Propranolol vs. other B-Blockers

[aim-agm]

Question from a psychiatrist: Not infrequently I see patients with conditions that would benefit from propranolol that are already on another beta-blocker. Assuming that they aren't on a cardioselective beta-blocker due to e.g. comorbid asthma, would there be any particular reason to not trial (or recommend that PCP trial) changing their beta-blocker to propranolol?

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[shouldigomd]

From a cardiac perspective most instances can be changed to propranolol unless the patient is on a beta blocker for HFrEF therapy. Propranolol is a "dirty" beta blocker with more side effects and TID dosing which is why its less commonly prescribed in the cardiac world.

 

[ROBINHO]

If they have HearT failure with reduced ejectio. Fraction then only three beta blockers have mortality benefit - bisoprolol, metoprolol succcinate and carvedilol.