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Can you take propranolol and Adderall together safely?

Combining propranolol and Adderall: Expert advice on side effects, risks, and when this treatment might be right for you.
Rebecca Rovenstine writer headshot
By | Updated on Jan. 13, 2025 Medically reviewed by Josephine Bawab, Pharm.D.
Blood pressure cuff and medications: Can you take propranolol and Adderall together

Key takeaways

  • Adderall and propranolol are safe to take in combination with each other but should be done under the advice of a healthcare provider.

  • Combining Adderall and propranolol can make them less effective and increase the risk of side effects.

  • Adderall and propranolol may be prescribed together to treat anxiousness or increased heart rate as a result of Adderall.

In this article:

Adderall, a stimulant medication, treats attention deficit hyperactivity disorder (ADHD). Users may experience increased blood pressure and heart rate as side effects. The prescription drug propranolol, a beta blocker, can reduce heart rate and blood pressure. It would make sense that propranolol could decrease the unwanted cardiovascular symptoms from Adderall. But, can these two popular medications be taken together without problems? We went to the medical experts to find out. 

Can you take propranolol and Adderall together?

“Yes, propranolol and Adderall can be taken together, but a healthcare provider should always guide this combination,” says Dr. James Lyons, MD, a medical consultant for Synergy Houses with expertise in psychiatry and family medicine.

While propranolol and Adderall can technically be taken at the same time, there are also some downsides to consider. Due to this, prescribing these medications together is at the discretion and preference of trained physicians. “That’s because these two medications can interact with each other,” explains Dr. Mike McGrath, MD, a board-certified psychiatrist and Chief Clinical Officer at The Oasis 

Let’s explore how each medicine works and what it treats to better understand how these medications may interact.

Adderall

Adderall, sold under the generic name amphetamine-dextroamphetamine, is a central nervous system stimulant drug formulated with the active ingredients d-amphetamine and l-amphetamine salts. It aids in the treatment of medical conditions like ADHD and narcolepsy.

A low percentage of people may be at risk of cardiomyopathy (heart disease) when taking ADHD stimulant medications, according to current research. Researchers determined this risk is “relatively low” overall. 

A few studies have linked ADHD medications, like Adderall, to heart attack and heart failure. However, these research articles are typically single case reports and look at stimulant use disorder (as the risk of misuse of Adderall is high). Overall, healthcare professionals believe the risk of heart conditions from ADHD medications, when taken as directed, is low.

The most common side effects of Adderall include:

  • Anxiousness
  • Loss of appetite
  • Weight loss
  • Dry mouth
  • Difficulty sleeping
  • Stomach pain

Propranolol 

Propranolol, which may be sold under the brand names Inderal LA, Hemangeol, or Inderal XL, belongs to a group of medicines called beta blockers. Beta blockers work by decreasing heart rate and treat a variety of heart problems, such as high blood pressure. Along with treating high blood pressure, possible uses of propranolol include treating atrial fibrillation, tremors, chest pain, anxiety, or migraine headaches.

Common side effects of propranolol include:

  • Headaches
  • Fatigue
  • Coldness in the extremities
  • Upset stomach

Increased heart rate

“Individuals with ADHD who experience stimulant-related side effects like increased heart rate or blood pressure might be prescribed propranolol to manage these symptoms,” says Dr. Lyons. 

If Adderall is causing increased heart rate or blood pressure, propranolol is just one option. Rather than propranolol, some physicians may recommend a medication change. There are non-stimulant medications that can treat ADHD symptoms and will be less likely to cause cardiovascular health conditions.

Anxiety

Adderall can cause anxiety or worsen existing anxiety. In this case, a doctor may prescribe propranolol to help with this side effect.

“Someone with ADHD who also struggles with performance anxiety or public speaking might use propranolol to reduce the physical effects of anxiety, like shaking or a pounding heart, while continuing to take Adderall to stay focused and alert,” explains Dr. Lyons.

Risks and interactions of taking propranolol and Adderall

There are no risks or concerning interactions when taking propranolol and Adderall or other stimulant ADHD meds together, but they can make each other less effective.

“Propranolol lowers heart rate and blood pressure while Adderall can increase blood pressure and heart rate,” says Dr. McGrath. “This can lead to decreased effectiveness of both Adderall and propranolol. It can also increase the risk of side effects from both medications.”

If you already experience adverse effects of either propranolol or Adderall, the increased risk of side effects is something you’ll want to consider before taking this drug combination. Both Adderall and propranolol can cause stomach issues, like nausea and vomiting. Both medications also may cause headaches, making them more likely to occur when taken together.

The biggest issue with taking the two prescription drugs together is that Adderall and propranolol can cancel each other out, making them less effective. “Propranolol can reduce exercise tolerance or cause fatigue, which might counteract some of the energizing effects of Adderall,” explains Dr. Lyons.

People with diabetes and hypoglycemia should also use caution when taking these medications together. Propranolol can mask the signs of low blood sugar (hypoglycemia). Since Adderall lowers appetite, the risk of low blood sugar can increase. It’s important to be vigilant in monitoring blood sugar levels when on either of these medications.

What medications should you not mix with propranolol or Adderall? 

You should not mix propranolol or Adderall with medications that they interact with individually. You can take propranolol with Adderall under the advice of a healthcare professional, but you should not add other beta blockers to this combination without express permission from your doctor.

Drugs that should not be taken with Adderall include:

  • Antacids
  • H2 blockers
  • Lithium
  • Monoamine oxidase inhibitors (MAOIs)
  • Other stimulant drugs
  • Select opioids
  • Tricyclic antidepressants
  • Triptans
  • Select serotonergic drugs like selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs)

Taking Adderall with serotonergic drugs like SSRIs or SNRIs can lead to serotonin syndrome, which can be life-threatening. Symptoms of serotonin syndrome can include tremors, dilated pupils, agitation, fever, and seizures.

Drugs that should not be taken with propranolol include:

  • Antacids containing aluminum
  • Antiarrhythmics
  • Nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Antihistamines
  • Migraine medications
  • Certain SSRIs

These are not full lists of drug interactions for propranolol or Adderall. When beginning a new medication, it’s important to speak with your physician or pharmacist for professional medical advice. During this conversation, you can get more drug information and ask questions about possible interactions, serious side effects, other treatment options, and your unique needs.