Can propranolol (beta blocker) cause Eustachian tube dysfunction?

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From the Guidelines

Propranolol is not typically associated with causing Eustachian tube dysfunction, and any symptoms suggesting this condition are more likely related to other factors such as upper respiratory infections or allergies. The primary concern with propranolol and similar beta blockers is their impact on cardiovascular health and potential side effects like dizziness or fatigue, as noted in various studies on medication side effects 1. Eustachian tube dysfunction is generally linked to conditions affecting the middle ear or nasal passages, such as sinus infections, allergies, or anatomical abnormalities, rather than to the use of beta blockers like propranolol.

When considering the management of nasal congestion or Eustachian tube dysfunction, topical decongestants can be an option for short-term relief, as they cause nasal vasoconstriction and decrease nasal edema, but they are not recommended for long-term use due to the risk of developing rhinitis medicamentosa 1. The use of oral decongestants, which act as vasoconstrictors to relieve nasal congestion, should be approached with caution, especially in patients with certain medical conditions like hypertension, arrhythmias, or hyperthyroidism, due to potential adverse effects such as elevated blood pressure or palpitations 1.

Key points to consider:

  • Propranolol's side effect profile does not typically include Eustachian tube dysfunction.
  • Eustachian tube problems are more commonly associated with upper respiratory conditions or anatomical issues.
  • If symptoms persist after starting propranolol, discussing them with a healthcare provider is advisable to rule out any potential links or need for treatment adjustment.
  • Topical decongestants can offer short-term relief for nasal congestion but should be used cautiously and not for extended periods.

From the Research

Eustachian Tube Dysfunction and Propranolol

  • There is no direct evidence to suggest that propranolol, a beta blocker, causes Eustachian tube dysfunction 2, 3, 4, 5, 6.
  • The provided studies focus on the treatment and management of Eustachian tube dysfunction, including the use of nasal decongestants, intranasal corticosteroids, and other interventions 2, 3, 4, 5, 6.
  • None of the studies mention propranolol as a potential cause of Eustachian tube dysfunction.

Treatment and Management of Eustachian Tube Dysfunction

  • Nasal decongestants, such as xylometazoline, have been studied for their effect on Eustachian tube function, with mixed results 3, 4.
  • Intranasal corticosteroids have been investigated as a potential treatment for Eustachian tube dysfunction, but the evidence is limited and inconclusive 5, 6.
  • Other interventions, such as Eustachian tuboplasty and balloon dilatation, have been associated with improved outcomes in some studies 2.

Conclusion on Propranolol and Eustachian Tube Dysfunction

  • Based on the available evidence, there is no clear link between propranolol and Eustachian tube dysfunction.
  • Further research would be needed to investigate any potential relationship between propranolol and Eustachian tube dysfunction.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Interventions for adult Eustachian tube dysfunction: a systematic review.

Health technology assessment (Winchester, England), 2014

Research

Can nasal decongestants improve eustachian tube function?

Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology, 2015

Research

Impact of xylomethazoline on eustachian tube function in healthy participants.

Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology, 2015

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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