Propranolol and Sumatriptan: (Can you use them 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 safety and efficacy of the concomitant use of Sumatriptan and Propranolol. Both of these are prescription medications and can be used in the treatment and management of several health related problems. 

This blog will cover if it’s okay to use these two meds together and we will also learn about some precautions that should be taken if you’re being treated with both of them. 

Can you use Sumatriptan and Propranolol together? 

Yes, you can use Sumatriptan and Propranolol together, but only if your healthcare provider has prescribed this combination. If you need these two meds together, your doctor will adjust the doses, especially of Sumatriptan, in order to make the treatment more safe and efficacious for you. 

This is because whenever medications are combined together, they are not given at their usual doses. Such doses can result in much more pronounced side effects and may make your initial condition much worse. 

This is why it is not recommended to combine meds on your own and you should always stick to your doctor’s advice. 

What does research suggest? 

Many researchers have investigated the pair of Sumatriptan and Propranolol to ensure its safety and efficacy. Clinical trials took place after gathering a lot of different volunteers. 

A 1991 study included ten male patients who were already taking Propranolol for the prevention of migraine. Propranolol was given at the 80mg dose twice a day and 300mg once daily Sumatriptan was added in the treatment regimen. 

The trial lasted for around 7 days. The results concluded that Propranolol did not react with Sumatriptan pharmacodynamically, or in easy words, it did not interfere with the usual mechanism of action of Sumatriptan and the drug performed its functions exactly like it was supposed to. 

Another research study combined the two drugs, Sumatriptan and Propranolol, to treat severe migraine. The doses of the drugs were adjusted and a proper treatment regimen was made. 

The treatment was continued for 3 to 4 weeks and it was seen that the combination provided satisfactory results in the treatment and management of migraine and related symptoms. Another study was conducted on heart patients. 

The most common use of Propranolol is in heart patients. This study gathered heart patients with the possible signs of migraine or migraine-related symptoms. This study was carefully designed to make sure that this combination is safe for cardiac patients or not. 

Normal individuals are more easy to deal with because they are usually healthy and they don’t have any underlying health condition that may interfere with the mechanism of the meds. This trial did not have a lot of participants because of the nature and selectivity of the trial. 

After a few weeks, it was observed that some people tolerated the combination of Sumatriptan and Propranolol well, but some didn’t. They experienced arrhythmia, heart palpitations, and QT elongation. This resulted in discontinuation of the combination therapy in such patients. 

As Propranolol is itself used in the prophylaxis of migraine, the study concluded that the dose of Sumatriptan should be kept low in order to achieve a safe and effective therapeutic outcome. 

This study indicated that there are a number of factors that can affect the quality of combined treatment of drugs in every other individual. A person who is absolutely healthy may not find any difficulty in bearing the combination of meds. 

However, he or she can be hypersensitive or allergic to the meds, but there is literally no way to predict that. As far as diseased people are concerned, their prescriptions should be carefully written. 

This is because any addition to their current prescription can either interact with the existing medications or the symptoms associated with their health condition. 

Even if the prescription is carefully written after weighing the pros and cons, some people still develop unusual side effects. This is exactly why it is recommended to start any medication, either individually or in combination with other meds, from the lowest effective dose. 

This way you’ll be sure if you’re not allergic to any of the active ingredients or excipients present in the formulation. If you are, the side effects associated with lower doses will not be life-threatening and will be easily managed. 

What is the difference between Sumatriptan and Propranolol? 

Both Sumatriptan and Propranolol are prescription medications. Sumatriptan belongs to the class of drugs called ‘Triptans’ or ‘Selective serotonin receptor agonists’. These meds basically work by causing vasoconstriction of the blood vessels in your brain. 

Sumatriptan can also inhibit the release of certain pain mediators in your brain, or chemicals which stimulate the pain signal and cause unbearable headaches associated with migraine. 

These chemicals also stimulate other migraine symptoms like nausea, vomiting, sensitivity to sound and light known as Hyperacusis and Photosensitivity respectively. This is how Sumatriptan treats and manages almost all of the symptoms associated with migraine. 

The tablet dose may not produce vasoconstrictive effects in the rest of the body, but the intravenous parenteral administration can significantly cause vasoconstriction in your cardiac blood vessels.

It may become a problem for people suffering from vascular diseases like coronary artery diseases or people suffering from congestive heart failure. 

This is another reason why the combination of Sumatriptan with Propranolol can be dangerous for cardiac patients and Sumatriptan may counteract the effects of Propranolol by making the heart condition worse. 

Propranolol, on the other hand, 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. This is what Propranolol works to counteract. The most common uses of Propranolol include:

  • 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 

How to ensure the proper use of Sumatriptan and Propranolol? 

