Propranolol
Also indexed as: Betachron, Inderal
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.
Summary of
Interactions with Vitamins, Herbs, and Foods
In some cases, an 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.
 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. |
Coenzyme Q10*
|
| 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. |
Coenzyme Q10*
|
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: 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
|
An asterisk (*) next to an item in the summary indicates that the
interaction is supported only by weak, fragmentary, and/or contradictory scientific
evidence.
Interactions with Dietary Supplements
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.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.
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
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 quitting.
References
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1. 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.
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. Newall CA, Anderson LA, Phillipson JD. Herbal Medicines: A Guide
for Health-Care Professionals. London: Pharmaceutical Press, 1996, 213–4.
6. Threlkeld DS, ed. Diuretics and Cardiovasculars, Beta-Adrenergic
Blocking Agents. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and
Comparisons, Feb 1993, 159a–9c.
7. Holt GA. Food & Drug Interactions. Chicago: Precept
Press, 1998, 225.
8. Threlkeld DS, ed. Diuretics and Cardiovasculars, Beta-Adrenergic
Blocking Agents. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and
Comparisons, Feb 1993, 159a–9c.
9. Deanfield J, Wright C, Krikler S, et al. Cigarette smoking and the
treatment of angina with propranolol, atenolol, and nifedipine. N Engl J Med
1984;310:951–4.
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The information presented in Aisle7 is for informational purposes only.
It is based on scientific studies (human, animal, or in vitro), clinical experience,
or traditional usage as cited in each article. The results reported may not necessarily occur
in all individuals. For many of the conditions discussed, treatment with prescription or over
the counter medication is also available. Consult your doctor, practitioner, and/or chemist
for any health problem and before using any supplements or before making any changes in
prescribed medications.