Drug interactions
Fluoxetine + Propranolol
Severity: Moderate
Fluoxetine 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
Fluoxetine inhibits CYP2D6, one of the pathways that clear propranolol, and can raise propranolol exposure. This may lead to excess bradycardia, hypotension and fatigue.
What this interaction means in plain words
Fluoxetine 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.
Fluoxetine belongs to Central Nervous System; Propranolol belongs to Cardiovascular.
Why it happens
Fluoxetine and norfluoxetine inhibit CYP2D6-mediated metabolism of propranolol.
What to do
Monitor heart rate and blood pressure when starting or stopping fluoxetine and reduce the propranolol dose if bradycardia or hypotension occurs. Consider a beta blocker not dependent on CYP2D6 if needed.
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 Fluoxetine
- Fluoxetine + Isocarboxazid Contraindicated
- Fluoxetine + Mavacamten Contraindicated
- Fluoxetine + Methylene blue Contraindicated
- Fluoxetine + Phenelzine Contraindicated
- Fluoxetine + Pimozide Contraindicated
- Fluoxetine + Rasagiline Contraindicated
Frequently asked questions
Can I take Fluoxetine with Propranolol?
MediHelp rates the interaction as moderate. Fluoxetine 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. Fluoxetine inhibits CYP2D6, one of the pathways that clear propranolol, and can raise propranolol exposure. This may lead to excess bradycardia, hypotension and fatigue.
How serious is the interaction between Fluoxetine 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: Monitor heart rate and blood pressure when starting or stopping fluoxetine and reduce the propranolol dose if bradycardia or hypotension occurs. Consider a beta blocker not dependent on CYP2D6 if needed.
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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