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Essential tremor guide

Essential tremor: propranolol tablets, online

For adults 18 or older whose essential tremor a clinician already diagnosed in person. A doctor reads your answers and your own pulse and blood pressure numbers. The doctor decides if the tablet is right for you. We do not order tests.

Start online

Start a $59 online review for Essential tremor.

Essential tremor is a shake you cannot control. It most often shakes the hands and arms. Propranolol is a tablet that can make the shake smaller. It does not cure the tremor. The FDA label lists this use. We use the label dose. We use it in no other way. A 2011 guide from US brain doctors says propranolol works. A 2026 review says the proof is weak, because the studies were small. Both are true. The doctor decides if the tablet is right for you.

If treatment is appropriate, your physician can send a non-controlled prescription to your pharmacy and provide portal instructions for the next step.

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Quick facts

  • You must be physically located in Virginia or West Virginia at the time of request.
  • Starts at $59
  • No insurance needed
  • No app download
  • Physician review around the clock
  • Non-controlled prescriptions can be sent to your pharmacy when appropriate
  • A work or school note can be included when medically appropriate
  • Response times apply 24/7, every day

Common symptoms

  • A shake you cannot control
  • Shaking that most often affects your hands and arms
  • A tremor that a clinician already diagnosed in person as essential tremor

May fit online care

  • Adults 18 and older
  • You are 18 or older
  • You have essential tremor that a clinician diagnosed in person
  • You saw a clinician in person about the tremor in the last 24 months
  • You have your own pulse and blood pressure numbers from the last 7 days
  • You have none of the warning signs below

