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Risk of cardiac ischemia after abrupt discontinuationBronchospastic diseaseHeart failureCardiogenic shockWolff-Parkinson-White syndromeDiabetesMay mask signs of hypoglycemiahyperthyroidismSurgerySLEMusculoskeletal diseaseRenal or hepatic impairmentAvoid abrupt cessationElderlyPregnancyCat.CNursing mothers.

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In patients with coronary artery diseaseabruptly stopping propranolol can suddenly worsen anginaand occasionally precipitate heart attacksIf it is necessary to discontinue propranololits dosage should be reduced gradually over several weeks.

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