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Propranolol Hydrochloride

Drug Name: Propranolol Hydrochloride

Drug ID: 162

Nutritional Considerations

  • Possible deficiencies include: Co-Q-10, and Chromium

    1. Kishi H, Kishi T, Folkers K: Bioenergetics in clinical medicine III - inhibition of coenzyme Q10-enzymes by clinically used antihypertensive drugs, Res Commun Chem Pathol Pharmacol, 1975, 12(3):533-40
    2. Mountokalakis T, Dourakis S, Karatzas N, et al: Zinc deficiency in mild hypertensive patients treated with diuretics, J Hypertens Suppl, 1984, 2(3):S571-2
    3. Roeback JR Jr, Hla KM, Chambless LE, Fletcher RH. Effects of chromium supplementation on serum high-density lipoprotein cholesterol levels in men taking beta-blockers. A randomized, controlled trial. Ann Intern Med, 1991;115(12):917-924
  • Avoid alcohol.

    1. Facts and Comparisons, Clinisphere 2.0, Wolters Kluwer Company, 2000
    2. Pronsky, Z Food Medication Interactions, 11th edition, 1999
  • Do not take propranolol with calcium or antacids. This may decrease absorption of the drug.

    1. Pronsky, Z Food Medication Interactions, 11th edition, 1999
    2. Facts and Comparisons, Clinsphere 2.0, Wolters Kluwer Company, 2000
  • Avoid high doses of vitamin C (more than 2 grams/day) because it can decrease metabolism and absorption of the drug.

    1. Pronsky, Z Food Medication Interactions, 11th edition, 1999
  • Use this medication with caution in diabetes because it can prolong hypoglycemia.

    1. Facts and Comparisons, Clinisphere 2.0, Wolters Kluwer Company, 2000
    2. Pronsky, Z Food Medication Interactions, 11th edition, 1999

Herbal Considerations

  • Tobacco can reduce the effects of propranolol.

    1. Brinker, F Herb Contraindications and Drug Interactions, Eclectic Medical Publications, 1998
    2. Pronsky, Z Food Medication Interactions, 11th edition, 1999
  • Avoid natural licorice.

    1. Brinker, F Herb Contraindications and Drug Interactions, Eclectic Medical Publications, 1998
    2. Pronsky, Z Food Medication Interactions, 11th edition, 1999
  • These herbs may increase the side effects or adverse reactions of Propranolol due to their cardiac properties: black hellebore, calamus, cereus, cola, coltsfoot, devil's claw, European mistletoe, fenugreek, fumitory, digitalis leaf, hedge mustard, figwort, lily of the valley roots, motherwort, pleurisy root, squill bulb leaf scales, white horehound, mate, scotch broom flower, shepherd's purse, and wild carrot

    1. Newall CA, Anderson LA, Phillipson JD. Herbal Medicines: A Guide for Health-care Professionals. London: The Pharmaceutical Press, 1996
    2. Facts and Comparisons, Review of Natural Products, Clinisphere 2.0, Wolters Kluwer Company, 2000
    3. PDR for Herbal Medicines, 2nd edition, Medical Economics Company, 2000
  • Black cohosh, poplar, sweet birch, and wintergreen and willow bark all have salicylate properties which may interfere with beta blockers.

    1. Brinker, F Herb Contraindications and Drug Interactions, Eclectic Medical Publications, 1998
  • Some herbs possess diuretic properties that may intensify the action of antihypertensive drugs. This could result in an excessive lowering of blood pressure. Such herbs include: Black Radish, Blue Cohosh, Cleavers, Couchgrass, Elder, Hops, Horsetail, Juniper, Black Safflower, and Sassafras

    1. Brinker, F Herb Contraindications and Drug Interactions, Eclectic Medical Publications, 1998
    2. Newall CA, Anderson LA, Phillipson JD. Herbal Medicines: A Guide for Health-care Professionals. London: The Pharmaceutical Press, 1996
  • Ephedra should not be taken together with other CNS stimulants or circulatory agents (digitoxin, beta-blockers, etc.). Theoretically, a single high dose could result in irregular heartbeats.

    1. Brinker, F Herb Contraindications and Drug Interactions, Eclectic Medical Publications, 1998
  • Cola, Guarana, Mate are some caffeine containing herbs that should be avoided with beta blockers.

    1. Brinker, F Herb Contraindications and Drug Interactions, Eclectic Medical Publications, 1998
  • Melatonin can reverse the sleep effects of propranolol and atenolol.

    1. Stoschitzky K, Sakotnik A, Lercher P, et al. Influence of beta-blockers on melatonin release. Eur J Clin Pharmacol 1999;55(2):111-115
    2. Van Den Heuvel CJ, Reid KJ, Dawson D. "Effect of atenolol on nocturnal sleep and temperature in young men: reversal by pharmacological doses of melatonin." Physiol Behav, Jun. 1997; 61(6):795-802.

NDC Codes

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