atrophic gastritis compatible with pernicious anemia. Biochemical confirmation of primary adrenal insufficiency was not possible because glucocorticoid therapy had been initiated before adrenal function testing. Nevertheless, the presence of anti-21-hydroxylase antibodies strongly supported autoimmune adrenalitis and raised suspicion for evolving APS-2. Extended autoimmune testing also demonstrated positivity for anti-gp210 antibodies and anti-triple tissue antibodies, suggesting latent autoimmune hepatobiliary involvement. Although these findings were not diagnostic of hepatobiliary or additional gastrointestinal autoimmune disease, they supported a broader autoimmune phenotype and highlighted the need for long-term multidisciplinary surveillance. This case highlights the diagnostic challenge of recognizing evolving APS-2 during an acute endocrine emergency, when severe thyrotoxicosis predominates and early corticosteroid therapy appropriately prioritized patient stabilization but limited definitive biochemical assessment of adrenal function. Compared with previously reported cases, this report emphasizes the value of identifying autoimmune adrenalitis before overt Addison's disease becomes clinically apparent and illustrates the importance of comprehensive autoimmune evaluation in patients presenting with severe thyrotoxicosis and multiple autoimmune manifestations. Early recognition, comprehensive autoimmune investigation, and multidisciplinary longitudinal follow-up are essential to prevent potentially life-threatening endocrine complications.

PMID 42871736
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PubMedJAMA neurology2026-10-12

Early Pregnancy Use of Anti-CGRP Monoclonal Antibodies and Propranolol and Spontaneous Abortion Risk.

Flatman Leah K LK, Leal Lisiane F LF, Leroux Elizabeth E, Lipton Richard B RB et al.

Migraine affects individuals of reproductive age, but treatment options during pregnancy are limited due to safety concerns. Anti-calcitonin gene-related peptide (CGRP) monoclonal antibodies (mAbs) are effective for migraine prevention; however, CGRP is important in placental development. To determine whether early pregnancy exposure to anti-CGRP mAbs or propranolol is associated with spontaneous abortion compared with no exposure. This retrospective cohort study used data from the AM-PREGNANT cohort, derived from the Merative MarketScan Commercial Database, from 2018 to 2021. Participants were followed up through 20 weeks' gestation or until spontaneous abortion or censoring. Among 7 991 200 pregnancies identified in the AM-PREGNANT cohort, 7119 individuals contributing 7579 singleton pregnancies met the predefined eligibility criteria, including age 15 to 45 years, continuous insurance enrollment, last menstrual period (LMP) on or after November 1, 2018, pregnancy end or 20-week censoring by December 31, 2021, and pregestational migraine, defined as a migraine diagnosis or triptan or ergot prescription within 6 months before LMP. Data were analyzed in early 2026. Anti-CGRP mAbs (erenumab, fremanezumab, galcanezumab, eptinezumab) or propranolol, defined as 1 or more filled prescription or injection procedure claim during follow-up and modeled as time-varying. Spontaneous abortion occurring at 20 weeks' or less gestation. Multivariable Cox proportional hazards models adjusted for comorbidities and concomitant medications estimated the risk of spontaneous abortion. Among 7579 pregnancies in 7119 individuals (mean [SD] age, 31.6 [5.5] years), 1862 spontaneous abortions occurred. There were 100 spontaneous abortions (28.6%) during anti-CGRP mAb-exposed person-time, compared with 37 events among propranolol-exposed person-time without anti-CGRP mAbs (12.8%). Compared with unexposed individuals, anti-CGRP mAbs exposure was associated with an increased risk of spontaneous abortion (adjusted hazard ratio [aHR], 1.42; 95% CI, 1.12-1.80), which remained similar in bias-adjusted analyses (HR, 1.33; 95% simulation interval [SI], 1.23-1.45). Propranolol exposure was not associated with increased risk (aHR, 1.02; 95% CI, 0.71-1.47; bias-adjusted HR, 1.00; 95% SI, 0.96-1.03). In this study, early pregnancy exposure to anti-CGRP mAb was associated with a higher risk of spontaneous abortion, while no association was observed with propranolol. These findings support further evaluation of anti-CGRP mAb safety and emphasize counseling for individuals of childbearing potential.

PMID 42862583
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PubMedLasers in medical science2026-10-11

Evaluation of the efficacy of oral propranolol combined with pulsed dye laser versus monotherapy with oral propranolol in the treatment of mixed infantile hemangiomas.

Gao Yang Y, Wang Hongliang H, Li Pan P, Lu Kai K et al.

Oral propranolol is first-line for problematic infantile hemangiomas (IHs) but often leaves superficial residual lesions. This study assessed the efficacy and safety of adding pulsed dye laser (PDL) to propranolol versus propranolol alone for mixed IHs. This single-center retrospective cohort study included children with mixed IHs treated from January 2020 to September 2024, assigned to oral propranolol alone or with PDL. VESS (Vascular Density, Color Intensity, Texture Change) scores at 3 months, Achauer grade ≥ 4 at 1, 3, and 6 months, and regression metrics at 6 months were measured. Safety, parent-reported outcomes, treatment duration, and 12-month sequelae were also recorded. A total of 247 children were included (132 propranolol, 115 combination). The combination group had lower VESS scores at 3 months (all P < 0.010). Achauer grade ≥ 4 was more frequent at all time points (40.87% vs. 22.73% at 1 month, P = 0.002). Area reduction (75.66% vs. 70.75%, P < 0.001), thickness reduction (P = 0.024), and colorimetric ΔE (P = 0.003) were greater. Superficial erythema resolution improved (P = 0.002) with similar deep mass volume reduction. Satisfaction with color improvement (P < 0.001) and quality of life (P < 0.001), and shorter treatment duration (5.79 vs. 6.55 months, P = 0.007) favored the combined group. Recurrence (2.61% vs. 9.85%, P = 0.041) and residual telangiectasia (5.22% vs. 12.88%, P = 0.039) were lower. Transient purpura occurred only with PDL (22.61% vs. 0%, P < 0.001); other events were comparable. Adding PDL to oral propranolol significantly improves superficial clearance and aesthetic outcomes, accelerates global improvement, and reduces long-term recurrence and residual telangiectasia in mixed IHs.

PMID 42858197
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