Omeprazole and Propranolol: Interaction Details
AI-assisted, pharmacist-reviewed · AI content regenerated Jul 11, 2026 · Source data updated Jul 2, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Omeprazole
Propranolol
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.
Omeprazole (Prilosec) and propranolol (Inderal) can interact. Omeprazole can slow down one of the liver enzymes that helps your body break down propranolol. When that happens, propranolol may build up a bit more than usual in your system.
Propranolol is a beta-blocker, so higher levels could make its effects stronger, things like a slower heart rate, lower blood pressure, tiredness, or lightheadedness. To be clear, this is based on theory, not strong proof, so it may not cause you any trouble at all. Keep taking both as prescribed, and let your pharmacist or doctor know if you feel unusually dizzy, tired, or notice a slow heartbeat. Your care team can easily manage this.
Mechanism: Omeprazole inhibits CYP2C19, a pathway involved in propranolol metabolism, potentially increasing propranolol exposure (higher AUC/Cmax). Propranolol is the affected active drug (not a prodrug), so increased levels mean enhanced beta-blockade.
- Direction: Increased propranolol effect (possible bradycardia, hypotension, fatigue).
- Severity: Moderate. Onset: Unspecified. Evidence: Theoretical; magnitude not quantified.
- Management: Use with caution. Monitor heart rate, blood pressure, and signs of excessive beta-blockade. Propranolol dose may need individualization if clinical effects emerge.
What happens
Increased propranolol exposure
Interaction Deep Dive
When propranolol, which is a substrate of CYP2C19, is given together with an inhibitor of CYP2C19, propranolol exposure may rise1; because this could affect either the efficacy or the toxicity of propranolol, the combination should be used with caution2.
Why it happens (mechanism)
Inhibition of CYP2C19-mediated propranolol metabolism
How to manage this interaction
This interaction is usually manageable. Here is what typically happens and what you can do:
- Keep taking both exactly as prescribed unless your doctor tells you otherwise.
- Your care team may monitor you more closely, checking your heart rate and blood pressure, especially early on.
- If needed, your propranolol dose may be adjusted and individualized by your team.
- Tell your pharmacist or prescriber if you notice dizziness, unusual tiredness, a slow heartbeat, or feeling faint.
Because the evidence here is theoretical, many people take these together without any issue.
Management is individual — confirm any change with your pharmacist or prescriber.
Common questions
Can I take Omeprazole and Propranolol together?
Omeprazole may raise propranolol levels and strengthen its effects, but this is theoretical and manageable. Keep taking both as prescribed and report any dizziness, fatigue, or slow heartbeat to your care team. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Omeprazole and Propranolol interaction?
It is rated moderate. Can be significant — usually manageable with monitoring.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How is the Omeprazole and Propranolol interaction managed?
This interaction is usually manageable. Here is what typically happens and what you can do: Keep taking both exactly as prescribed unless your doctor tells you otherwise. Your care team may monitor you more closely, checking your heart rate and blood pressure, especially early on. If needed, your propranolol dose may be adjusted and individualized by your team. Tell your pharmacist or prescriber i… 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:
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- Interaction Question: Omeprazole, Spironolactone And Phentermine
- How To Dose Omeprazole And Sucralfate Together
- Is Tulsi Tea Safe With Xanax and Propranolol?
- Can I Take Mushroom Gummies With Propranolol and Sumatriptan?
- Question Regarding Timing of Multiple Propranolol Doses
Questions for your pharmacist
- Does my dose of Omeprazole 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 anything you'd monitor while I'm on both?
References (2)
- Product Information: HEMANGEOL(R) oral solution, propranolol HCl oral solution. Pierre Fabre Pharmaceuticals Inc (per FDA), Parsippany, NJ, 2021. DailyMed
- Product Information: Propranolol HCl oral tablets, propranolol HCl oral tablets. Amneal Pharmaceuticals LLC (per DailyMed), Bridgewater, NJ, 2019. DailyMed
Keep reading about Omeprazole
Keep reading about Propranolol
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