Can Propranolol be used with acid reflux medications?

By OptimistMinds
Page last updated: 14/12/2022 | Next review date: 14/12/2024

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In this blog post, we are going to answer the question, “Can Propranolol be used with acid reflux medications?”. Propranolol is one of the most commonly prescribed beta-blockers which can be used to treat a variety of mental health conditions. 

However, it may not work that well when combined with some other medications. This blog will cover the safety and efficacy of the concomitant use of Propranolol and acid reflux medications. 

Can Propranolol be used with acid reflux medications?

Yes, you can use Propranolol with acid reflux medications, but you need to talk to your healthcare provider first. This is because some of the acid reflux medications may interfere with Propranolol, especially if both of them are taken exactly at the same time. 

What are the most common acid reducers and how does Propranolol interact with them? 

There are three most common classes of acid reflux medications that are used worldwide for the management of increased stomach acidity and heartburn. These include:

  • Proton pump inhibitors 
  • Antacids 
  • Histamine-2 (H2) receptor antagonists 

Proton pump inhibitors

Proton pump inhibitors are one of the most commonly used over-the-counter acid reducers. They basically block the pump in our stomach which plays an important role in the stomach acid production. This way PPIs reduce acid reflux and all the related symptoms. 

They can be combined with typical antacids to give more pronounced effects. Most commonly used PPIs include:

  • Esomeprazole (Nexium)
  • Lansoprazole (Prevacid)
  • Omeprazole (Risek)

Reaction with Propranolol:

Proton pump inhibitors or PPIs are considered free of side effects at therapeutic doses. However, some of them may interact with Propranolol. 

Omeprazole is believed to reduce the availability of Propranolol by decreasing the rate of absorption of this beta-blocker in your stomach. This way you may not be able to achieve the therapeutic response that you have been hoping for. 

This is because Omeprazole may increase the removal of Propranolol from the body before giving it enough time to be absorbed in the blood completely. However, this problem can be solved by choosing another proton pump inhibitor.

Research suggests that Lansoprazole is a good alternative to Omeprazole when given with Propranolol. However, you can still use Omeprazole if Lansoprazole is not available. You just have to change the timing at which you take these two meds. 

You should at least give a 4-hour gap between the two meds. Take Propranolol first so that it will have plenty of time to be absorbed in your body without having Omeprazole around to interfere with the process. Then you can take Omeprazole and you’ll be good to go. 

Antacids

Antacids are another commonly used acid reducers. These agents are basically alkaline in nature. Once they get inside your body, they try to neutralise the stomach acid. This way, the acid is converted into salt and water inside your stomach and it helps relieve the disturbing symptoms. 

They can either be used alone, or paired with another acid reducer like PPIs for more promising results. Some of the examples of typical antacids include:

  • Pepto-Bismol
  • Calcium carbonate (Alka-Seltzer)
  • Aluminium hydroxide gel (Alternagel)
  • Gaviscon 
  • Magnesium hydroxide, also called milk of magnesia.

Reaction with Propranolol:

Antacids, although are considered harmless, can affect negatively with Propranolol. They, just like Omeprazole, can interfere with the usual absorption of Propranolol in your body. 

Magnesium antacids may not affect the absorption that much, much aluminium containing antacids should be avoided while you’re being treated with Propranolol. 

Although they are over-the-counter meds, they should not be used without your doctor’s approval if you’re already being treated with other meds. For a person who has no prescription medication, antacids can be a great choice of acid reducers. 

Histamine-2 (H2) receptor antagonists 

They are another class of acid reflux medications, but they have the highest percentage of interaction with other prescription medications, as compared to both Proton pump inhibitors and antacids. This is because H2 receptor antagonists are a bit complex in nature. 

They work by blocking histamine type 2 receptors, which also play an important role in the acid production inside our stomach. The most commonly used H2 receptor antagonists include:

  • Nizatidine
  • Famotidine (Pepcid AC) 
  • Cimetidine
  • Rimantadine 
  • Zantac 360 

Reaction with Propranolol:

As stated earlier, Histamine-2-blockers are more capable of interacting with other prescription medications, including Propranolol, as compared to both Proton pump inhibitors and antacids. 

Several research studies have indicated that some H2 blockers like Cimetidine and Rimantadine can interact negatively with Propranolol by inhibiting the metabolism of this beta-blocker. It means that Cimetidine and Rimantadine can increase the stay time of Propranolol in your body. 

This can significantly increase the plasma level of Propranolol and may cause more prominent side effects. This effect of Cimetidine and Rimantadine is because they act on the liver enzyme Cytochrome P450 which is responsible for the breakdown of Propranolol into its inactive metabolites. 

These metabolites are then eliminated from your body via urine. When H2 blockers block this enzyme system, Propranolol is not broken down like it is supposed to and more concentration of drug is available in the body to produce its effects. 

