-
What you will learn in this post:
Propranolol is a popular beta blocker medication that’s been used for decades to treat common heart conditions and, occasionally, tremors. According to data from 2020, over 8 million prescriptions for propranolol were written over the year to just under 2 million patients. The prevalence of propranolol prescriptions shouldn’t come as a surprise, since heart disease is the leading cause of death in the U.S. According to the CDC, in 2020, 697,000 people died from heart disease, and 805,000 people suffered a heart attack.
Cannabis is also known to affect the cardiovascular system, making the combination of propranolol and weed potentially concerning for those with heart conditions. Since both propranolol and medical marijuana are commonly used, many patients wonder if it’s safe to combine the two.
What is Propranolol?
Propranolol is a prescription medication used to treat various cardiovascular conditions. It’s part of a class of medications known as beta blockers. Beta-blockers block B1 and/or B2 receptors that regulate cardiovascular activity. B1 receptors excite the cardiovascular system, increasing heart rate and blood pressure. B2 receptors relax it. Propranolol is a non-selective beta blocker, which blocks both B1 and B2 receptors, leading to a more neutral state.
Propranolol is commonly used to treat a range of heart conditions like high blood pressure, arrhythmias, angina, hypertrophic subaortic stenosis, atrial fibrillation, coronary artery disease, and heart failure. It is also used to treat restless leg syndrome, migraines, tremors, and some forms of kidney disease because it changes how the body responds to other nerve impulses.
This common cardiovascular medication was first developed more than 50 years ago by Sir James Black, a British scientist looking for a treatment for angina (chest pain). Propranolol has since been regularly prescribed for various conditions. And while the beta blocker is considered relatively safe, propranolol is not without its side effects, which may include:
- Lightheadedness or dizziness
- Gastrointestinal changes, like diarrhea or constipation
- Unusual or excessive tiredness
- Difficulty sleeping
- Anxiety and irritability
- Restlessness
- Shaking
- Strange dreams
- Dry mouth
- Rapid breathing
There are also more severe side effects to look out for, including:
- Difficulty breathing
- Trouble swallowing
- Rashes, blistering, or skin peeling
- Excessive itching
- Swelling in the face, especially the lips, tongue, or throat
- Unexplained weight gain
- Feeling weak or faint
- Erratic or irregular heartbeat
Propranolol is available under several brand names, including:
- Hemangeol
- Inderal
- Inderal LA
- Inderal XL
- InnoPran
- InnoPran XL
- Pronol
Propranolol is also found in the combination medications Inderide and Inderide LA.
Is Propranolol Addictive?
Propranolol isn’t addictive in the traditional sense, but it does cause a form of dependency. Stopping a beta blocker like propranolol too quickly may cause changes in blood pressure, heart rhythm, and even has the potential to lead to a heart attack. If you’re considering stopping propranolol, speak with your doctor about gradually easing off the medication, rather than stopping abruptly.
Propranolol and Weed: Interactions and Risks
Unfortunately, there isn’t much research into the combined effects of propranolol and cannabis, and what there is doesn’t focus on the safety of using both treatments simultaneously.
The research around cannabis and heart disease is inconclusive. Many consumers point to the plant’s ability to fight stress and inflammation as signs it can alleviate cardiovascular problems. But THC has been linked to increased heart rate, and there’s evidence that it may increase the risk of a heart attack in at-risk individuals in the hours directly following cannabis use.1,2
The picture around high blood pressure is similar. Multiple studies suggest that cannabis, especially CBD, can help to reduce blood pressure. At the same time, for nearly every one of those studies, there’s separate research claiming that cannabis can increase blood pressure.
When it comes to cardiovascular health, the only definitive claim we can make is that there is a need for more research and larger sample sizes. The research that does exist on the combination of cannabis and propranolol, specifically, deals largely with one-off case studies, though they do have interesting results.
In a case study from 1977, a man used cannabis and propranolol together, and the combination actually reduced the negative cardiovascular effects typically associated with cannabis.3 Another study in 2017 showed that propranolol may help to treat the symptoms of cannabis hyperemesis syndrome.4 However, both of these were single-person studies, indicating promising results and a need for further study.
With a lack of research, and considering both cannabis and propranolol can affect the cardiovascular system, there is still too much we don’t know about how the two drugs may interact. As such, it is ill-advised to combine them without guidance from a qualified healthcare professional.
Are There Any Benefits to Using Propranolol with Weed?
While research is limited, there doesn’t appear to be any clear benefit to using cannabis and propranolol together.
Studies have failed to demonstrate a direct drug interaction between the substances, but both cannabis and propranolol affect the cardiovascular system, which could lead to unforeseen complications. And studies that have found potential benefits were far too small in scale to suggest the combination of medications is safe for general use.
