The Royal College of Pharmacy (RCPharm) has called for a review of propranolol safety information.
The college said patient safety concerns over use of the medicine for generalised anxiety prompted leading experts to call for a review of its safety information, “particularly around overdose, self-harm and suicide risk”.
Read more: ‘Highly toxic’: Coroner warns GPs of propranolol overdose risk
RCPharm and the Royal College of Physicians (RCP) Medicines Safety Joint Working Group, in collaboration with the National Poisons Information Service, have written to the Medicines and Healthcare products Regulatory Agency (MHRA) requesting updates to propranolol’s Summary of Product Characteristics.
The college said the request was based on “evidence and clinical experience” and that the current licensed indication for propranolol in generalised anxiety is “problematic for a number of reasons”.
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It said that:
- There is no proven evidence that propranolol is effective in the treatment of generalised anxiety disorder
- Propranolol poisoning is life-threatening, difficult to treat and is associated with a significant number of deaths
- Prescribing for propranolol in general practice is increasing, partly because the medicine is perceived to be relatively safe
- Patients at increased risk of overdose, including those taking antidepressants or with a history of overdose, continue to be prescribed propranolol
The RCPharm noted that propranolol prescribing in general practice in England has risen by over 2 million items since the financial year 2020/21, standing at more than 8.3 million items between May 2025 and April 2026.
“Serious consequences of overdose”
Joint chair of the RCPharm/RCP Medicines Safety Joint Working Group Kate Ryan said that “patient safety is at the heart of this work”.
“While propranolol remains an effective treatment for many patients, its use for anxiety presents challenges. We are concerned about the serious consequences of overdose, particularly for vulnerable individuals,” she said.
Fellow joint chair Dr Zuzanna Sawicka said that “strengthening awareness of these risks among healthcare professionals and patients could support safer prescribing decisions and help prevent avoidable harm”.
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It comes after a coroner warned GPs of the risk of propranolol overdose in April following the death of a man who took a “significant amount” of the drug.
And it follows the MHRA updating safety guidance for hair loss drug finasteride and prostate drug dutasteride in May after reviewing evidence on the risks of “sexual dysfunction, depression and suicidal thoughts”.
