Propranolol and Caffeine: Is there any interaction? (3 disturbing side effects) 

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 possible interactions between Propranolol and Caffeine. Propranolol is one of the most commonly prescribed beta-blockers which can be used for a number of health conditions. 

Caffeine, on the other hand, is one of the most commonly used beverages. This blog will cover the safety and efficacy of the concomitant use of Propranolol and Caffeine. 

Is there any interaction between Propranolol and Caffeine? 

Propranolol and Caffeine can interact with one another and cause disturbing side effects. These include:

  • Reduced efficacy of Propranolol 
  • Arrhythmia
  • Nerve-racking anxiety

Reduced efficacy of Propranolol 

When caffeine is taken along with Propranolol for a long period of time, it can result in decreasing the effectiveness of Propranolol. Caffeine is a central nervous system (CNS) in nature. 

This property of caffeine, which is one of the most commonly used beverages, can significantly reduce the efficacy of Propranolol by counteracting the effects this drug produces. This is exactly why some healthcare providers recommend to stop using caffeine altogether. 

The concomitant use of these two can affect some people more than the others. People who have unstable heart conditions and require to take Propranolol direly, can not afford this therapeutic failure. 

Always talk to your healthcare provider before consuming caffeine if you’re being treated with Propranolol. Every person has a different tolerance level and different disease severity. 

If you’re taking Propranolol just for your blood pressure then you may be able to take a little bit of caffeine, like a cup or two. The timing at which you take these two can also make a difference as consuming both Propranolol and Caffeine at the same time can cause much more consequences. 

If you take a cup of coffee in the morning and then take Propranolol in the evening or at night, this may reduce the chances of interaction. But again, that is only advisable for people who do not have a serious cardiac condition. 

Arrhythmia 

As stated earlier, Caffeine is a CNS stimulant. It releases excitatory chemicals which wake you up in the morning. These chemicals not only affect your brain, but they also stimulate your other basic physiological functions. 

Caffeine can boost your metabolism and increase your energy consumption by making your heart beat harder and faster. That’s where the trouble begins. Propranolol is a beta-blocker or a beta-adrenergic blocker. 

It actually counteracts the effects of epinephrine, which is the most important chemical for increasing your heart rate or literally jump starting your heart. Have you ever seen in movies where they always try to revive a dying person by injecting something in the chest? 

Well, that something is ‘Epinephrine’. That’s what Propranolol works against. Caffeine can increase the level of this chemical and I’m sure now you can tell what goes wrong when you take Propranolol and Caffeine together. 

This can result in arrhythmia and heart palpitations. This irregular heartbeat can cause life-threatening complications in cardiac patients. 

Nerve-racking anxiety

Anxiety is another concern when it comes to using Propranolol and Caffeine together. Let’s talk about Propranolol for a second here. This drug is not only used for heart conditions, but it can also be used for anxiety and essential tremors. 

This means that Propranolol is capable of controlling excessive neuronal firing in your brain that can cause both anxiety and tremors. Now let’s talk about caffeine for a bit. Caffeine, as I’m telling you for the third time, is a CNS stimulant. It increases the neuronal firing in your brain. 

This way caffeine actually makes the anxiolytic effects of Propranolol useless and you may suffer from nerve-racking anxiety and agitation. Excessive use of Caffeine is enough itself to cause anxiety in an absolutely normal person. 

The Food and Drug Authority (FDA) recommends no more than 400 milligrams (about four or five cups of coffee) per day, and that too for a normal person. People who are suffering from some conditions or taking some medications that may interact negatively with caffeine should drink way less than that. 

If you’re taking Propranolol for tremors, the excessive use of caffeine can result in therapeutic failure and trust me, this is not something you want when you’re suffering from essential tremors. 

What are the common side effects associated with the use of Propranolol and Caffeine? 

Both Propranolol and Caffeine are associated with some side effects. No medication is free from unwanted effects on this planet. You just have to make sure you’re using them right. 

Side effects of Propranolol 

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

Some serious side effects include:

  • Difficulty in breathing and chest tightness 
  • Swollen hands and feet as a result of an allergic reaction. 
  • Wheezing
  • Blackouts 
  • Unexplained weight gain or loss
  • Arrhythmia 

Side effects of Caffeine 

Some common side effects of caffeine include:

  • Anxiety 
  • Sleep disturbance or insomnia. It also decreases sleep quality
  • Headaches
  • Dizziness
  • Tachycardia 
  • Dehydration, as it causes diuresis 
  • Muscle pain
  • Addiction
  • Fatigue
  • Tolerance
  • Gastrointestinal issues like nausea, vomiting, diarrhoea etc.

