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Propranolol from Inderal capsules is almost completely absorbed from the gastrointestinal tract and undergoes extensive presystemic elimination due to its high hepatic clearance. Propranolol can, in certain patients, be used alone or as an initial agent in patients in whom, in the judgment of the physician, treatment should be started with a beta-blocker rather than a diuretic. Propranolol exerts ant arrhythmic effects in concentrations producing beta-adrenergic blockade, which appears to be due to a reduction of the elevated outflow pressure gradient which is exacerbated by beta-adrenergic receptor stimulation. Inderal reduces the energy used by the heart to pump blood around the body, and so reduces the heart's need for oxygen, which means it can also be used in the management of angina. The body, and so reduces the heart's need for oxygen, which means it can also be used in the management of angina. Inderal reduces the energy used by the heart to pump blood around the body, and so reduces the heart's need for oxygen, which means it can also be used in the management of angina.