Look for another care setting

  • If more than one item fits, follow the first one.
  • Trouble breathing or wheezing (call 911 or go to the ER now).
  • Swelling of the lips, face, tongue, or throat, or trouble swallowing (call 911 or go to the ER now).
  • Blistering or peeling skin (call 911 or go to the ER now).
  • Chest pain, pressure, or tightness (call 911 or go to the ER now).
  • Fainting, feeling like you are about to faint, or severe light-headedness (call 911 or go to the ER now).
  • A very slow pulse (under 40 when you count it), an uneven pulse, or a heartbeat that skips beats (call 911 or go to the ER now).
  • Sudden weakness or numbness on one side, a drooping face, sudden trouble speaking, sudden confusion, a seizure, or sudden loss of balance, trouble walking, or loss of coordination (call 911 or go to the ER now).
  • Signs of low blood sugar that do not get better after you eat a snack that has sugar (call 911 or go to the ER now).
  • You have thoughts of ending your life, or of hurting yourself or someone else (call 911 or go to the ER now).
  • You or someone else took more tablets than the plan says, even a double dose, or you are not sure whether you took extra, or a child may have swallowed tablets, even if the person seems fine (call 911 or go to the ER now).
  • Do not drive yourself. Tell the staff what medicines you take. If you take propranolol, say so and bring your tablets.
  • A new rash or hives (go to the ER or urgent care today).
  • Shaking that started or got worse after you stopped or cut down on drinking a lot of alcohol (go to the ER or urgent care today).
  • New dizziness or light-headedness when you stand up, or a pulse that feels very slow (go to the ER or urgent care today).
  • Your resting pulse is under 50 when you count it (after you start the tablets) (go to the ER or urgent care today).
  • Please go to the ER or urgent care today. Tell the staff what medicines you take. If you take propranolol, say so and bring your tablets.
  • You have new shortness of breath when you walk or do activity, new swelling in your legs or feet, or fast weight gain (see a doctor in person today).
  • You have a fever with a sore throat and body aches (see a doctor in person today).
  • You have a blood pressure reading of 180 or more on top, or 120 or more on the bottom (see a doctor in person today).
  • You are vomiting, or you cannot eat or drink normally (see a doctor in person today).
  • Your top blood pressure number is under 90 (after you start the tablets) (see a doctor in person today).
  • For the items that say to see a doctor in person today: Tell the doctor what medicines you take. If you take our tablets, we do not send your next fill of propranolol. The doctor reads your answers first. Then the doctor can send a plan to stop slowly.
  • You are under 18 (see a doctor in person today).
  • Your tremor started in the last 3 months, or it is clearly different from when your clinician diagnosed it (see a doctor in person within 7 days).
  • Your tremor is getting worse fast, over days or weeks (see a doctor in person within 7 days).
  • Your tremor is only on one side of your body (see a doctor in person within 7 days).
  • Your hands shake when they are resting, or you have slow movements, stiff muscles, or shuffling steps (see a doctor in person within 7 days).
  • You have new trouble with balance or walking, slurred speech, or weakness or numbness that came on slowly, over days or weeks (see a doctor in person within 7 days).
  • You lost weight without trying, you feel hot all the time, or your heart races (see a doctor in person within 7 days).
  • Your resting pulse is over 100 (see a doctor in person within 7 days).
  • For the items that say to see a doctor in person within 7 days: Tell the doctor what medicines you take. If you take our tablets, we do not send your next fill of propranolol. The doctor reads your answers first. Then the doctor can send a plan to stop slowly.
  • A clinician has not told you in person that you have essential tremor, or you are not sure (see your own doctor).
  • Your last in-person visit about your tremor was more than 24 months ago, or you do not remember (see your own doctor).
  • Your tremor started or got worse after you started a medicine, or a clinician told you it may come from another cause, or more tests are planned (see your own doctor).
  • For your diagnosis, your last visit, or the cause of your tremor: Do not change how you take any medicine unless your own doctor tells you. If you take our tablets, we do not send your next fill of propranolol. The doctor reads your answers first. Then the doctor can send a plan to stop slowly.
  • Your resting pulse is under 60 (before you start the tablets) (see your own doctor).
  • Your top blood pressure number is under 100 (before you start the tablets) (see your own doctor).
  • For your pulse or blood pressure before you start the tablets: Do not change how you take any medicine unless your own doctor tells you. If you take our tablets, we do not send your next fill of propranolol. The doctor reads your answers first. Then the doctor can send a plan to stop slowly.
  • Asthma, COPD, chronic bronchitis, emphysema, or any wheezing problem (see your own doctor).
  • Heart block, a slow heartbeat, a pacemaker, or a heart rhythm problem (see your own doctor).
  • Heart failure, a heart attack, or angina (chest pain from the heart) (see your own doctor).
  • Wolff-Parkinson-White syndrome (an extra electrical path in the heart) (see your own doctor).
  • Fainting spells, or low blood pressure that a clinician told you about (see your own doctor).
  • This visit does not cover these conditions. Do not change how you take any medicine unless your own doctor tells you. If you take our tablets, we do not send your next fill of propranolol. The doctor reads your answers first. Then the doctor can send a plan to stop slowly.
  • You have diabetes treated with insulin or with a pill that can cause low blood sugar, such as glipizide, glyburide, glimepiride, repaglinide, or nateglinide (see your own doctor).
  • You have an overactive thyroid (hyperthyroidism) (see your own doctor).
  • You have liver disease or kidney disease (see your own doctor).
  • You had a past severe allergic reaction that needed epinephrine or the ER (see your own doctor).
  • You are allergic to propranolol (see your own doctor).
  • You have a known adrenal gland tumor (pheochromocytoma) (see your own doctor).
  • For diabetes, thyroid, liver, kidney, allergy, or adrenal gland problems: Do not change how you take any medicine unless your own doctor tells you. If you take our tablets, we do not send your next fill of propranolol. The doctor reads your answers first. Then the doctor can send a plan to stop slowly.
  • You are pregnant, or you might be (see your own doctor).
  • You are trying to get pregnant (see your own doctor).
  • You are breastfeeding (see your own doctor).
  • For pregnancy or breastfeeding: Do not change how you take any medicine unless your own doctor tells you. If you take our tablets, we do not send your next fill of propranolol. The doctor reads your answers first. Then the doctor can send a plan to stop slowly.
  • You already take propranolol from another clinician, or another beta blocker, such as metoprolol, atenolol, carvedilol, nadolol, or sotalol (see your own doctor).
  • You take verapamil or diltiazem (see your own doctor).
  • You take clonidine (see your own doctor).
  • You take a heart rhythm medicine, such as digoxin, amiodarone, flecainide, propafenone, or quinidine (see your own doctor).
  • You take warfarin (see your own doctor).
  • You take haloperidol or thioridazine (see your own doctor).
  • If you already take one of these, do not change how you take it. The doctor who prescribes it decides. If you take our tablets, we do not send your next fill of propranolol. The doctor reads your answers first. Then the doctor can send a plan to stop slowly.
  • You have no resting pulse reading from the last 7 days (take your reading, with a home device or a pharmacy machine, and start a new visit).
  • You have no blood pressure reading from the last 7 days (take your reading, with a home device or a pharmacy machine, and start a new visit).
  • Use a home device or a pharmacy machine. Then start a new visit.

