Propranolol and Venlafaxine (Can you use these two together?)

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

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The Optimistminds editorial team is made up of psychologists, psychiatrists and mental health professionals. Each article is written by a team member with exposure to and experience in the subject matter.  The article then gets reviewed by a more senior editorial member. This is someone with extensive knowledge of the subject matter and highly cited published material.


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In this blog post, we are going to talk about the concomitant use of Propranolol and Venlafaxine. Both of them are prescription medications. Propranolol is a beta-blocker, whereas Venlafaxine is an antidepressant. This blog will cover the safety and efficacy of this combination treatment. 

Can you use Propranolol and Venlafaxine together? 

Yes, you can use Propranolol and Venlafaxine together, but only if prescribed by your healthcare provider. These two meds can be used together for the prevention of migraine and they can also help manage anxiety. 

Although they don’t have any known interactions, it does not indicate that no interaction can ever occur. It is a common fact that medications affect everyone differently. You can not predict how your body will react once it is exposed to either one medication or the combination of meds. 

This is exactly why there is no way to be sure that the combination of Propranolol and Venlafaxine is completely free from interaction. Some people may get away with common and expected side effects, whereas some other people may suffer significantly from this combination. 

The one way to be safe is to ensure the proper use of meds. At least, make sure that you’re taking every single precaution that you can and everything is handled perfectly from your end. The rest is not in your hands and you just have to hope for the best.

These meds are not that dangerous, but again, people are always affected differently. If, let’s say, this combination works amazingly for you, it doesn’t mean it will work in the exact same way when I take this combination. 

What are the possible side effects associated with the concomitant use of Propranolol and Venlafaxine? 

The combination of Propranolol and Venlafaxine is considered free from interactions, but we are going to talk about the ‘possibilities’. Some of the possible side effects include:

  • Hypotension 
  • Insomnia
  • Severe dizziness or lightheadedness 

Hypotension 

Hypotension is one of the possible side effects associated with the concomitant use of Propranolol and Venlafaxine. This is because Propranolol is most commonly used to reduce blood pressure and heart rate. 

It is, in fact, one of the most commonly prescribed medications for the management of condition after a heart attack. However, the combined use of Propranolol and Venlafaxine may increase the body’s exposure to Propranolol by increasing its stay time in the body. 

This is because Venlafaxine can interfere with the metabolism and excretion of Propranolol. This way the drug remains in your body, in an active form, for a longer period of time. This simply means: More pronounced therapeutic results. 

It may cause some serious complications in non-cardiac patients. This is because a cardiac patient needs management of blood pressure, but if we imagine a normal person, with a blood pressure of 70/110 mmHg, high Propranolol exposure can seriously lower this blood pressure. 

It can even lead to blackouts if not managed properly. There are a few things that might help you overcome this problem. 

  • One: Dose adjustment – If you’re taking both of these meds together, the best thing to avoid any possible interaction is to reduce the dose of both of the drugs. This way, the amount of drug will not be high enough to cause serious complications. 
  • Second: Separate timings of dose administration – This is another way to make sure that both of the meds are not present in the highest concentration in your body, at the same time. When you take these two at different timings, you’ll be able to avoid any possible interaction. 

Insomnia 

Insomnia is another possible consequence of taking Propranolol and Venlafaxine together. Both of these meds have this side effect. Propranolol has shown in several clinical trials that it is capable of causing insomnia or inability to fall asleep. 

Venlafaxine, on the other hand, can also increase insomnia and anxiety, especially during the early course of the treatment. This indicates that if you combine these two together, it may affect the sleep quality in some people. 

Again, there is no way to be sure who will develop this side effect. Make sure you immediately inform your healthcare provider if you suffer from any such side effect that ruins the quality of your sleep. 

However, if you do suffer from this side effect, there are a few things that may help you fall asleep. These include:

  • Drink chamomile tea. This herb is free from side effects in appropriate amounts and can significantly help you fall asleep. It can also relieve your anxiety and agitation. 
  • Try aromatherapy with lavender. It is another nature’s gift that can help you feel relaxed and happy. This can increase the quality of your sleep. 
  • Passion flowers are also used to cure insomnia. They are known to induce sleep quickly and it also decreases your nighttime wakefulness. It is available in the form of teabags at different supermarkets. 
  • Ashwagandha is another Indian native herb that can significantly cure insomnia just after 3 months of its use. 
  • You can also drink warm milk with a bit of turmeric. It is believed to possess natural tranquillisation properties and help you fall asleep. It can also relieve any kind of pain or sore muscles in your body. 

Severe dizziness or lightheadedness 

Dizziness and lightheadedness is another possible complication associated with the concomitant use of Propranolol and Venlafaxine. This side effect can be related to hypotension. 

