Taking propranolol with other medicines and herbal supplements

There are some medicines that may affect the way propranolol works.

Tell your doctor or pharmacist if you're taking any other medicines including:

• other medicines for high blood pressure. The combination with propranolol can sometimes lower your blood pressure too much. This may make you feel dizzy or faint. If this keeps happening to you, your doctor may change your dose
• other medicines for an irregular heartbeat such as amiodarone, digoxin or flecainide
• other medicines which can lower your blood pressure – these include some antidepressants, nitrates (for chest pain), baclofen (a muscle relaxant), medicines for an enlarged prostate like tamsulosin, or Parkinson's disease medicines such as levodopa
• asthma or chronic obstructive pulmonary disease (COPD) medicines
• diabetes medicines, particularly insulin – propranolol may make it more difficult to recognise the warning signs of low blood sugar. Speak to your doctor if you have low blood sugar levels without getting any of the usual warning signs. Check your blood sugar after exercise, and follow usual advice about checking it before driving, cycling or operating machinery
• medicines to treat nose or sinus congestion, or other cold remedies (including those you can buy in a pharmacy)
• medicines for allergies, such as ephedrine, noradrenaline or adrenaline
• non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, diclofenac or naproxen – these medicines may increase your blood pressure, so it's best to keep them to a minimum
• rizatriptan for migraines

These are not all the medicines that may cause problems if you take them with propranolol. For a full list, see the leaflet inside your medicine packet.