# Propranolol Issues please advise



## mross (Jul 10, 2012)

Hi,

Hoping someone can help/ offer some advice.  I take 80mg slow release propranolol daily as a preventative for migraine and have taken for almost two years.  Before starting ivf we spoke to a doctor who said that as im crippled with migraine without the tablet I am best to stay on the 80mg a day throughout pregnancy to manage the migrains, he called a neurologist to check who agreed.  When starting IVF we discussed this with the doctor who agreed it was OK to stay on the tablet up until close to the birth.

I went to the Doctor on Monday to discuss coming down to a lower dose as now im pregnant and saw the heart beat I don't like taking a high dose of these pills.  THe Doctor was a different one and he refused to prescribe me any propranolol and told me how dangerous it was and that he cant see in my notes that I should still be on them.  He then called a neurologist and a obstetrician who all agreed I must come off them immediately.  

I was going to go to my old doctor and discuss however Ive decided I need to come off these awful tablets as I don't want them to harm my baby.  Im terrified that if I come 80mg to nothing I will harm the baby by getting really anxious and stressed without the tablets, but one doctor has said to do this!  I have 40mg in the house of normal propranolol (not the slow release).  Should I come down to that for a week or so fist?  What would be your advice on the safest and easiest way to come off the 80mg slow release without causing to much stress to me or the baby?

Many thanks in advance.


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## mazv (Jul 31, 2006)

Did the doctor you saw regarding the prescription know your full history in relation to migraine? Was it your usual GP that you saw?

Whilst prophylactic treatment is not commonly prescribed in pregnancy it can be considered where benefit outweighs risk. The UK national teratology service conclude that there is evidence that propranolol and amitriptylline have been used safely in pregnancy in the past although they may carry some degree of risk. 

One other thing to consider is how you will be able to control migraine if it returns? Do your migraines respond to treatment, will you need to take medication to treat attacks? I'm assuming you would normally require a triptan drug to treat it. Did the doctor discuss this issue you at all? I'd suggest you speak to them again to discuss how you will manage any attack in pregnancy. 

In terms of stopping there is no need to reduce the dose but if you feel that it would be less stressful to cut down to 40mg first, then there wouldn't a problem to do that for a few days before stopping.


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## mross (Jul 10, 2012)

Thanks so much for your reply.  The Doctor who has told me to come off them immediately has never seen me before so didn't know very much about my situation.  I would use sumatriptan before If my migraine was a full blown one and these 98% of the time will work, however obviously this is a no go in pregnancy.  Nobody really can help which is a real pain.  Ive booked to see my regular gp today to check that im coming off propranolol correctly.  I do feel that I need to come off them even if it means 7.5 months in bed with migraine, because I want baby to be ok.  Thanks again for your advice x


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