Can You Take Propranolol with Sertraline?
Last reviewed: · Source: US FDA drug label database
Propranolol and sertraline are often prescribed together for anxiety — the combination is generally manageable, but sertraline can raise propranolol levels, so watch for slow pulse and dizziness.
Is it safe to take Propranolol with Sertraline?
This is a common real-world pairing: sertraline for the underlying anxiety or depression, propranolol for physical symptoms like palpitations and tremor. It's usually well tolerated, but sertraline mildly inhibits the enzymes that clear propranolol, which can enhance its effects — slower heart rate, lower blood pressure, more fatigue, vivid dreams. It is a combination to be used knowingly, not avoided.
How do Propranolol and Sertraline interact?
Propranolol is metabolised by CYP2D6, CYP1A2 and CYP2C19. Sertraline is a mild-to-moderate CYP2D6 inhibitor, modestly raising propranolol exposure. Pharmacodynamically both can cause fatigue; propranolol's bradycardic effect may be accentuated.
Data sourced from the US Food and Drug Administration (FDA) drug label database: OpenFDA propranolol label — CYP2D6 inhibitor interactions.
Who should be careful?
People with asthma (propranolol is non-selective and can trigger bronchospasm regardless of sertraline), those with low resting heart rate or blood pressure, diabetics (masked hypoglycaemia signs), and anyone experiencing fainting or a pulse persistently below 50.
What if I've already taken Propranolol and Sertraline?
This is very likely an intentional prescription — continue as directed. Report a very slow pulse, blackouts, cold extremities, worsening fatigue, or wheeze to your GP. Do not stop propranolol suddenly.
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Frequently Asked Questions
Can I take propranolol and sertraline together?
Yes — it's a common combination for anxiety. Sertraline can strengthen propranolol's effects, so report dizziness or a very slow pulse.
Why do doctors prescribe both for anxiety?
Sertraline treats the underlying condition over weeks; propranolol immediately damps physical symptoms like racing heart, tremor and shaky voice.
Can this combination make me tired?
Both drugs can cause fatigue and the effect can add together, especially in the first weeks. It often settles; if not, your GP can adjust doses.
Is propranolol safe if I have asthma?
Propranolol is generally avoided in asthma because it can trigger bronchospasm. This applies regardless of sertraline — tell your prescriber about any asthma history.