Drug interactions
Escitalopram + Propranolol
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.
Overview
Escitalopram (a weak CYP2D6 inhibitor) may increase propranolol exposure and enhance beta‑blockade, leading to bradycardia and hypotension; additive negative chronotropy may occur.
Mechanism of action
Pharmacokinetic: mild CYP2D6 inhibition may raise propranolol levels. Pharmacodynamic: additive heart rate and blood pressure lowering.
Clinical management
Monitor heart rate and blood pressure after initiation or dose changes; consider starting propranolol at a lower dose and titrate cautiously; adjust dose based on clinical response.
Drug reference
References
- Escitalopram (Lexapro) Prescribing Information – Drug Interactions with CYP2D6 substrates — FDA Label
- Drug Interactions: SSRIs and Beta‑blockers (metoprolol/propranolol) — Lexicomp
- Selective serotonin reuptake inhibitors: Pharmacology and adverse effects (CYP interactions) — UpToDate
Frequently asked questions
Can I take Escitalopram with Propranolol?
The interaction is rated: Moderate. Escitalopram (a weak CYP2D6 inhibitor) may increase propranolol exposure and enhance beta‑blockade, leading to bradycardia and hypotension; additive negative chronotropy may occur.
How serious is the interaction between Escitalopram and Propranolol?
The interaction is rated: Moderate. Evidence level: Moderate.
How is the interaction between Escitalopram and Propranolol managed?
Monitor heart rate and blood pressure after initiation or dose changes; consider starting propranolol at a lower dose and titrate cautiously; adjust dose based on clinical response.
Why do Escitalopram and Propranolol interact?
Pharmacokinetic: mild CYP2D6 inhibition may raise propranolol levels. Pharmacodynamic: additive heart rate and blood pressure lowering.
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