Drug interactions
Propranolol + Ranolazine
Severity: Minor
Propranolol and Ranolazine: minor 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
Ranolazine weakly inhibits CYP2D6 and may modestly increase propranolol exposure. The clinical effect is mostly additional bradycardia or hypotension, and ranolazine can also prolong the QT interval slightly.
What this interaction means in plain words
Propranolol and Ranolazine have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised.
Propranolol belongs to Cardiovascular; Ranolazine belongs to Cardiovascular.
Why it happens
Weak inhibition of CYP2D6 by ranolazine reduces propranolol metabolism.
What to do
Monitor heart rate and blood pressure after starting ranolazine. Adjust the propranolol dose only if symptomatic bradycardia or hypotension occurs.
What to ask your pharmacist
- Is there anything I should notice while taking both?
- Do I need to tell my doctor at the next visit?
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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 Ranolazine
- Adagrasib + Ranolazine Contraindicated
- Amobarbital + Ranolazine Contraindicated
- Apalutamide + Ranolazine Contraindicated
- Butabarbital + Ranolazine Contraindicated
- Carbamazepine + Ranolazine Contraindicated
- Clarithromycin + Ranolazine Contraindicated
Frequently asked questions
Can I take Propranolol with Ranolazine?
MediHelp rates the interaction as minor. Propranolol and Ranolazine have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised. Ranolazine weakly inhibits CYP2D6 and may modestly increase propranolol exposure. The clinical effect is mostly additional bradycardia or hypotension, and ranolazine can also prolong the QT interval slightly.
How serious is the interaction between Propranolol and Ranolazine?
MediHelp rates it minor, 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 after starting ranolazine. Adjust the propranolol dose only if symptomatic bradycardia or hypotension occurs.
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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