Drug interactions
Lidocaine + Propranolol
Severity: Moderate
Lidocaine 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
Propranolol reduces hepatic blood flow and lidocaine clearance, which can raise lidocaine levels and the risk of CNS and cardiac toxicity. With lidocaine containing epinephrine, non-selective beta-blockade can cause hypertension and reflex bradycardia.
What this interaction means in plain words
Lidocaine 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.
Lidocaine belongs to Cardiovascular; Propranolol belongs to Cardiovascular.
Why it happens
Propranolol decreases hepatic blood flow and possibly inhibits lidocaine metabolism, and unopposed alpha effects occur with epinephrine.
What to do
Use the lowest effective lidocaine dose, especially with infusions, and monitor for toxicity. Avoid large doses of epinephrine-containing anesthetic and monitor blood pressure and heart rate.
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
- Albuterol + Propranolol Major
- Amifostine + Propranolol Major
- Amiodarone + Propranolol Major
Other interactions of Lidocaine
- Bupivacaine liposome + Lidocaine Major
- Disopyramide + Lidocaine Major
- Ex vivo expanded autologous human corneal epithelial cells containing stem cells + Lidocaine Major
- Lidocaine + Nirmatrelvir / ritonavir Major
- Lidocaine + Ombitasvir / paritaprevir / ritonavir and dasabuvir Major
- Lidocaine + Pimozide Major
Frequently asked questions
Can I take Lidocaine with Propranolol?
MediHelp rates the interaction as moderate. Lidocaine 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. Propranolol reduces hepatic blood flow and lidocaine clearance, which can raise lidocaine levels and the risk of CNS and cardiac toxicity. With lidocaine containing epinephrine, non-selective beta-blockade can cause hypertension and reflex bradycardia.
How serious is the interaction between Lidocaine 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 lidocaine dose, especially with infusions, and monitor for toxicity. Avoid large doses of epinephrine-containing anesthetic and monitor blood pressure and heart rate.
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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