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Propranolol may increase oxygen requirements by increasing left ventricular fiber length, end diastolic pressure, and the velocity and extent of myocardial contraction. 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. Treatment must always be initiated and individual titration of dosage carried out using the conventional tablets. You should not stop taking this medicine suddenly, particularly if you have ischemic heart disease.