PROPRANOLOL-HYDROCHLOROTHIAZID

Propranolol Hydrochloride 40mg, Hydrochlorothiazide 25mg, Oral tablet

Marijuana

· Severity: Major

· Notes for Consumers: Marijuana can decrease the ability of this medicine to control your blood pressure and heart rate. You may need to monitor your blood pressure and heart rate more often to make sure they are well-controlled. If you check your own blood pressure at home and notice an increase in your blood pressure or heart rate, contact your health care provider.

· Notes for Professionals: Avoid administering marijuana and beta-blockers together as concurrent use may result in decreased beta-blocker efficacy. Marijuana is known to produce significant increases in heart rate and cardiac output lasting for 2-3 hours. Further, rare case reports of myocardial infarction and cardiac arrhythmias have been associated with marijuana use. These marijuana-induced cardiovascular effects may be detrimental to patients requiring treatment with beta-blockers; thus, coadministration of beta-blockers and marijuana should be avoided.

Propranolol Hydrochloride 40mg, Hydrochlorothiazide 25mg, Oral tablet

Tobacco

· Severity: Major

· Notes for Consumers: Tobacco smoking may reduce the effectiveness of Propranolol for treating conditions like high blood pressure or chest pain. Tobacco smoke contains substances that speed the removal of Propranolol from the body, which can make this drug less effective. Also, Tobacco smoking may increase the blood pressure or contribute to the risk of heart disease and related problems. Alternatively, if you take Propranolol and suddenly stop Tobacco smoking, you may feel dizzy or faint, or slow heart rate or low blood pressure may occur. Make sure your prescriber is aware that you smoke Tobacco or if you plan to stop smoking.

· Notes for Professionals: Tobacco smoke contains polycyclic aromatic hydrocarbons that induce hepatic CYP450 microsomal enzymes and may increase the systemic clearance of propranolol. At this time, no specific propranolol dosage adjustments are recommended for tobacco smokers. Monitor patients carefully for the desired clinical effects when changes in tobacco smoking status occur.

Propranolol Hydrochloride 40mg, Hydrochlorothiazide 25mg, Oral tablet

Alcohol

· Severity: Moderate

· Notes for Consumers: It is best to limit your intake of alcohol while taking this drug. Alcohol can increase the risk for low blood pressure and dizziness. If the blood pressure drops too low, you may feel dizzy or faint, in some cases falls or fainting may occur. Do not drive or operate machinery, or perform other hazardous tasks if you have been taking alcohol with this drug.

· Notes for Professionals: Patients should be cautioned that ingesting alcohol can increase the chance of low blood pressure and dizziness when taking a thiazide diuretic or the related drug, metolazone. Patients may wish to limit alcohol ingestion while taking one of these diuretics and should be monitored for signs or symptoms of hypotension, including postural hypotension and dizziness.

<b>DISCLAIMER:</b><em> This drug information content is provided for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Patients should always consult their physician with any questions regarding a medical condition and to obtain medical advice and treatment. Drug information is sourced from GSDD (Gold Standard Drug Database ) provided by Elsevier.</em>