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Propranolol in thyrotoxicosis

Authoring team

Propranolol blocks the peripheral adrenergic features of hyperthyroidism and partially inhibits the conversion of T4 to T3.

Regimen:

  • initially, 40 mg tds or qds PO - this is a high initial dose and reflects the increased metabolism of propranolol in hyperthyroidism

  • if there is no symptomatic relief within the first 24-48 hours, increase to 80 or 160 mg tds or qds

  • continue treatment until thyroid function has returned to normal via other therapies; then withdraw gradually

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