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ARTICLE |

Caution in Propranolol Withdrawal FREE

Zenonas Danilevicius, MD
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JAMA. 1977;237(1):53-53. doi:10.1001/jama.1977.03270280055024
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There have been warnings that abrupt withdrawal of propranolol hydrochloride therapy in patients with or without coronary heart disease may be hazardous. This happens more often in patients treated for severe angina, especially those with unstable disease. Slome1 reported that sudden withdrawal of propranolol therapy was often followed by myocardial infarction, and Olson et al2 described acute and catastrophic exacerbation of symptoms following the abrupt cessation of treatment with large doses of propranolol in patients with coronary artery disease.

The latest warning comes from Mizgala and Counsell,3 who observed 15 acute coronary episodes in 14 patients with severe angina who had been receiving propranolol hydrochloride in daily doses of 80 to 400 mg for periods of seven days to six years. Abrupt cessation of propranolol therapy in these patients produced severe, sudden, acute coronary syndromes. Cessation was followed by rapid worsening of symptoms in 11 of 15

REFERENCES

Slome R:  Withdrawal of propranolol and myocardial infarction . Lancet 1:156, 1973;.
Olson HG, Miller RR, Amsterdam EA, et al:  The propranolol withdrawal rebound phenomenon: Acute and catastrophic exacerbation of symptoms and death following the abrupt cessation of large doses of propranolol in coronary artery disease . Am J Cardiol 35:162, 1975;.
Mizgala HF, Counsell J:  Acute coronary syndromes following abrupt cessation of oral propranolol therapy . Can Med Assoc J 114:1123-1126, 1976;.
Pantano JA, Lee Y:  Abrupt propranolol withdrawal and myocardial contractility . Arch Intern Med 136:867-871, 1976;.
Diaz RG, Somberg J, Freeman E, et al:  Myocardial infarction after propranolol withdrawal . Am Heart J 88:257-258, 1974;.

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Slome R:  Withdrawal of propranolol and myocardial infarction . Lancet 1:156, 1973;.
Olson HG, Miller RR, Amsterdam EA, et al:  The propranolol withdrawal rebound phenomenon: Acute and catastrophic exacerbation of symptoms and death following the abrupt cessation of large doses of propranolol in coronary artery disease . Am J Cardiol 35:162, 1975;.
Mizgala HF, Counsell J:  Acute coronary syndromes following abrupt cessation of oral propranolol therapy . Can Med Assoc J 114:1123-1126, 1976;.
Pantano JA, Lee Y:  Abrupt propranolol withdrawal and myocardial contractility . Arch Intern Med 136:867-871, 1976;.
Diaz RG, Somberg J, Freeman E, et al:  Myocardial infarction after propranolol withdrawal . Am Heart J 88:257-258, 1974;.
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