Bronchial asthma, pronounced bradycardia, manifest heart failure, second and third degree heart block, hypersensitivity to hymenoptera toxins (increased risk of anaphylaxis).

Propranolol: Cautions

Propranolol is less effective in smokers (increased presystemic metabolism). To avoid a rebound reaction propranolol ought to be withdrawn gradually. It should not be discontinued before a narcosis as this could lead to unpredictable intra-operative complications.

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