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**Propranolol + pseudoephedrine** is a combination of two active pharmaceutical ingredients: propranolol, a non-selective beta adrenergic antagonist, and pseudoephedrine, a sympathomimetic decongestant. Propranolol works primarily by blocking beta-adrenergic receptors, reducing heart rate, cardiac output, and blood pressure[4]. Pseudoephedrine acts mainly on alpha-adrenergic receptors, inducing vasoconstriction to relieve nasal congestion, and can modestly stimulate beta-adrenergic receptors[5]. There is pharmacological interaction: pseudoephedrine can counteract the antihypertensive effects of propranolol due to its pressor properties. However, a single standard dose of pseudoephedrine does not significantly alter blood pressure or heart rate in hypertensive patients stabilized on propranolol, though caution is advised in clinical use, especially at high doses or in sensitive patients[3][1][5][6].
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