Drug & supplement interaction

Cinchona + Propranolol

Propranolol brand names: Inderal LA, Inderal, Angilol, Syprol, Inderal Injection, and others.

Moderate Interaction
The bottom line Moderate

Cinchona has a moderate interaction with Propranolol. Theoretically, taking cinchona might inhibit cytochrome P450 2D6 (CYP2D6) and increase levels of drugs metabolized by this enzyme.

Read the full interaction report
SeverityModerate
LikelihoodPossible
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Cinchona and Propranolol

Here is the interaction we found between these two, with the evidence behind it.

Moderate

CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES

Why this applies to Propranolol

Propranolol falls under CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES — the group Cinchona interacts with.

Theoretically, taking cinchona might inhibit cytochrome P450 2D6 (CYP2D6) and increase levels of drugs metabolized by this enzyme.
Quinidine, a constituent of cinchona, inhibits CYP2D6-mediated metabolism in humans.
Severity Moderate Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the gist for propranolol. Your body relies on a liver enzyme called CYP2D6 to help clear this beta blocker out. Cinchona bark contains quinidine, which is a known blocker of that same enzyme. So in theory, pairing the two could let propranolol pile up higher than usual in your system.

Since propranolol works as-is (it is not a prodrug that needs activating), more of it usually means a stronger effect. That could show up as a slower heart rate, lower blood pressure, lightheadedness, or feeling unusually tired. Keep in mind this concern is theoretical, based on how the chemistry should behave, not on solid human studies. Still, cinchona bark itself is unpredictable, so please check with your pharmacist or doctor before combining them.

References
  1. Hansten PD, Horn JR. Drug Interactions Analysis and Management. Vancouver, WA: Applied Therapeutics Inc., 1997 and updates.
  2. Bramer SL, Suri A. Inhibition of CYP2D6 by quinidine and its effects on the metabolism of cilostazol. Clin Pharmacokinet. 1999;37 Suppl 2:41-51. PubMed

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Cinchona Also Interacts With Other Medications

Cinchona has 3 major, 472 moderate, 16 minor known drug interactions in our database — the Propranolol one above is one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Cinchona

Covers the 2,830 medications we’ve checked against Cinchona. Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With Propranolol

This page covers Cinchona only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Propranolol page lists 236 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), American Hellebore (major), American Mistletoe (major), Indian Snakeroot (major) and Tyramine (major).

By severity: 5 major · 194 moderate · 37 minor.

From our pharmacist’s overview on the Propranolol page

“Propranolol (Inderal) slows the heart and lowers blood pressure, which is exactly why its 236-ingredient interaction list deserves genuine care. Five entries rate major, and those are the ones to understand first.”

Reviewed by 2 · Jul 18, 2026

Open the Propranolol interaction page

One more smart check

Taking Cinchona as Part of a Dietary Supplement Product? Check It for Interactions

We hold 12 real supplement products containing Cinchona, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Cinchona. Your product may carry other ingredients that interact with Propranolol too, on top of Cinchona — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Cinchona and Propranolol Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Cinchona
Steady interest

#925 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Propranolol
Top 1%

#11 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Cinchona

What is Cinchona?

Cinchona
  • Malaria (historical/traditional)
  • Fever
  • Leg cramps and restless legs
  • Digestive upset and loss of appetite
  • Bitter tonic

Cinchona bark is the natural source of quinine and has been used for centuries to treat malaria and fever, but the bark itself is not standardized and can be unpredictable and risky. Modern medicine uses purified, dose-controlled quinine instead, and the supplement form carries real dangers, including serious heart and blood problems. Talk to a pharmacist or doctor before using it, and avoid it during pregnancy.

Read the full Cinchona monograph & all interactions
Medication

About Propranolol (Cardiovascular)

What Is Propranolol (Cardiovascular) Used For?

Brand names: Inderal LA, Inderal, Angilol, Syprol, Inderal Injection, Half-Inderal LA, Bedranol SR, Half Beta Prograne, Beta Prograne, Lopranol LA, Slo-Pro, InnoPran XL

This intravenous (IV) form of propranolol is used in hospital or clinical settings to treat dangerous heart rhythm problems. It is generally reserved for life-threatening arrhythmias (abnormal heart rhythms) or those that occur during anesthesia.

Specific conditions it treats include fast heart rates coming from the upper chambers of the heart (supraventricular tachycardia), certain arrhythmias caused by digitalis toxicity, dangerous ventricular rhythms that haven't responded to other treatments, and fast heart rates caused by excess adrenaline-like substances during surgery.

See full Propranolol (Cardiovascular) drug information
Keep checking

Other Drugs & Cinchona

Browse every other medication we’ve checked against Cinchona — both the ones with a known interaction and the ones without. Select any drug for the full detail.

3Major
472Moderate
16Minor
2,338No known interaction
Major

3 interactions

Moderate

472 interactions

Showing 60 of 472 moderate interactions — see all 472 on the Cinchona page.

Minor

16 interactions

No interaction 2,338 drugs checked — show the list
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

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Pharmacist Counseling Corner

Taking Cinchona and Propranolol Together: Common Questions

Can you take Cinchona with Propranolol?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Cinchona and Propranolol interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Propranolol and Cinchona?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.