If you’re considering using propranolol and cannabis together, speak with your doctor first. They can provide medical guidance based on your individual circumstances.
What About CBD and Propranolol?
There isn’t any research addressing the combination of CBD and propranolol. That said, some of the same potential risks associated with using beta blockers and high-THC cannabis still apply.
CBD, like THC, can affect the cardiovascular system. Interestingly, the research indicates that it lowers blood pressure, but this isn’t necessarily a good thing in combination with propranolol. Because both substances reduce blood pressure, there’s a risk of it dropping too low, leading to dizziness, lightheadedness, and fainting. If blood pressure falls too low, there are also more serious risks.
While CBD is generally considered safe to use in proper doses, it may interact with certain medications. If you’re considering using both propranolol and CBD, consult with your physician first.
Precautions to Take When Using Propranolol and Marijuana
It’s safest not to take propranolol and cannabis together. These substances both interact with the cardiovascular system, which could result in unpredictable changes to blood pressure and heart rate.
If you choose to use both at the same time, it’s best to do so with medical supervision or a caregiver close by. Never drive or operate heavy machinery while using cannabis and propranolol together. If you have a smartwatch or fitness tracker, use it to ensure your heart rate and blood pressure remain within normal ranges.
It’s always best to consult your doctor before combining medications, even natural ones like cannabis. Before using cannabis and propranolol, speak with your doctor about how the combination may affect you.
When to Seek Medical Help
If you’re using cannabis and propranolol together look out for warning signs. The first thing to be on the lookout for are the side effects of propranolol alone, which may intensify when used alongside cannabis.
It’s also a good idea to monitor your heart rate and blood pressure. If they move outside the normal range, it’s time to see medical help.
And in general, you want to keep an eye out for cardiovascular symptoms.
- Dizziness or lightheadedness
- Blurry vision
- Chest pain
- Shortness of breath or difficulty breathing
- Rapid or racing heart beat
- Pain spreading from the shoulder down the arm
- Nausea
- Cold sweat
- Excess or unexplained fatigue
- Headaches
If you aren’t feeling well or begin experiencing the above cardiovascular symptoms while taking propranolol and cannabis, always err on the side of caution and seek medical assistance.
Propranolol and Weed FAQ
Is there a specific cannabis consumption method that’s safer when combined with Propranolol?
There isn’t any hard evidence that one form of cannabis use is better than any other when combined with propranolol. However, the dangers of smoking on heart health are well established, and it’s worth avoiding smoking and vaping when using propranolol.
How long should I wait to consume cannabis after taking Propranolol?
It takes a body with a healthy liver and kidney function up to 6 hours to clear propranolol from the system. However, propranolol creates a physical dependence that alters cardiovascular function. For that reason, it’s not recommended to stop taking propranolol abruptly. Rather, individuals should seek a doctor’s guidance in slowly reducing their dosage. As a result, it’s probably best to wait at least 24 hours after propranolol has been gradually removed before using cannabis.
Can propranolol eliminate the adverse cardiovascular effects of cannabis?
According to a single case study from the 70’s, yes. But there isn’t much evidence beyond that. Cannabis and propranolol both affect the cardiovascular system and can lead to unexpected effects which may be severe. It’s best to be cautious and avoid combining these substances without a doctor’s approval.
References
- Dabiri, Ali E., and Ghassan S. Kassab. “Effects of Cannabis on Cardiovascular System: The Good, the Bad, and the Many Unknowns.” Medical Cannabis and Cannabinoids, 12 Nov. 2021, pp. 1–11, https://doi.org/10.1159/000519775. Accessed 19 Nov. 2021.
↩︎ - Latif, Zara, and Nadish Garg. “The Impact of Marijuana on the Cardiovascular System: A Review of the Most Common Cardiovascular Events Associated with Marijuana Use.” Journal of Clinical Medicine, vol. 9, no. 6, 1 June 2020, p. 1925, www.mdpi.com/2077-0383/9/6/1925/htm, https://doi.org/10.3390/jcm9061925. Accessed 2 Sept. 2020.
↩︎ - Sulkowski A, Vachon L, Rich ES. Propranolol effects on acute marihuana intoxication in man. Psychopharmacology. 1977;52(1):47-53. doi:https://doi.org/10.1007/bf00426599
↩︎ - Richards JR, Dutczak O. Propranolol Treatment of Cannabinoid Hyperemesis Syndrome. Journal of Clinical Psychopharmacology. 2017;37(4):482-484. doi:https://doi.org/10.1097/jcp.0000000000000735
↩︎
The information in this article and any included images or charts are for educational purposes only. This information is neither a substitute for, nor does it replace, professional legal advice or medical advice, diagnosis, or treatment. If you have any concerns or questions about laws, regulations, or your health, you should always consult with an attorney, physician or other licensed professional.
