Taking Propranolol With Altace (Ramipril)

There is no interaction between Altace (ramipril) and propranolol. However, both lower blood pressure.

Taking Propranolol With Altace (Ramipril)
Nov 15, 2018

And asked

Can you take propranolol with ramipril 2.5 mg? This will be for anxiety.

At a glance

  • Altace (ramipril) and propranolol don't have an interaction per se, but both lower blood pressure. Taking both together could potentially cause hypotension. Nevertheless, they can be used in combination in certain situations.


Drug Interaction Title


There aren't any drug interactions between Altace (ramipril) and propranolol, but both will lower your blood pressure.

Therefore, using both together has the potential to cause:

  • Dizziness
  • Lightheadedness
  • Lethargy
  • Fatigue

Nevertheless, both Altace (ramipril) and propranolol are often used together as they cover different indications and have different mechanisms of actions

For example, Altace is an ACE-Inhibitor, which work by blocking the conversion of angiotensin I to angiotensin II (a potent vasoconstrictor).

Altace is primarily indicated for the treatment of cardiovascular conditions, such as:

  • Heart failure
  • Hypertension
  • Stroke prophylaxis

Propranolol on the other hand is a beta-blocker, which work by blocking beta-receptors in the heart and vascular smooth muscle. This has a variety of effects, including:

  • A decrease in both resting and exercise heart rate
  • A decrease in cardiac output
  • A decrease in both systolic and diastolic blood pressure

Propranolol is used for cardiac indications, as well as others, including:

  • Migraine Prophylaxis
  • Tremor
  • Anxiety/panic attacks (off-label)
  • Performance anxiety (off-label)

Although propranolol and Altace can both be used for low blood pressure lowering, they are often used together for their synergistic anti-hypertensive effects as well as the fact that they work differently and cover separate indications.

So, yes, propranolol and Altace can be used together safely. Just be sure to look out for certain effects, such as symptoms of low blood pressure (e.g. dizziness, lightheadedness). If any side effects occur, be sure to discuss them with your doctor.

  1. Altace Prescribing Information. AccessFDA
  2. Inderal Prescribing Information. AccessFDA

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