What to have ready

  • Who diagnosed your tremor, and when
  • The date and place of your last in-person visit about the tremor
  • Your own resting pulse from the last 7 days (rest for 10 minutes, count the beats at your wrist for 30 seconds, then multiply by 2)
  • Your own blood pressure from the last 7 days (use an approved home device or a pharmacy machine)
  • Every medicine and supplement you take
  • How much alcohol and caffeine you use

What happens next

Standard

$59

Within 6 hours

Priority

$99

Within 3 hours

Rush

$149

Within 1 hour

Start the request on the website, answer a few questions to check that this visit fits you, and choose how fast you want an answer (the response window). If your concern still fits this service, a physician reviews it and sends you a secure update after you sign in. When appropriate, non-controlled prescriptions can be sent to your pharmacy, and a basic work or school note can be included at physician discretion.

How does the visit work?

A clinician is a doctor, nurse practitioner, or physician assistant. We do not order tests. We do not examine you. You tell us who diagnosed the tremor and when. The doctor reads your answers and your own pulse and blood pressure numbers and decides if the tablet is right for you.

How do I check my pulse and blood pressure?

Pulse: Sit and rest for 10 minutes. Put two fingers on the inside of your other wrist, below the thumb. Press until you feel the beat. Count the beats for 30 seconds. Then multiply by 2. Blood pressure: Do not exercise, drink coffee, or smoke for 30 minutes first. Sit and relax for 5 minutes. Keep your feet flat. Rest your arm at the level of your heart. Use an approved home device or a pharmacy machine.

How often do I check my pulse and blood pressure?

Check your pulse and blood pressure every morning for the first 7 days of each new dose. After that, check once a week. Write the numbers down and bring them to each check-in.

Does the tablet work?

A 2011 guide from US brain doctors says propranolol works. A 2026 review says the proof is weak, because the studies were small. Both are true. The doctor decides if the tablet is right for you. Propranolol makes the shake smaller. It does not stop it. It may not help everyone. If your tremor is not clearly better after 8 weeks, message us.

Do I need to keep seeing my own doctor?

Yes. We send at most 3 supplies, 90 days in all. Then your own doctor takes over. At your second paid check-in, tell us the date of your visit with your own doctor. Make that visit before your tablets run out. About day 80 you get one more free check-in. We ask once more about that visit. It sends no tablets. At each check-in, tell us about any new medicine you started.

Can I stop the tablets when I want?

Do not stop propranolol suddenly. Stopping all at once can cause chest pain or a heart attack. It can also cause a thyroid emergency if your thyroid is overactive. Never let your tablets run out. If you want to stop, message us. The doctor sends a plan that lowers the dose slowly, over at least 4 weeks.

What are the side effects?

Tiredness, a stuffy nose, vivid dreams, an upset stomach, and mild light-headedness can happen. Stand up slowly. Keep taking the tablets. If they bother you, message us.

What about food and low blood sugar?

Propranolol can hide some signs of low blood sugar, like a fast heartbeat. Do not go long without food. If you are vomiting or you cannot eat or drink normally, see a doctor in person today. Know the signs of low blood sugar. They are new or worse shaking, sweating, hunger, a headache, weakness, and unclear thinking. If you have them, drink juice or a drink with sugar, or eat a snack. If you do not feel better, get a ride to the ER or call 911. Do not drive yourself.

When do I need care right away?

The warning lists on this page start with the most urgent. Find the first list that has an item that fits you, and do what it says. If more than one item fits, follow the first one. Call 911 or go to the ER now for trouble breathing, chest pain, fainting, a very slow pulse (under 40 when you count it), an uneven pulse, or a seizure. Also call 911 or go to the ER now for sudden weakness or numbness on one side, a drooping face, sudden trouble speaking, or swelling of the lips, face, tongue, or throat. Do the same for blistering or peeling skin, signs of low blood sugar that do not get better after a snack that has sugar, thoughts of ending your life, or more tablets than the plan says. Do not drive yourself. Tell the staff what medicines you take. If you take propranolol, say so and bring your tablets. Go to the ER or urgent care today for a new rash or hives, or new dizziness when you stand up. See a doctor in person today for new shortness of breath, a fever with a sore throat and body aches, or vomiting. See a doctor in person within 7 days if your tremor started in the last 3 months or is getting worse fast. These are only some of the signs. Read the full lists on this page.

What does the visit cost?

The visit price is shown before you pay. You get a free check-in at about 2 weeks. It checks your numbers and side effects. It does not send more tablets. For more tablets, you do a check-in before each new supply. That is about day 25 and about day 55. Each of those two check-ins has a price that is shown before you pay. About day 80 you get one more free check-in. It sends no tablets. You pay the pharmacy for the medicine. There are no automatic refills. We send at most 3 supplies, 90 days in all. Then your own doctor takes over. We add nothing else.

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