In order to ensure the proper use of Sumatriptan and Propranolol, you should have a sound knowledge of both of these meds. You can read the leaflets which are provided with the meds. 

They contain all the basic information regarding the medication. Let’s look at some important points related to the safe and effective use of Sumatriptan and Propranolol. 

Safety precautions for Sumatriptan

  • Take Sumatriptan exactly as directed by your healthcare provider. 
  • Do not deviate from the prescribed dose. In case of overdose, immediately reach out to your doctor. Inform accurately how much drug has been taken and when. 
  • Sumatriptan can be taken again if the effects of the drug wear off. However, do not take two medications at the same time. 
  • Keep the bottle out of reach of children and pets. 
  • Report any sign of an allergic reaction right away. 

Sumatriptan should be used cautiously in some people. As discussed earlier, you should inform your healthcare provider if you have any cardiac problem prior to the use of Sumatriptan. 

It is also important to make sure that you are not taking this med with some other medications that may increase the chances and the severity of the possible side effects. Medications that should not be used with Sumatriptan include:

  • Other selective serotonin receptor agonists, including Eletriptan, Almotriptan, Rizatriptan, Frovatriptan etc. 
  • Monoaminoxidase inhibitors, including Selegiline, Phenelzine, isocarboxazid etc. 
  • Tricyclic antidepressants, including Amitriptyline, Nortriptyline, Imipramine etc. 
  • Selective serotonin reuptake inhibitors, including Sertraline, Paroxetine, Fluoxetine, Escitalopram, Citalopram etc. 
  • Serotonin-norepinephrine reuptake inhibitors, including Venlafaxine, Desvenlafaxine, Milnacipran, Levomilnacipran, Duloxetine etc. 
  • Ergot-containing medications, including Ergoloid mesylates, Cabergoline, Bromocriptine, Methysergide etc. 

It is also extremely important to inform your doctor if you have any other disease related to blood vessels or the flow of blood. These things are absolutely necessary to determine the safety and efficacy of Sumatriptan for you. Make sure you don’t leave out any details. 

Safety precautions for Propranolol 

  • Take Propranolol exactly as directed by your healthcare provider. 
  • Do not deviate from the prescribed dose. In case of overdose, immediately reach out to your doctor. Inform accurately how much drug has been taken and when. 
  • In case you have accidentally missed your Propranolol dose, you can take it as soon as you remember. If a lot of time has passed and your next dose is near then do not take the dose. Wait for the next one and take that one on time. Propranolol overdose can cause disturbing complications. 
  • Keep the bottle out of reach of children and pets. 
  • Report any sign of an allergic reaction right away. 

Make sure you’re not taking this medication if it has not been prescribed by your doctor. Propranolol is not suitable to be used in people who have respiratory illnesses like asthma or chronic obstructive pulmonary disease (COPD). It should also be used cautiously in people with diabetes. 

Conclusion 

In this blog post, we have discussed the safety and efficacy of the concomitant use of Sumatriptan and Propranolol. You can use these together, but only if your healthcare provider has prescribed this combination. 

If you need these two meds together, your doctor will adjust the doses, especially of Sumatriptan, in order to make the treatment more safe and efficacious for you. 

This is because whenever medications are combined together, they are not given at their usual doses. Make sure you never start or stop using any medication without your doctor’s approval. 

FAQs: sumatriptan and propranolol 

Can you take sumatriptan with propranolol?

Yes, you can use Sumatriptan and Propranolol together, but only if your healthcare provider has prescribed this combination. If you need these two meds together, your doctor will adjust the doses, especially of Sumatriptan, in order to make the treatment more safe and efficacious for you. 

Can you take propranolol with triptans?

Yes, you can but make sure you don’t take this combination without your doctor’s approval. Report to your healthcare provider immediately if you exhibit any sign of an allergic reaction or any unusual side effect after taking these two meds together. 

What can you not take with sumatriptan?

  • Other selective serotonin receptor agonists, including Eletriptan, Almotriptan, Rizatriptan, Frovatriptan etc. 
  • Monoaminoxidase inhibitors, including Selegiline, Phenelzine, isocarboxazid etc. 
  • Tricyclic antidepressants, including Amitriptyline, Nortriptyline, Imipramine etc. 
  • Selective serotonin reuptake inhibitors, including Sertraline, Paroxetine, Fluoxetine, Escitalopram, Citalopram etc. 
  • Serotonin-norepinephrine reuptake inhibitors, including Venlafaxine, Desvenlafaxine, Milnacipran, Levomilnacipran, Duloxetine etc. 
  • Ergot-containing medications, including Ergoloid mesylates, Cabergoline, Bromocriptine, Methysergide etc. 

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. 

What medications should not be taken with propranolol?

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

References 

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