Drug interactions
Propranolol + Rifampin
Severity: Moderate
Propranolol and Rifampin: 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
Rifampin markedly induces hepatic metabolism of propranolol, lowering its plasma levels and reducing beta-blocking effect. Loss of heart rate, blood pressure or angina control can occur.
What this interaction means in plain words
Propranolol and Rifampin 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.
Why it happens
Induction of CYP enzymes (including CYP1A2 and CYP2D6 pathways) and other hepatic processes increases propranolol clearance.
What to do
Monitor heart rate and blood pressure and increase the propranolol dose as needed, or switch to a less affected beta-blocker such as atenolol.
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
Frequently asked questions
Can I take Propranolol with Rifampin?
MediHelp rates the interaction as moderate. Propranolol and Rifampin 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. Rifampin markedly induces hepatic metabolism of propranolol, lowering its plasma levels and reducing beta-blocking effect. Loss of heart rate, blood pressure or angina control can occur.
How serious is the interaction between Propranolol and Rifampin?
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 and increase the propranolol dose as needed, or switch to a less affected beta-blocker such as atenolol.
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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