Propranolol

Also indexed as: Angilol, Apo-Propranolol, Apsolol, Bedranol SR, Berkolol, Beta Prograne, Betachron, Cardinol, Half Beta Prograne, Half-Inderal, Inderal, Inderal-LA, Lopranol LA, Nu-Propranolol, Probeta LA, Propanix, Propanix SR

Combination drugs: Inderetic, Inderex, Inderide

Illustration
Top

Propranolol is a beta-blocker drug. Propranolol is used to treat or prevent some heart conditions, reduce the symptoms of angina pectoris (chest pain), lower blood pressure in people with hypertension, and improve survival after a heart attack. Propranolol is sometimes used to prevent migraine headaches, to reduce movement associated with essential tremor, and to reduce performance anxiety.

Top

Summary of Interactions with Vitamins, Herbs, and Foods
In some cases, a herb or supplement may appear in more than one category, which may seem contradictory. For clarification, read the full article for details about the summarized interactions.

Beneficial May Be Beneficial: Depletion or interference—The medication may deplete or interfere with the absorption or function of the nutrient. Taking these nutrients may help replenish them.

Co-Enzyme Q10*
Beneficial May Be Beneficial: Side effect reduction/prevention—Taking these supplements may help reduce the likelihood and/or severity of a potential side effect caused by the medication.

Co-Enzyme Q10*
Avoid Avoid: Adverse interaction—Avoid these supplements when taking this medication because taking them together may cause undesirable or dangerous results.

High-potassium foods*

Pleurisy root*

Potassium supplements*

Tobacco
Check Check: Other—Before taking any of these supplements or eating any of these foods with your medication, read this article in full for details.

Pepper
Supportive interaction

None known
Reduced drug absorption/bioavailability

None known
Top

An asterisk (*) next to an item in the summary indicates that the interaction is supported only by weak, fragmentary, and/or contradictory scientific evidence.

Top

Interactions with Dietary Supplements

Co-Enzyme Q10
Propranolol inhibits enzymes dependent on co-Enzyme Q10 (CoQ10). In one trial, propranolol-induced symptoms were reduced in people given 60 mg of CoQ10 per day.1

Potassium
Some beta-adrenergic blockers (called “nonselective” beta blockers) decrease the uptake of potassium from the blood into the cells,2 leading to excess potassium in the blood, a potentially dangerous condition known as hyperkalemia.3 People taking beta-blockers should therefore avoid taking potassium supplements, or eating large quantities of fruit (e.g., bananas), unless directed to do so by their doctor.

Top

Interactions with Herbs

Pepper (Piper nigrum, Piper longum)
In a single-dose human study, piperine, a chemical found in black pepper and long pepper, was reported to increase blood levels of propranolol,4 which could increase the activity and risk of side effects of the drug.

Pleurisy root
As pleurisy root and other plants in the Aesclepius genus contain cardiac glycosides, it is best to avoid use of pleurisy root with heart medications such as beta-blockers.5

Top

Interactions with Foods and Other Compounds

Food
Food increases the absorption of propranolol.6 Propranolol should be taken at the same time every day, always with or always without food. High-protein foods may interfere with propranolol metabolism, increasing propranolol blood levels and activity.7

Alcohol
Propranolol may cause drowsiness or dizziness.8 Alcohol may intensify this action. To prevent accidental injury, people taking propranolol should avoid alcohol.

Tobacco
In a double-blind study of ten cigarette smokers with angina treated with propranolol for one week, angina episodes were significantly reduced during the nonsmoking phase compared with the smoking phase.9 People with angina taking propranolol who do not smoke should avoid starting. Those who smoke should consult with their prescribing doctor about giving up.

Top
References
(To view, roll mouse over the "References" heading; to hide, click on the heading)