Drug interactions
Bupivacaine + Propranolol
Severity: Moderate
Bupivacaine and Propranolol: moderate 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
Beta-blockers may reduce hepatic clearance of amide local anesthetics, and both can depress cardiac conduction and contractility. Bupivacaine is notably cardiotoxic, so excess exposure risks hypotension, bradycardia and arrhythmia.
What this interaction means in plain words
Bupivacaine and Propranolol can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Bupivacaine belongs to Central Nervous System; Propranolol belongs to Cardiovascular.
Why it happens
Additive cardiac depression plus reduced hepatic blood flow and clearance of bupivacaine with propranolol.
What to do
Use the lowest effective bupivacaine dose, avoid inadvertent intravascular injection, and monitor ECG and blood pressure. Have resuscitation measures available during blocks.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Propranolol
- Propranolol + Thioridazine Contraindicated
- Acebutolol + Propranolol Major
- Adrenaline-articaine + Propranolol Major
- Amifostine + Propranolol Major
- Amiodarone + Propranolol Major
- Arformoterol + Propranolol Major
Other interactions of Bupivacaine
- Bupivacaine + Bupivacaine implant Major
- Amlodipine-benazepril + Bupivacaine Moderate
- Benazepril + Bupivacaine Moderate
- Bupivacaine + Bupivacaine liposome Moderate
- Bupivacaine + Captopril Moderate
- Bupivacaine + Dofetilide Moderate
Frequently asked questions
Can I take Bupivacaine with Propranolol?
MediHelp rates the interaction as moderate. Bupivacaine and Propranolol can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Beta-blockers may reduce hepatic clearance of amide local anesthetics, and both can depress cardiac conduction and contractility. Bupivacaine is notably cardiotoxic, so excess exposure risks hypotension, bradycardia and arrhythmia.
How serious is the interaction between Bupivacaine and Propranolol?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use the lowest effective bupivacaine dose, avoid inadvertent intravascular injection, and monitor ECG and blood pressure. Have resuscitation measures available during blocks.
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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