Propranolol and Clonidine Transdermal Patch: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Clonidine Transdermal Patch
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.
What happens
An increased risk of worsen sinus node dysfunction and atrioventricular node conduction, an increased risk of bradycardia and AV block and an increased risk of hypotension
Interaction Deep Dive
Avoid concomitant use of cloNIDine and a beta blocker as it may affect sinus node function or AV node conduction with cloNIDine potentiate bradycardia and risk of AV block. Measure heart rate and blood pressure prior to initiation of therapy, following dose increases, and periodically while on therapy, adjust dosages accordingly1. Abrupt withdrawal of cloNIDine while receiving a beta blocker may exaggerate the rebound hypertension due to unopposed alpha stimulation 2456. If therapy is to be discontinued in patients receiving a beta-blocker and cloNIDine concurrently, the beta-blocker should be withdrawn several days before the gradual discontinuation of cloNIDine tablets. In the case of a hypertensive crisis following discontinuation of cloNIDine, IV phentolamine or oral cloNIDine can be used to reverse the excessive rise in blood pressure 3.
Why it happens (mechanism)
Additive effects on sinus node or AV node conduction; additive hypotensive effects
Literature reports
1 report — tap to read
Common questions
Can I take Propranolol and Clonidine Transdermal Patch together?
An increased risk of worsen sinus node dysfunction and atrioventricular node conduction, an increased risk of bradycardia and AV block and an increased risk of hypotension Always confirm with your pharmacist or prescriber before making any change.
How serious is the Propranolol and Clonidine Transdermal Patch 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 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 Propranolol or Clonidine Transdermal Patch 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 (6)
- Product Information: ONYDA(TM) XR extended release suspension, clonidine hydrochloride extended release suspension. Tris Pharma, Inc (Per FDA), Monmouth Junction, NJ, 2024.
- Bailey RR & Neale TJ: Rapid clonidine withdrawal with blood pressure overshoot exaggerated by beta-blockade. Br Med J 1976; 1:942-943. PubMed
- Product Information: CATAPRES oral tablet, clonidine hydrochloride oral tablet. Boehringer Ingelheim Promeco SA de CV, Mexico, Mexico, 2010. DailyMed
- Cummings DM & Vlasses PH: Antihypertensive drug withdrawal syndrome. Drug Intell Clin Pharm 1982; 16:817-822. PubMed
- Lilja M, Jounela AJ, Juustila HJ, et al: Abrupt and gradual change from clonidine to beta blockers in hypertension. Acta Med Scand 1982; 211:375-380. DOI
- Rosenthal T, Rabinowitz B, Boichis H, et al: Use of labetalol in hypertensive patients during discontinuation of clonidine therapy. Eur J Clin Pharmacol 1981; 20:237-240. PubMed
Keep reading about Clonidine Transdermal Patch
Keep reading about Propranolol
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Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:
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