Drug interactions
Propranolol + Salmeterol
Severity: Major
Propranolol and Salmeterol: 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 is a non-selective beta blocker that blocks beta-2 receptors and opposes the bronchodilating effect of salmeterol. It can also precipitate severe bronchospasm in patients with asthma or COPD.
What this interaction means in plain words
Propranolol and Salmeterol 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; Salmeterol belongs to Respiratory.
Why it happens
Pharmacodynamic antagonism at beta-2 adrenergic receptors in the airways.
What to do
Avoid non-selective beta blockers in patients with asthma and use a cardioselective agent with caution if a beta blocker is essential. Monitor respiratory status.
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 Salmeterol
- Ritonavir + Salmeterol Contraindicated
- Salmeterol + Saquinavir Contraindicated
- Amitriptyline + Salmeterol Major
- Arformoterol + Salmeterol Major
- Atazanavir + Salmeterol Major
- Budesonide-formoterol + Salmeterol Major
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 Salmeterol?
MediHelp rates the interaction as major. Propranolol and Salmeterol 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 is a non-selective beta blocker that blocks beta-2 receptors and opposes the bronchodilating effect of salmeterol. It can also precipitate severe bronchospasm in patients with asthma or COPD.
How serious is the interaction between Propranolol and Salmeterol?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid non-selective beta blockers in patients with asthma and use a cardioselective agent with caution if a beta blocker is essential. Monitor respiratory status.
What other medicines interact with Salmeterol?
MediHelp also lists interactions of Salmeterol with, for example, Ritonavir, Saquinavir, Amitriptyline. The full list is on the Salmeterol page.
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