Drug interactions
Prazosin + Propranolol
Severity: Moderate
Prazosin 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 propranolol can magnify and prolong the first-dose hypotensive reaction to prazosin. Patients may experience dizziness, syncope or orthostatic hypotension, especially at initiation or after dose increases.
What this interaction means in plain words
Prazosin 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.
Prazosin belongs to Genitourinary; Propranolol belongs to Cardiovascular.
Why it happens
Additive vasodilation from alpha-1 blockade plus beta blockade, which also limits compensatory reflex tachycardia.
What to do
Start prazosin at a low dose, preferably at bedtime, and advise the patient to rise slowly. Monitor standing and sitting blood pressure after each dose change.
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 Prazosin
- Alfuzosin + Prazosin Major
- Amifostine + Prazosin Major
- Avanafil + Prazosin Major
- Doxazosin + Prazosin Major
- Dutasteride-tamsulosin + Prazosin Major
- Phenoxybenzamine + Prazosin Major
Frequently asked questions
Can I take Prazosin with Propranolol?
MediHelp rates the interaction as moderate. Prazosin 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 propranolol can magnify and prolong the first-dose hypotensive reaction to prazosin. Patients may experience dizziness, syncope or orthostatic hypotension, especially at initiation or after dose increases.
How serious is the interaction between Prazosin 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: Start prazosin at a low dose, preferably at bedtime, and advise the patient to rise slowly. Monitor standing and sitting blood pressure after each dose change.
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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