Drug interactions
Guanfacine + Propranolol
Severity: Moderate
Guanfacine 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
Both drugs lower blood pressure and heart rate, so combined use may cause bradycardia and hypotension. If guanfacine is stopped abruptly during propranolol therapy, rebound hypertension can be severe.
What this interaction means in plain words
Guanfacine 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.
Guanfacine belongs to Cardiovascular; Propranolol belongs to Cardiovascular.
Why it happens
Additive sympatholytic effects, with unopposed alpha activity during central alpha-2 agonist withdrawal in beta-blocked patients.
What to do
Monitor blood pressure and heart rate and taper guanfacine gradually. If both are stopped, withdraw the beta blocker first.
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 Guanfacine
- Clonidine + Guanfacine Major
- Guanfacine + Lofexidine Major
- Aldesleukin + Guanfacine Moderate
- Amiodarone + Guanfacine Moderate
- Amisulpride + Guanfacine Moderate
- Amitriptyline + Guanfacine Moderate
Frequently asked questions
Can I take Guanfacine with Propranolol?
MediHelp rates the interaction as moderate. Guanfacine 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. Both drugs lower blood pressure and heart rate, so combined use may cause bradycardia and hypotension. If guanfacine is stopped abruptly during propranolol therapy, rebound hypertension can be severe.
How serious is the interaction between Guanfacine 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 blood pressure and heart rate and taper guanfacine gradually. If both are stopped, withdraw the beta blocker first.
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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