Propranolol and Sertraline: 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
Sertraline
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.
Let's talk about taking sertraline (an antidepressant) together with propranolol (a beta-blocker used for things like blood pressure, heart rhythm, tremor, or migraines). Sertraline can partly block a liver enzyme (called CYP2D6) that normally breaks down propranolol. When that happens, more propranolol can build up in your body.
In practice, that could mean a stronger effect from propranolol, such as a slower heart rate, lower blood pressure, or feeling more tired or lightheaded. The good news is this concern is theoretical, meaning it's based on how the drugs work rather than clear problems in real patients. Your care team can manage this easily by watching how you feel and adjusting your dose if needed.
Effect: Increased propranolol exposure via sertraline's inhibition of CYP2D6, the enzyme mediating propranolol metabolism. Propranolol is an active drug (not a prodrug), so higher exposure means enhanced beta-blockade.
- Direction: Increased propranolol AUC/Cmax, potentially greater efficacy and/or toxicity (bradycardia, hypotension, fatigue).
- Evidence: Theoretical; magnitude not quantified.
- Onset: Unspecified.
- Management: Use with caution. Monitor heart rate and blood pressure; if excessive beta-blockade occurs, a propranolol dose reduction can be considered and individualized.
What happens
Increased propranolol exposure
Interaction Deep Dive
Because propranolol is metabolized by CYP2D6, giving it together with a CYP2D6 inhibitor can raise propranolol levels1, potentially affecting how well propranolol works and/or its toxicity, so caution is advised with this combination 2. Abiraterone acetate acts as a CYP2D6 inhibitor, and its concurrent use with a CYP2D6 substrate should be avoided when even small shifts in that substrate's concentration could produce serious toxicities. When no alternative therapy is available, reducing the dose of the accompanying CYP2D6 substrate drug should be considered 3.
Why it happens (mechanism)
Inhibition of CYP2D6-mediated propranolol metabolism
How to manage this interaction
This interaction can usually be managed well, so keep taking both medications as prescribed unless your prescriber tells you otherwise.
- Your care team may monitor you more closely, checking your heart rate and blood pressure and asking how you feel.
- If propranolol's effect seems too strong, your propranolol dose may be adjusted and individualized by your team.
- Tell your pharmacist or doctor if you notice a slow heartbeat, dizziness, unusual tiredness, or lightheadedness.
- Always mention all your medicines when starting or stopping anything.
Management is individual — confirm any change with your pharmacist or prescriber.
Common questions
Can I take Propranolol and Sertraline together?
Sertraline can raise propranolol levels by slowing its breakdown, which may increase propranolol's effects like a slower heart rate or lower blood pressure. This is a theoretical, manageable concern, so keep taking both as prescribed and report any dizziness or slow heartbeat to your care team. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Propranolol and Sertraline 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 Propranolol and Sertraline interaction managed?
This interaction can usually be managed well, so keep taking both medications as prescribed unless your prescriber tells you otherwise. Your care team may monitor you more closely, checking your heart rate and blood pressure and asking how you feel. If propranolol's effect seems too strong, your propranolol dose may be adjusted and individualized by your team. Tell your pharmacist or doctor if you… 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:
- Switching Between Generic Sertraline Brands: What to Know
- Is Ashwagandha Safe With Bupropion, Sertraline And Azelastine?
- Converting Doses Of Lexapro (Escitalopram) To Zoloft (Sertraline)
- 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 Propranolol or Sertraline 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 (3)
- Product Information: HEMANGEOL(R) oral solution, propranolol HCl oral solution. Pierre Fabre Pharmaceuticals Inc (per FDA), Parsippany, NJ, 2020. DailyMed
- Product Information: Propranolol HCl oral tablets, propranolol HCl oral tablets. Amneal Pharmaceuticals LLC (per DailyMed), Bridgewater, NJ, 2019. DailyMed
- Product Information: AKEEGA(TM) oral tablets, niraparib, abiraterone acetate oral tablets. Janssen Biotech, Inc. (per FDA), Horsham, PA, 2023. DailyMed
Keep reading about Sertraline
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.
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