Drug General Information (ID: DDIV6HXFN1)
Drug Name			Propranolol		Drug Info		Hydrochlorothiazide		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Antianxiety Agents				Diuretics
Structure

Mechanism of Propranolol-Hydrochlorothiazide Interaction (Severity Level: Moderate)
Increased risk of hyperglycemia Click to Show/Hide Mechanism Graph
Drug Name		Propranolol				Hydrochlorothiazide
Mechanism 1		Hyperglycemia				Hyperglycemia
Key Mechanism Factor 1
		Factor Name		Hyperglycemia
		Factor Description		Drugs can induce hyperglycemia through a variety of mechanisms, including altered insulin secretion and sensitivity, direct cytotoxic effects on pancreatic cells, and increased glucose production. Hyperglycemia may increase the risk of microvascular and macrovascular complications, infection, metabolic coma and even death.
Mechanism Description		Increased risk of hyperglycemia by the combination of Propranolol and Hydrochlorothiazide
Mechanism 2		Hyperglycemic effects				Hyperglycemia
Key Mechanism Factor 2
		Factor Name		Hyperglycemia
		Factor Description		Drugs can induce hyperglycemia through a variety of mechanisms, including altered insulin secretion and sensitivity, direct cytotoxic effects on pancreatic cells, and increased glucose production. Hyperglycemia may increase the risk of microvascular and macrovascular complications, infection, metabolic coma and even death.
Mechanism Description		Increased risk of hyperglycemia by the combination of Propranolol and Hydrochlorothiazide
Mechanism 3		Hyperglycemia				Hyperglycemic effects
Key Mechanism Factor 3
		Factor Name		Hyperglycemia
		Factor Description		Drugs can induce hyperglycemia through a variety of mechanisms, including altered insulin secretion and sensitivity, direct cytotoxic effects on pancreatic cells, and increased glucose production. Hyperglycemia may increase the risk of microvascular and macrovascular complications, infection, metabolic coma and even death.
Mechanism Description		Increased risk of hyperglycemia by the combination of Propranolol and Hydrochlorothiazide
Mechanism 4		Hyperglycemic effects				Hyperglycemic effects
Key Mechanism Factor 4
		Factor Name		Hyperglycemia
		Factor Description		Drugs can induce hyperglycemia through a variety of mechanisms, including altered insulin secretion and sensitivity, direct cytotoxic effects on pancreatic cells, and increased glucose production. Hyperglycemia may increase the risk of microvascular and macrovascular complications, infection, metabolic coma and even death.
Mechanism Description		Increased risk of hyperglycemia by the combination of Propranolol and Hydrochlorothiazide
Increased risk of ventricular arrhythmias Click to Show/Hide Mechanism Graph
Drug Name		Propranolol				Hydrochlorothiazide
Mechanism 5		Bradycardia				Electrolyte disturbances
Key Mechanism Factor 5
		Factor Name		Ventricular arrhythmias
		Factor Description		Ventricular arrhythmias are abnormal heart rhythms that cause your heart's lower chambers to pump blood instead of pumping it. This can limit or stop your heart from supplying blood to your body. While some of these arrhythmias are harmless and do not cause symptoms, others can have serious, even fatal, effects on your body.
Mechanism Description		Increased risk of ventricular arrhythmias by the combination of Propranolol and Hydrochlorothiazide
Mechanism 6		Delay atrioventricular conduction				Electrolyte disturbances
Key Mechanism Factor 6
		Factor Name		Ventricular arrhythmias
		Factor Description		Ventricular arrhythmias are abnormal heart rhythms that cause your heart's lower chambers to pump blood instead of pumping it. This can limit or stop your heart from supplying blood to your body. While some of these arrhythmias are harmless and do not cause symptoms, others can have serious, even fatal, effects on your body.
Mechanism Description		Increased risk of ventricular arrhythmias by the combination of Propranolol and Hydrochlorothiazide

Recommended Action
Management		Monitoring of serum potassium levels, blood pressure, and blood glucose is recommended during coadministration. Patients should be advised to seek medical assistance if they experience dizziness, weakness, fainting, fast or irregular heartbeats, or loss of blood glucose control.

References
1	Dean S, Kendall MJ, Potter S, Thompson MH, Jackson DA "Nadolol in combination with indapamide and xipamide in resistant hypertensives." Eur J Clin Pharmacol 28 (1985): 29-33. [PMID: 3987783]
2	Dornhorst A, Powell SH, Pensky J "Aggravation by propranolol of hyperglycaemic effect of hydrochlorothiazide in type II diabetics without alteration of insulin secretion." Lancet 1 (1985): 123-6. [PMID: 2857210]
3	Marcy TR, Ripley TL "Aldosterone antagonists in the treatment of heart failure." Am J Health Syst Pharm 63 (2006): 49-58. [PMID: 16373465]
4	Product Information. Lozol (indapamide). Rhone-Poulenc Rorer, Collegeville, PA.
5	Roux A, Le Liboux A, Delhotal B, Gaillot J, Flouvat B "Pharmacokinetics in man of acebutolol and hydrochlorothiazide as single agents and in combination." Eur J Clin Pharmacol 24 (1983): 801-6. [PMID: 6884417]