MajorCentral α2-adrenergic agonist×Non-selective beta blocker
Updated · Methodology
Mechanism
Propranolol is a non-selective beta-blocker (β1 and β2). On abrupt clonidine withdrawal, additional β2-blockade amplifies the residual α1 effect, making the hypertensive crisis particularly severe.
Symptoms
Abrupt clonidine withdrawal causes hypertensive crisis: sharp blood pressure rise, headache, tachycardia, anxiety, sweating. Symptoms appear 18–24 hours after a missed clonidine dose.
Management
For planned clonidine withdrawal, stop propranolol 3–7 days beforehand, then taper clonidine over 1–2 weeks. Alternative antihypertensives: an ACE-I plus amlodipine (without clonidine) or a selective beta-blocker (bisoprolol).
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.
Summary of a multi-drug list →
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Sources
- FDA: Clonidine hydrochloride tablet (Alembic Pharmaceuticals Limited) – Prescribing Information section 7 (2012)– ; DailyMed setid 88a8db46-0fc9-48cd-b7cc-ac9c9cdea100
- AEMPS: Ficha técnica: Propranolol (nº registro 89692), sección 4.5 (2026)– AEMPS, CIMA, nº registro 89692, revisión 05/2026, sección 4.5