How to ensure the proper use of Propranolol? 

Make sure you use Propranolol as directed by your healthcare provider. This med may not be a good choice for everyone and it may not suit everyone. Some people have developed an allergic reaction right after taking their first ever Propranolol dose. 

Such people can not continue taking this medicine and it is often switched to a safer one. Propranolol should be used cautiously in people with diabetes. This medication lowers your heart rate and blood pressure, which is why a diabetic patient fails to detect the low blood sugar levels. 

Propranolol is contraindicated to be used in patients who suffer from chronic breathing illnesses, including asthma and chronic obstructive pulmonary disease (COPD). Propranolol causes bronchoconstriction and makes the airways narrow. 

People with asthma and COPD already live with breathing difficulty and this Propranolol bronchoconstriction can make their symptoms much more severe. It can also lead to hospitalisation. Propranolol should be used cautiously in pregnancy. 

You should also ask your healthcare provider if you are trying to get pregnant as this drug may produce unwanted side effects. However, the intensity of these effects can vary from woman to woman. 

Studies have indicated that Propranolol and other beta blockers can pass the placenta and act on the growing fetus, which is exactly why this medication is in Category C of pregnancy medications. 

Studies have also revealed that Propranolol can pass into the breastmilk and it might cause unwanted effects in the breastfed babies. Make sure you ask your healthcare provider if the use of Propranolol is safe for your child during breastfeeding. 

Several studies suggested that Propranolol should not be used in people who suffer from poor blood flow to several other body parts. This is because Propranolol can end up exacerbating the poor blood flow because the drug further lowers down the heart rate and blood pressure. 

Conclusion 

In this blog post, we have discussed the concomitant use of Propranolol and Caffeine. When caffeine is taken along with Propranolol for a long period of time, it can result in decreasing the effectiveness of Propranolol. 

Propranolol and Caffeine together can also cause arrhythmia and heart palpitations. This irregular heartbeat can cause life-threatening complications in cardiac patients. Caffeine can also make the anxiolytic effects of Propranolol useless and you may suffer from nerve-racking anxiety and agitation. 

Make sure you talk to your healthcare provider before you start using these two together. You need to discuss the severity of your symptoms and the possible consequences of taking Propranolol and Caffeine together. This way you can completely understand what could go wrong if you don’t stick to your doctor’s directions.

FAQs: propranolol and caffeine 

Can I have caffeine on beta-blockers? 

Caffeine should be avoided while you’re being treated with beta-blockers. When caffeine is taken along with beta-blockers for a long period of time, it can result in decreasing the effectiveness of these meds. Beta-blockers and Caffeine together can also cause arrhythmia and heart palpitations. This irregular heartbeat can cause life-threatening complications in cardiac patients. Caffeine can also make the anxiolytic effects of beta-blockers useless and you may suffer from nerve-racking anxiety and agitation.

What should you not take propranolol with?

Propranolol should not be taken with other beta blockers or any other drug that can reduce blood pressure or workload of your heart rate. The additive effects can dangerously slow down your circulatory system and give rise to a number of complications. 

Can you stop Propranolol after a week?

No, it is not suitable to stop Propranolol just after a week. It is one of those beta-blockers which are associated with disturbing withdrawal effects when stopped abruptly. However, if you start exhibiting the signs of an allergic reaction right after taking your first ever Propranolol dose, then you don’t have to continue the treatment and you can stop taking Propranolol right away. 

Does propranolol last all day?

Propranolol usually stays in your system for about a day or two. Propranolol has a half-life of about 3-6 hours, which means that the concentration of the drug is reduced to half after this time period. The remaining concentration is then further reduced to half after the next 3 to 6 hours. This process keeps on going until Propranolol is completely removed from your system. 

Can you take propranolol with other anxiety meds?

Yes, you can take propranolol with anti-anxiety meds together, but only if advised by your healthcare provider. This combination does hold some clinical importance and many researchers have investigated the safety and efficacy of the concomitant use of propranolol and antianxiety meds, most commonly benzodiazepines.

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. 

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

References 

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