When your heart rate drops, it starts pumping a lesser amount of blood than your body usually requires. When the heart fails to meet the body’s requirement, you may start to feel generally sick and fatigued. 

However, if the flow of blood towards the brain is affected, that’s when you start to feel dizzy, lightheaded, and your vision may start to become a bit blurry. 

This is because blood is responsible to carry all the nutrients, minerals, oxygen towards your brain. When the brain starts to get malnourished and it doesn’t get enough oxygen, the cells start to become tired and may make you feel dizzy. 

This problem can be avoided by the following ways. 

  • Dose adjustment: When your dose is adjusted, you may not feel that dizzy. Appropriate doses do not slow your heart rate excessively. Hence, there is no hindrance in the supply of blood towards your brain. 
  • Exercise: Mild to moderate exercise can really help strengthen your heart muscles and will increase the flow of blood towards your brain. You can also try lying down flat on the floor with your legs raised upwards. This way the blood will flow towards your brain because of the force of gravity. 

What is the difference between Propranolol and Venlafaxine? 

Propranolol is a beta-blocker or a beta-adrenergic blocker. It works by inhibiting the action of adrenaline or epinephrine, which is an important chemical related to the excitatory system in your body. Adrenaline can increase your heart rate, blood pressure, and anxiety. 

Venlafaxine, on the other hand, is an antidepressant. It belongs to the class of Serotonin-norepinephrine reuptake inhibitors (SNRIs). It works by inhibiting the reuptake of serotonin and norepinephrine, which are the excitatory neurotransmitters present in your brain. 

This way it counteracts the effects of depression. However, both Propranolol and Venlafaxine can be used for the treatment and management of vestibular migraine and both are considered effective medications. Make sure you’re using these two right. 

Conclusion 

In this blog post, we have discussed the concomitant use of Propranolol and Venlafaxine. These two meds can be used together for the prevention of migraine and they can also help manage anxiety. 

Although they don’t have any known interactions, it does not indicate that no interaction can ever occur. It is a common fact that medications affect everyone differently. You can not predict how your body will react once it is exposed to either one medication or the combination of meds. 

This is exactly why there is no way to be sure that the combination of Propranolol and Venlafaxine is completely free from interaction. Always make sure that you stick to your doctor’s recommended dose and do not take more than that. It is also not recommended to stop using either Propranolol or Venlafaxine abruptly. 

FAQs: propranolol and venlafaxine 

Can propranolol be taken with antidepressants?

Yes, you can take Propranolol with antidepressants but only if prescribed by your healthcare provider. Always make sure that you stick to your doctor’s recommended dose and do not take more than that. It is also not recommended to stop using either Propranolol or antidepressants suddenly. Both of these meds are associated with disturbing withdrawal symptoms when stopped abruptly. 

What drugs should not be taken with venlafaxine?

  • Monoaminoxidase inhibitors (MAOIs). The combination use can increase the risk of serotonin syndrome. 
  • Non-steroidal anti-inflammatory drugs (NSAIDS). The combination use can increase the risk of bleeding. 
  • Pimozide. The concomitant use can increase the plasma concentration(availability of a drug in the blood) of pimozide to much higher levels. It can result in life-threatening arrhythmia.
  • Controlled substances, including all narcotic analgesics. The concomitant use can cause severe psychological side effects. 
  • Mood stabilisers 
  • Alcohol 

Is propranolol the same as venlafaxine?

No, Propranolol is not the same as Venlafaxine. Propranolol is a beta-blocker or a beta-adrenergic blocker. It works by inhibiting the action of adrenaline or epinephrine, which is an important chemical related to the excitatory system in your body. Adrenaline can increase your heart rate, blood pressure, and anxiety. Venlafaxine, on the other hand, is an antidepressant. It belongs to the class of Serotonin-norepinephrine reuptake inhibitors (SNRIs). It works by inhibiting the reuptake of serotonin and norepinephrine, which are the excitatory neurotransmitters present in your brain. This way it counteracts the effects of depression.

What medications should not be taken with propranolol?

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

How much propranolol should I take for migraines?

The initial dose of Propranolol for migraine is around 40 mg. The dose can later be increased by the doctor according to the severity of your condition. However, it is not recommended to take more than what your healthcare provider has prescribed. 

How long does it take to stop taking Propranolol?

The duration of Propranolol withdrawal and the frequency of dose tapering can vary from person to person. Your doctor will recommend the appropriate time period until which your Propranolol will be tapered and then will be stopped. The time duration also depends on the health condition for which you started taking Propranolol in the first place. 

References 

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