Abametapir and Propranolol: Interaction Details
AI-assisted, pharmacist-reviewed · AI content regenerated Jul 11, 2026 · Source data updated Jun 30, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Abametapir
No brand names on recordPropranolol
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
Abametapir is a lotion used to treat head lice. Even though you put it on your scalp, a little gets into your body and can briefly slow down a liver enzyme (called CYP1A2) that helps break down propranolol, your blood pressure and heart medicine.
When that enzyme is slowed, propranolol can build up more than usual. That could make its effects stronger, like a slower heart rate, lower blood pressure, dizziness, or feeling tired. This is based on how the drugs work rather than reported cases, but the concern is taken seriously. The good news: this is very manageable. Please talk with your pharmacist or doctor before using the lice treatment so they can guide the timing.
Mechanism: Abametapir inhibits CYP1A2. Propranolol is partly metabolized by CYP1A2 (along with CYP2D6), so inhibition can increase propranolol exposure (AUC/Cmax).
Direction/effect: Increased propranolol effect, with potential for enhanced beta-blockade (bradycardia, hypotension, fatigue, dizziness).
- Evidence: Theoretical, based on CYP1A2 inhibition.
- Onset: Unspecified; enzyme inhibition may persist for up to 2 weeks after a single topical application.
- Management: Avoid CYP1A2 substrates for 2 weeks after abametapir; if unavoidable, avoid abametapir. Monitor HR and BP if co-exposure occurs.
What happens
Increased exposure of CYP1A2 substrates
Interaction Deep Dive
Within a 2-week window following the application of abametapir, refrain from administering CYP1A2 substrates. Should that not be possible, abametapir itself should be avoided 1.
Why it happens (mechanism)
Inhibition of CYP1A2-mediated metabolism by abametapir
How to manage this interaction
Keep taking your propranolol as prescribed. The main point is to loop in your care team before using the abametapir lice lotion.
- The documented guidance is to avoid CYP1A2 substrates (including propranolol) for 2 weeks after applying abametapir. If that is not possible, the alternative is to avoid using abametapir.
- Your care team can choose the best plan, which may include an alternative lice treatment or closer monitoring of your heart rate and blood pressure.
- Tell your pharmacist or prescriber if you feel unusually dizzy, tired, or notice a slow heartbeat.
Management is individual — confirm any change with your pharmacist or prescriber.
Common questions
Can I take Abametapir and Propranolol together?
Abametapir can slow the breakdown of propranolol for up to 2 weeks, potentially boosting its effects, so check with your pharmacist or doctor before using the lice lotion; they may recommend avoiding one of the two or watching you more closely. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Abametapir and Propranolol interaction?
It is rated major. Potentially serious — often needs a change or close monitoring.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How is the Abametapir and Propranolol interaction managed?
Keep taking your propranolol as prescribed. The main point is to loop in your care team before using the abametapir lice lotion. The documented guidance is to avoid CYP1A2 substrates (including propranolol) for 2 weeks after applying abametapir. If that is not possible, the alternative is to avoid using abametapir. Your care team can choose the best plan, which may include an alternative lice trea… Management is individual — always follow your own care team's guidance.
How strong is the evidence for this interaction?
The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.
From our Q&A
Real reader questions about these medications, each personally answered by our pharmacist:
Questions for your pharmacist
- Does my dose of Abametapir or Propranolol need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there a safer alternative to one of these medications for me?
References (1)
- Product Information: XEGLYZE(TM) topical lotion, abametapir topical lotion. Dr Reddy’s Laboratories Inc (per FDA), Princeton, NJ, 2020. DailyMed
Keep reading about Abametapir
Keep reading about Propranolol
These medications also interact with supplements
Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:
major · moderate · minor — check everything you take with our drug–supplement interaction checker.
Check another combination
Our instant two-drug interaction checker is almost here.
Still have questions about this combination?
Every question gets a real answer from a licensed pharmacist — free, and usually within a day.
Ask the pharmacist