Migraine Treatments

Propranolol for Migraine Prevention: What You Should Know

What is propranolol?

You don’t have to in the midst of a migraine in order to treat it. Propranolol is a preventative prescription medication that can help reduce the frequency and severity of migraine headaches.

What will it do for me?

Propranolol is a beta blocker or that’s often used to treat high blood pressure. But it can also act as a first line of defense when it comes to preventing your migraines.

How does it help?

Migraine brains experience blood flow a little differently than others. There is often too much blood flow in the brain’s blood vessels, which leads to that infamous pounding feeling in your head. Propranolol keeps things straight and narrow by possibly reducing that oncoming traffic to the brain. It can also increase electrical movement across the brain (things tend to slow down during a migraine).

How do I get Propranolol?

Propranolol is a prescription medicine so you’ll need to talk to your doctor first. Get started today with a Cove doctor consultation.

How should I take it?

Take propranolol on an empty stomach to ensure that your blood flow remains stable and predictable.

What should I be cautious of?

If you’ve had any of the below, tell your doctor before taking propranolol…

  • An allergic reaction to propranolol or another beta blocker (hives included)
  • Asthma
  • Diabetes (you’re currently taking insulin)
  • Heart arrhythmias
  • Heart failure
  • Low blood pressure
  • Low heart rate
  • Poor circulation
  • Raynaud’s Syndrome

Can I take propranolol with other migraine medications?

You can take propranolol with other migraine medications. However, if you’re taking rizatriptan alongside propranolol, make sure to cut your usual dose of rizatriptan in half.

What happens if I can’t take it right away?

If you forget a dose, take it as soon as you remember to help maintain consistent prevention. Propranolol is short-acting, so if you forget a dose, you may experience a temporary increase in your heart rate.

Where should I keep my Propranolol?

Keep it in a cool, dry place.

Are there any common side effects?

Propranolol rarely comes with any serious side effects, but if you do experience any possible side effects, you might notice…

  • Fatigue
  • Feeling sluggish
  • Lightheadedness
  • Slow heart rate
  • Bad circulation in fingers and toes

What other beta blockers does Cove offer?

Cove currently offers metoprolol.


Propranolol and metoprolol are used to treat high blood pressure and prevent migraine headaches. Do not stop taking these drugs all of a sudden. If you do, chest pain that is worse and in some cases heart attack may occur. The risk may be greater if you have certain types of heart disease. To avoid side effects, you will want to slowly stop this drug as ordered by your doctor. Call your doctor right away if you have new or worse chest pain or if other heart problems occur. You can read more about propranolol side effects, warnings, and precautions here. Full prescribing information for propranolol is available here. You can read more about metaprolol side effects, warnings, and precautions here. Full prescribing information for metoprolol is available here. Rizatriptan is an oral medication indicated for the acute treatment of migraine with or without aura in adults and not for the prophylactic therapy of migraine attacks or for the treatment of cluster headache. Tell your doctor if you are pregnant or plan on getting pregnant. You will need to talk about the benefits and risks of using either of these drugs while you are pregnant. Tell your doctor if you are breast-feeding. Call your doctor right away if you have chest, throat, neck, or jaw tightness, pain, pressure, or heaviness; break out in a cold sweat; shortness of breath; a fast heartbeat; a heartbeat that does not feel normal; or very bad dizziness or passing out. Very bad and sometimes deadly brain blood vessel problems like stroke have rarely happened with this drug. Call your doctor right away if you have weakness on 1 side of the body, trouble speaking or thinking, change in balance, drooping on 1 side of the face, or change in eyesight. You can read more about Rizatriptan side effects, warnings, and precautions here. Full prescribing information for rizatriptan is available here.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit MedWatch: https://www.fda.gov/Safety/MedWatch/default.htm or call 1-800-FDA-1088.