In normal subjects receiving oral doses of racemic propranolol, -enantiomer concentrations exceeded those of the -enantiomer by 40-90 as result of stereoselective hepatic metabolism. Essential Tremor In week, double-blind, parallel, placebo-controlled study of patients with essential or familial tremor, propranolol, at dose titrated as needed from 40-80 mg. Before using this medication, tell your doctor or pharmacist of all prescription and nonprescription herbal products you may use, especially of: alpha blockers. Race study conducted in 12 Caucasian and 13 African-American male subjects taking propranolol, showed that at steady state, the clearance of and -propranolol were about 76 and 53 higher in African-Americans than in Caucasians, respectively. Cardiac Failure Sympathetic stimulation may be vital component supporting circulatory function in patients with congestive koper inderal billig utan recept heart failure, and its inhibition by beta blockade may precipitate more severe failure.