Version June 2024
| Drug | Possible effects | Precautions |
| Aluminum hydroxide gel | Decreased beta-blocker adsorption and therapeutic effect | Avoid beta-blocker-aluminum hydroxide combination |
| Aminophylline | Mutual inhibition | Observe patient's response |
| Amiodarone | May induce cardiac arrest | Combination should be used with extreme caution |
| Antidiabetic agents | Enhanced hypoglycemia; hypertension | Monitor for altered diabetic response |
| Calcium channel inhibitors (verapamil, diltiazem) | Potentiation of bradycardia, myocardial depression, and hypotension | Avoid use, although few patients show ill effects |
| Cimetidine | Prolongs half-life of propranolol | Combination should be used with caution |
| Clonidine | Hypertension during clonidine withdrawal | Monitor for hypertensive response; withdraw beta blocker before withdrawing clonidine |
| Digitalis glycosides | Potentiation of bradycardia | Observe patient's response; interactions may benefit angina patients with abnormal ventricular function |
| Epinephrine | Hypertension; bradycardia | Administer epinephrine cautiously; cardioselective beta blocker may be safer |
| Ergot alkaloids | Excessive vasoconstriction | Observe patient's response; few patients show ill effects |
| Glucagon | Inhibition of hyperglycemic effect | Monitor for reduced response |
| Halofenate | Reduced beta-blocking activity; induction of propranolol withdrawal rebound | Observe for impaired response to beta blockade |
| Indomethacin | Inhibition of antihypertensive response to beta blockade | Observe patient's response |
| Isoproterenol | Mutual inhibition | Avoid concurrent use or choose cardiac-selective beta blocker |
| Levodopa | Antagonism of levodopa's hypotensive and positive inotropic effects | Monitor for altered response; interaction may have favorable results |
| Lidocaine | Propranolol pretreatment increases lidocaine levels with potential toxicity | Combination should be used with caution; use lower doses of lidocaine |
| Methyldopa | Hypertension during stress | Monitor for hypertensive episodes |
| MAO inhibitors | Uncertain, theoretical | Manufacturer of propranolol considers concurrent use contraindicated |
| Phenothazines | Additive hypotensive effects | Monitor for altered response, especially with high doses of phenothiazines |
| Phenylpropranolamine | Severe hypertensive reaction | |
| Phenytoin | Additive cardiac depressant effects | Administer IV phenytoin with great caution |
| Quinidine | Additive cardiac depressant effects | Observe patient's response; few patients show ill effects |
| Reserpine | Excessive sympathetic blockade | Observe patient's response |
| Rifampin | Increased metabolism of beta blockers | Observe patient's response |
| Smoking | Increased metabolism of beta blockers | Observe patient's response |
| Tricyclic antidepressants | Inhibits negative inotropic and chronotropic effects of beta blockers | Observe patient's response |
| Tubocurarine | Enhanced neuromuscular blockade | Observe response in surgical patients, especially after high doses of propranolol |
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