Safety of propranolol in portal hypertension. Conventional and long acting formulations

Propranolol is likely to be widely used to prevent variceal haemorrhage in patients with cirrhosis. Adverse reactions to propranolol in this group of patients are unusual, although the treatment group as a whole appears to tolerate drug therapy poorly. Therefore, compliance is likely to be a limiting factor, particularly in the prophylactic setting, and the use of once-daily long acting propranolol, which appears to be equally effective, has distinct advantages over the conventional, shorter acting formulation.