Inderal injection

How can this medicine affect other medicines?

It is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start treatment with this medicine. Similarly, check with your doctor or pharmacist before taking any new medicines while taking this one, to ensure that the combination is safe.

In people with diabetes, propranolol can prolong the lowering of blood sugar (hypoglycaemia) caused by insulin or other antidiabetic medicines. Individuals should monitor their blood sugar, as propranolol can also mask the signs of hypoglycaemia.

If propranolol is taken with calcium channel blockers such as verapamil, nifedipine or diltiazem, there may be an increased risk of slow heart rate, low blood pressure and heart failure. Verapamil and diltiazem must not be given as an injection into a vein (intravenously) within 48 hours of discontinuing propranolol, and vice versa.

If propranolol is taken in combination with clonidine to lower blood pressure, there is a risk of a rebound increase in blood pressure if the clonidine is stopped. To avoid this, the propranolol should be stopped several days before slowly stopping the clonidine.

Non-steroidal anti-inflammatory drugs (NSAIDs) such as indomethacin may reduce the antihypertensive effects of propranolol.

Care should be taken if adrenaline is given with propranolol, as this combination can cause severely high blood pressure and slow heart rate.

Anti-arrhythmic medicines such as amiodarone or disopyramide may increase the risk of slow heart rate if they are taken with this medicine.

There is an increased risk of slow heart rate when propranolol is taken with digoxin.

If propranolol is taken in combination with ergotamine or dihydroergotamine there may be an increased risk of adverse reactions involving the blood circulation to the extremities.

Administration of propranolol during an intravenous infusion of lidocaine may increase the blood level of lidocaine by approximately 30%. The combination should be avoided.

If any of the following medicines are taken in combination with propranolol, it may result in a change in the blood level of propranolol, the other medicine, or both:-

- calcium channel blockers eg isradipine, lacidipine, nisoldipine, nifedipine, nicardipine
- antipsychotics, eg chlorpromazine, thioridazine
- theophylline
- quinidine
- hydralazine
- propafenone
- rifampicin
- warfarin
- cimetidine.

Other medicines containing the same active ingredient

Beta-prograne

Inderal LA

Syprol

Propranolol tablets, sustained release capsules and syrup are also available without a brand name, ie as the generic medicine.

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