Drug interactions
Amiodarone + Propranolol
Severity: Major
Amiodarone and Propranolol: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Together these drugs can cause additive bradycardia, sinus arrest and AV block, and amiodarone may also raise propranolol levels. Patients with sinus node dysfunction or conduction disease are at highest risk.
What this interaction means in plain words
Amiodarone and Propranolol can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Amiodarone belongs to Cardiovascular; Propranolol belongs to Cardiovascular.
Why it happens
Additive negative chronotropic and dromotropic effects, plus amiodarone inhibition of CYP2D6-mediated propranolol metabolism.
What to do
Monitor ECG and heart rate closely, especially at initiation, and reduce the propranolol dose as needed. Avoid in patients with sick sinus syndrome or AV block unless a pacemaker is in place.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Propranolol
- Propranolol + Thioridazine Contraindicated
- Acebutolol + Propranolol Major
- Adrenaline-articaine + Propranolol Major
- Albuterol + Propranolol Major
- Amifostine + Propranolol Major
- Arformoterol + Propranolol Major
Other interactions of Amiodarone
- Amiodarone + Amisulpride Contraindicated
- Amiodarone + Arsenic trioxide Contraindicated
- Amiodarone + Dofetilide Contraindicated
- Amiodarone + Dronedarone Contraindicated
- Amiodarone + Droperidol Contraindicated
- Amiodarone + Eliglustat Contraindicated
Frequently asked questions
Can I take Amiodarone with Propranolol?
MediHelp rates the interaction as major. Amiodarone and Propranolol can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Together these drugs can cause additive bradycardia, sinus arrest and AV block, and amiodarone may also raise propranolol levels. Patients with sinus node dysfunction or conduction disease are at highest risk.
How serious is the interaction between Amiodarone and Propranolol?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor ECG and heart rate closely, especially at initiation, and reduce the propranolol dose as needed. Avoid in patients with sick sinus syndrome or AV block unless a pacemaker is in place.
What other medicines interact with Propranolol?
MediHelp also lists interactions of Propranolol with, for example, Thioridazine, Acebutolol, Adrenaline-articaine. The full list is on the Propranolol page.
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