What is the interaction between Propranolol and Alprazolam (Xanax)?

Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
Educational purpose only • Exercise caution as content is pending human review
Article Review Status
Submitted
Under Review
Approved

Last updated: March 24, 2025View editorial policy

Personalize

Help us tailor your experience

Which best describes you? Your choice helps us use language that's most understandable for you.

From the FDA Drug Label

The pharmacokinetics of oxazepam, triazolam, lorazepam, and alprazolam are not affected by coadministration of propranolol

  • No interaction is expected between Propranolol and Alprazolam (Xanax) based on the provided drug label information 1.
  • The label explicitly states that the pharmacokinetics of alprazolam are not affected by coadministration of propranolol.

From the Research

Propranolol and Xanax (alprazolam) should not typically be taken together without medical supervision due to potential dangerous interactions. These medications can cause additive effects on the central nervous system, potentially leading to excessive sedation, dizziness, confusion, and respiratory depression [ 2 ]. Propranolol is a beta-blocker commonly used for high blood pressure, angina, and anxiety symptoms like tremors, while Xanax is a benzodiazepine prescribed for anxiety disorders and panic attacks.

Key Considerations

  • The combination of propranolol and Xanax may lead to increased risk of adverse effects, including hypotension and postural syncope [ 2 ].
  • There is limited data available on the specific interaction between propranolol and Xanax, but the potential for additive effects on the central nervous system is a concern [ 3 ].
  • Propranolol has been shown to penetrate the CNS, blocking beta-adrenergic receptors, which may contribute to its anxiolytic effects [ 4 ].
  • The use of beta-blockers like propranolol in anxiety disorders is supported by some studies, but the combination with benzodiazepines like Xanax requires careful consideration [ 3 ].

Recommendations

  • If you're currently taking one medication and your doctor has prescribed the other, inform them about all medications you're taking.
  • Never adjust dosages or stop either medication suddenly without medical guidance, as this could cause withdrawal symptoms or rebound effects.
  • The combination might be appropriate in specific cases under careful medical monitoring, but this requires individualized assessment by your healthcare provider who can weigh the benefits against risks based on your specific health conditions [ 2 ].
  • If you experience increased drowsiness, difficulty breathing, or unusual dizziness while taking these medications, seek immediate medical attention.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

Have a follow-up question?

Our Medical A.I. is used by practicing medical doctors at top research institutions around the world. Ask any follow up question and get world-class guideline-backed answers instantly.