I'm having some trouble with mild heart palpitations and anxiety, so my cardiologist put me on Telma 40 and propranolol 40 mg. The good news is my palpitations and angina are gone since starting propranolol, but now I'm experiencing some erection issues. I'm wondering, could I switch from propranolol to Nevivolol? Or would it be okay to take tadalafil along with the propranolol? Could you give me some advice on these two options?

1. Instead of Propranolol 40 mg, you can use Nebivolol. The recommended dosage for Nebivolol is 5 mg to 10 mg once daily. It is also effective in managing heart palpitations and anxiety, with a lower risk of causing erectile dysfunction compared to Propranolol. 2. You can take Tadalafil with Propranolol, but it is important to consult with your cardiologist or healthcare provider before combining these medications. Tadalafil is used to treat erectile dysfunction, and the combination with Propranolol may help alleviate the erection problem you are experiencing. The usual starting dose of Tadalafil is 10 mg taken prior to anticipated sexual activity, with a maximum frequency of once per day.