Propranolol

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Topic Contents

Propranolol

Drug Information

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.

Common brand names:

Inderal, Inderal LA

Summary of Interactions with Vitamins, Herbs, & Foods

Types of interactions: Beneficial Adverse Check

Replenish Depleted Nutrients

  • none

Reduce Side Effects

  • none

Support Medicine

  • none

Reduces Effectiveness

  • none

Potential Negative Interaction

  • 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.1

    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
  • 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.

    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.

Explanation Required 

  • Black Pepper

    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.

  • Long Pepper

    In a single-dose human study, piperine, a chemical found in black pepper and long pepper, was reported to increase blood levels of propranolol,5 which could increase the activity and risk of side effects of the drug.

  • Coenzyme Q10

    Propranolol inhibits enzymes dependent on coenzyme Q10 (CoQ10). In one trial, propranolol-induced symptoms were reduced in people given 60 mg of CoQ10 per day.6

    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
The Drug-Nutrient Interactions table may not include every possible interaction. Taking medicines with meals, on an empty stomach, or with alcohol may influence their effects. For details, refer to the manufacturers’ package information as these are not covered in this table. If you take medications, always discuss the potential risks and benefits of adding a new supplement with your doctor or pharmacist.

References

1. Newall CA, Anderson LA, Phillipson JD. Herbal Medicines: A Guide for Health-Care Professionals. London: Pharmaceutical Press, 1996, 213-4.

2. Rosa RM, Silva P, Young JB, et al. Adrenergic modulation of extrarenal potassium disposal. N Engl J Med 1980;302:431-4.

3. Lundborg P. The effect of adrenergic blockade on potassium concentrations in different conditions. Acta Med Scand Suppl 1983;672:121-6 [review].

4. Bano G, Raina RK, Zutshi U, et al. Effect of piperine on bioavailability and pharmacokinetics of propranolol and theophylline in healthy volunteers. Eur J Clin Pharmacol 1991;41:615-7.

5. Bano G, Raina RK, Zutshi U, et al. Effect of piperine on bioavailability and pharmacokinetics of propranolol and theophylline in healthy volunteers. Eur J Clin Pharmacol 1991;41:615-7.

6. Hamada M, Kazatain Y, Ochi T, et al. Correlation between serum CoQ10 level and myocardial contractility in hypertensive patients. In Biomedical and Clinical Aspects of Coenzyme Q, vol 4, ed. K Folkers, Y Yamamura. Amsterdam: Elsevier, 1984, 263-70.

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