Make sure you avoid using these H2 blockers with Propranolol. Even if you do, make sure it is recommended by your healthcare provider. The timing at which you take these two meds can make a difference and separate timings may help you avoid this pharmacokinetic interaction. 

Is there any natural way to reduce acidity while you’re being treated with Propranolol? 

There are a few ways that can help you control your stomach acidity without using any medication at all. However, most of them lifestyle changes, but they can surely help you in the long run. These include:

Make sure you’re eating the good stuff 

The diet you take plays a major role in the acid production in your stomach. When you eat heavy and greasy meals, your body has to produce more acid in order to digest the bulky meal. This is why you should always eat things that are light on your stomach. 

It is also quite important to make sure that you are not eating late at night. Heavy meals before bed can not only increase your stomach acidity, but it can significantly affect your sleep quality. 

Do not eat too much spices

It is a known fact that people don’t like bland food and you always feel like adding your favourite spicy seasonings to add flavour to your food, but too much spices can increase your stomach acidity. 

This can subject you to other disturbing symptoms as well, like heartburn, lower and upper abdominal pain, bloating, flatulence, diarrhoea etc. 

The food literally stays for a few minutes on your lips, but the symptoms can disturb you for a lot longer than that. Don’t risk your health just because you want to eat something that tastes good. 

Avoid excessive intake alcohol and coffee

Both alcohol and caffeine can increase your stomach acidity. It may affect some people more than the others. If we specifically talk about alcohol, then acid reflux is not the only thing you should be worried about. 

There are plenty of other harmful effects of alcohol that can give rise to a number of disturbing symptoms. It can also interact negatively with Propranolol and may make your heart rate a lot slower. Cut back on alcohol as much as you can. 

Caffeine, on the other hand, can also increase your stomach acidity. It can also cause diarrhoea by increasing the intestinal motility of your stomach. 

Excessive intake of coffee can enhance some of the side effects associated with Propranolol like insomnia. It can also cancel out the anxiolytic effects of Propranolol by increasing your anxiety and agitation. 

Drink plenty of water 

Water is an essential part of your body and it can help you overcome your gastric acidity. Water can literally help you dilute the acid in your stomach without leaving it in high concentrations long enough to cause stomach damage. Make sure you drink lots and lots of water. It can help you in several other ways as well. 

Try to walk after dinner

Several studies suggest that walking after dinner can help you digest your food effectively. It can help release gastric enzymes in your body and helps control your stomach acidity. 

On the other hand, lying down straight on bed after dinner can significantly make your stomach more acidic and can cause a number of digestive complications. 

Conclusion 

In this blog post, we have discussed the concomitant use of Propranolol and acid reflux medications. Propranolol is one of the most commonly prescribed beta-blockers which can be used to treat a variety of health conditions. 

However, it may not work that well with other meds. We have learned that Propranolol can interfere with antacids as these agents can decrease the bioavailability of Propranolol and hence, you don’t get the desired therapeutic response. 

The same happens with some of the proton pump inhibitors, like Omeprazole. It inhibits the active absorption of Propranolol in your body. Histamine-2-receptor antagonists, on the other hand, produce entirely different effects. 

They increase the amount of Propranolol in your body and increase the inhibition of beta receptors. Just make sure that you don’t use any acid reducer, even over-the-counter ones, without your doctor’s approval. 

FAQs: acid reflux medication propranolol 

Can propranolol cause acid reflux?

Yes, Propranolol and other beta blockers can cause acid reflux by increasing the production of stomach acid. However, it may affect some people more than others. If you suffer from any such side effect, consult your healthcare provider right away. Do not use any acid reducer without your doctor’s approval. 

What are the most common side effects of propranolol?

The most common side effects of Propranolol include:

  • Xerostomia or dry mouth 
  • Nausea 
  • Vomiting 
  • Constipation 
  • Flatulence 
  • Acid reflux 
  • Depression 
  • Fatigue 
  • Lightheadedness 
  • Abnormal pain
  • Acid reflux 
  • Flu like symptoms 
  • Skin rash

Can you take antacids with propranolol?

Antacids can interfere with the usual absorption of Propranolol in your body. Magnesium antacids may not affect the absorption that much, much aluminium containing antacids should be avoided while you’re being treated with Propranolol. 

What is propranolol usually prescribed for?

Propranolol is a beta-blocker or a beta-adrenergic blocker which can be used to treat the following health conditions:

  • High blood pressure 
  • Angina pectoris
  • Management of congestive heart failure 
  • Arrhythmia or irregular heart beat
  • Myocardial infarction 
  • Tachycardia 
  • Coronary artery diseases 
  • Glaucoma 
  • Migraine 
  • Anxiety and agitation 
  • Essential tremors 

What should you avoid when taking propranolol?

  • Other beta-blockers
  • Angiotensin receptor blockers 
  • ACE Inhibitors 
  • Alpha blockers 
  • Calcium channel blockers 

References 

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