Can't find Propranolol? Learn about safe, effective alternatives like Metoprolol, Atenolol, and Nadolol that your doctor may prescribe instead.
If you've been trying to fill your Propranolol prescription and keep hearing "out of stock," you may be wondering whether there's another medication that can do the same job. The good news is that there are several effective alternatives to Propranolol — and your doctor can help you decide which one is right for you.
In this article, we'll explain what Propranolol is, how it works, and walk through the most commonly used alternatives so you can have an informed conversation with your healthcare provider.
Propranolol is a non-selective beta-blocker that has been used for more than 50 years. It was the first beta-blocker ever developed, earning its inventor, Sir James Black, a Nobel Prize. Today, it remains one of the most widely prescribed medications in its class.
Propranolol is FDA-approved to treat:
It's also frequently prescribed off-label for performance anxiety, thyrotoxicosis, and other conditions. For a deeper look, see our guide on what Propranolol is and how it's used.
Propranolol works by blocking both beta-1 and beta-2 adrenergic receptors. Beta-1 receptors are primarily found in the heart, and blocking them reduces heart rate, contractility, and blood pressure. Beta-2 receptors are found in the lungs, blood vessels, and other tissues — blocking them can cause airway constriction, which is why Propranolol is not recommended for people with asthma or COPD.
For a detailed explanation, visit our article on how Propranolol works.
Understanding this mechanism helps explain why some alternatives might be a better fit depending on your medical history.
The following medications are commonly considered when Propranolol is unavailable or not suitable for a patient. Always talk to your doctor before switching medications — never substitute a drug on your own.
Metoprolol is a selective beta-1 blocker, meaning it primarily targets beta-1 receptors in the heart and has much less effect on beta-2 receptors in the lungs. This makes it a better option for patients who have mild asthma or COPD.
Metoprolol comes in two forms:
It is widely used for hypertension, heart failure, angina, and after heart attacks. It's one of the most affordable generics available, with prices as low as $4 to $8 with a discount coupon.
Key difference from Propranolol: Less effective for migraine prevention and essential tremor because those benefits appear to come from non-selective beta-blockade and CNS penetration that Propranolol provides.
Atenolol is another selective beta-1 blocker. It is taken once daily and does not cross the blood-brain barrier as readily as Propranolol, which means it causes fewer central nervous system side effects like vivid dreams, fatigue, and depression.
Atenolol is commonly used for:
Generic Atenolol is very affordable — often available for $4 to $10 for a 30-day supply.
Key difference from Propranolol: Less effective for migraine prevention and tremor. Because it doesn't cross the blood-brain barrier well, it's not typically used for performance anxiety.
Nadolol is a non-selective beta-blocker, similar to Propranolol. It blocks both beta-1 and beta-2 receptors, which means it can be used for many of the same conditions, including migraine prophylaxis and essential tremor.
Advantages of Nadolol include:
Generic Nadolol typically costs $15 to $40 for a 30-day supply with a coupon.
Key difference from Propranolol: Similar therapeutic profile, but may be slightly harder to find and more expensive. Also contraindicated in patients with significant kidney impairment.
Timolol is another non-selective beta-blocker that is FDA-approved for migraine prophylaxis and hypertension. It is less commonly prescribed in oral form today, as it's more widely known for its ophthalmic (eye drop) formulation used to treat glaucoma.
However, oral Timolol can be an option when other beta-blockers are unavailable, particularly for patients who primarily need migraine prevention.
Key difference from Propranolol: Less widely available in oral form and fewer prescribers are experienced with its oral use.
If you can't find Propranolol, here's how to approach the conversation with your doctor:
While Propranolol is an excellent medication with a long track record, it's not the only option. Metoprolol, Atenolol, Nadolol, and Timolol are all viable alternatives depending on your condition and medical history.
If you're struggling to find Propranolol, start by checking pharmacy availability on Medfinder. If it's truly out of stock everywhere, talk to your doctor about one of the alternatives listed above.
For more on the current supply situation, read our Propranolol shortage update for 2026.
You focus on staying healthy. We'll handle the rest.
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