Drug interactions
Propranolol + Rizatriptan
Severity: Major
Propranolol and Rizatriptan: major interaction.
Last updated Sources: US FDA label
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 raises rizatriptan plasma concentrations by roughly a third to a half, increasing the risk of triptan adverse effects such as dizziness, drowsiness and chest tightness. The rizatriptan labeling specifically requires a lower dose with propranolol.
What this interaction means in plain words
Propranolol and Rizatriptan can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Propranolol belongs to Cardiovascular; Rizatriptan belongs to Central Nervous System.
Why it happens
Propranolol inhibits monoamine oxidase A-mediated metabolism of rizatriptan, increasing its exposure.
What to do
Use the reduced rizatriptan dose of 5 mg per dose with a maximum of 3 doses in 24 hours. Consider an alternative triptan if adverse effects occur.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
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 Rizatriptan
- Almotriptan + Rizatriptan Contraindicated
- Dihydroergotamine intranasal + Rizatriptan Contraindicated
- Dihydroergotamine + Rizatriptan Contraindicated
- Eletriptan + Rizatriptan Contraindicated
- Ergoloid mesylates + Rizatriptan Contraindicated
- Ergotamine + Rizatriptan Contraindicated
Frequently asked questions
Can I take Propranolol with Rizatriptan?
MediHelp rates the interaction as major. Propranolol and Rizatriptan can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Propranolol raises rizatriptan plasma concentrations by roughly a third to a half, increasing the risk of triptan adverse effects such as dizziness, drowsiness and chest tightness. The rizatriptan labeling specifically requires a lower dose with propranolol.
How serious is the interaction between Propranolol and Rizatriptan?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use the reduced rizatriptan dose of 5 mg per dose with a maximum of 3 doses in 24 hours. Consider an alternative triptan if adverse effects occur.
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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