Moderate
Alprazolam × Propranolol
Benzodiazepines. Short-to-medium-acting anxiolytics×Non-selective beta blocker
Mechanism
Additive bradycardia, hypotension, and sedation. Propranolol is non-selective (blocks β1 and β2); risk higher than with bisoprolol.
Symptoms
Lower blood pressure, postural dizziness, fatigue. Older patients: fall risk.
Management
In older patients, check pulse and blood pressure 1–2 weeks after start. In asthma or COPD, a selective beta-blocker (bisoprolol, metoprolol) is preferable. Alternative anxiolytic: hydroxyzine or a short lorazepam course.
Check the full regimen, not just this pair
Opens the checker with these two drugs prefilled. Add the rest of the regimen and recompute additive risks.