Adverse drug reactions propranolol

A study in 6 healthy subjects receiving 30-hour infusions of lidocaine at a rate of 2 mg/minute found that pretreatment with propranolol 80 mg every 8 hours for 3 days raised the steady-state plasma lidocaine levels by 19% (from 2.1 to 2.5 micrograms/mL) and reduced the plasma clearance by 16%. Other similar studies have found a 22.5 to 30% increase in steady-state serum lidocaine levels and a 14.7 to 46% fall in plasma clearance due to the concurrent use of propranolol. Two cases of lidocaine toxicity attributed to a lidocaine-propranolol interaction were revealed by a search of the FDA adverse drug reaction file in 1981. A further case of lidocaine toxicity (seizures) has been described in a man on propranolol after accidental oral ingestion of lidocaine for oesophageal anaesthesia. High serum levels of lidocaine were detected. ... 

Adverse Drug Reactions Advisory Committee. Chlormediiazole/propranolol interaction MedJAust (1979) 2,553. 

The manufacturer of doxazosin states that no adverse drug interaction has been observed between doxazosin and beta blockers, althorrgh they do note that the most common adverse reactions associated with doxazosin are of a postural hypotension type. They specifically note that doxazosin has been given with atenolol and propranolol without evidence of an adverse interaction. ... 

Although no adverse reactions have been reported with intranasal administration of propranolol, complications may occur, as ocular administration has produced some systemic side effects [118]. The influence of substrate lipophilicity on drug uptake by the nasal route was reported in humans. Alprenolol and metoprolol, 3 blockers with varying degrees of lipophilicity, were used. The findings from these studies demonstrate that the more hydrophilic drugs showed a lower bioavailability. Alprenolol showed rapid uptake into the systemic circulation by the nasal route and also a higher bioavailability [126,127]. 

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