Ramipril and propranolol are safe to take together and there is no drug interaction associated with concomitant use. Theoretically, since both drugs decrease blood pressure, you could experience lower blood pressure when taking these medications together. Checking your blood pressure often and keeping a log of your readings to take to your doctor's visits is a good way to ensure that your blood pressure is not too low on these drugs.
Propranolol (Inderal, Inderal LA, InnoPran XL) is a non-selective beta blocker used to treat high blood pressure, angina, rapid heart rate, tremors, and even performance anxiety. It can also be used to prevent heart attack and to decrease migraines. It works by blocking beta-1 and beta-2 activation which leads to a decrease in heart rate, blood pressure, and demand for oxygen in the heart. It takes about 1-4 hours to see the peak effects of propranolol.
Side effects associated with propranolol include feeling cold, slow heart rate, irritability, drowsiness, insomnia, decreased sex drive, and fatigue. Serious side effects of propranolol include slow or uneven heart beats, feeling lightheaded, fainting, swelling of ankles, depression, fever, and sore throat. If you notice any of these side effects it is important to contact your doctor immediately. It is important to avoid drinking alcohol with propranolol as this can increase the blood levels of the drug leading to more side effects.
Ramipril (Altace) is an angiotensin converting enzyme inhibitor (also known as an ACE inhibitor). It is used to treat high blood pressure and can increase survival if given after a heart attack. Common side effects of ramipril include cough, headache, and dizziness. Serious side effects include passing out, dark colored urine, yellowing of the skin/eyes, flu like symptoms, and swelling of the lips/tongue. If you notice these serious side effects you should call your doctor immediately. Ramipril can increase the amount of potassium in your blood so you should avoid salt substitutes and potassium supplements while you are taking this drug. This drug should not be used in pregnancy. Stop using ramipril and call your doctor immediately if you become pregnant.