Alcohol may change the way beta-blockers work. People who drink and take beta-blockers should discuss the risks and benefits of the medication with a doctor. In some cases, they may need to quit drinking.

Alcohol can potentially make beta-blockers less effective or increase the risk of side effects. Although there is limited research around this subject, the effects of beta-blockers and alcohol mean that people should be extremely cautious when taking them together.

Keep reading to learn more about the effects and risks of taking beta-blockers alongside alcohol.

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Mixing alcohol and beta-blockers can cause unpleasant, and sometimes dangerous, side effects. The effects depend on the specific beta-blocker, how much alcohol the person drinks, and the medical condition for which they take the beta-blocker.

For example, alcohol undermines the effectiveness of the extended-release form of metoprolol. When a person takes this drug with alcohol, it releases into the body faster, which increases the risk of side effects.

In one study of metoprolol, researchers looked at the interaction of alcohol and the beta-blocker in a lab. At the 2-hour mark, they found that the capsule had released 89% of the drug with 40% alcohol compared with just 17% with 5% alcohol. This finding suggests that very potent drinks may make the drug work differently.

A small number of studies have tested the use of beta-blockers to prevent heart issues in people who drink. For example, a 2019 case study details the case of a 75-year-old with atrial fibrillation. Doctors prescribed beta-blockers before drinking to prevent atrial fibrillation, and the treatment worked.

Therefore, beta-blockers may be appropriate in some people who drink, but only under the supervision of a doctor.

Few recent studies have tested beta-blockers in people who drink. A much older study from 1990 found that metoprolol still controlled blood pressure in eight males who drank. However, the small sample size and dated nature of the study mean that the results are not conclusive. Researchers must continue to study the relationship between alcohol and beta-blockers.

Little recent research has tested the potential effects of beta-blockers when a person is drinking. As a result, researchers do not know how specific dosages of beta-blockers might respond to various quantities of alcohol.

In general, alcohol may decrease the effectiveness of beta-blockers, possibly by changing their release into the body or the speed at which the body metabolizes them.

Alcohol, especially excessive drinking, may also lead to high blood pressure and heart rhythm issues, as well as chronic health issues — such as high cholesterol — that increase the risk of heart disease. A person taking a beta-blocker for a heart condition may see fewer benefits if they drink alcohol, especially in large quantities.

Alcohol may also increase the risk of certain beta-blocker side effects, particularly when it causes the body to absorb an extended-release formula more quickly. Some beta-blocker side effects include:

  • dizziness
  • nausea
  • feeling cold
  • confusion
  • shortness of breath
  • low blood pressure
  • trouble sleeping

In addition to decreasing the effectiveness of beta-blockers, alcohol may increase the risk of the more severe effects of these drugs. These include worsening heart failure and arterial insufficiency.

Suddenly stopping beta-blockers may cause life threatening health issues, such as thyroid storm, in people with hyperthyroidism. A thyroid storm affects the body’s ability to regulate many systems, making it a medical emergency. People should never stop using beta-blockers just so that they can drink.

Similarly, a person who drinks and then experiences worrying side effects should call a doctor but continue taking the beta-blocker. The risk of suddenly stopping beta-blockers is usually higher than the risk of having a drink or two with these drugs.

Beta-blockers, which doctors sometimes call beta adrenergic blocking agents, slow or stop the release of the hormones epinephrine and norepinephrine (sometimes called adrenaline and noradrenaline) in some parts of the body. In doing so, they slow the heart rate and reduce the force with which the heart pumps, lowering blood pressure.

These drugs may help with certain heart health issues, including:

  • heart and chest pain (angina)
  • heart rhythm irregularities, such as atrial fibrillation
  • high blood pressure
  • heart failure

Beta-blockers may also prevent heart attacks in people with a history of this cardiovascular event. In some cases, people may take them to treat anxiety or migraine.

Different beta-blockers are available. They include:

  • atenolol (Tenormin)
  • carvedilol (Coreg)
  • bisoprolol (Zebeta)
  • metoprolol (Lopressor)
  • propranolol (Inderal)
  • nebivolol (Bystolic)
  • esmolol (Brevibloc)

Most people tolerate beta-blockers well, but they can cause some side effects. People with very low blood pressure, a very slow heartbeat, poorly controlled heart failure, and some kidney disorders may not be able to take beta-blockers safely.

Learn more about beta-blockers here.

Some drugs, such as diltiazem (Cardizem) and verapamil (Calan), may be alternatives to beta-blockers. These drugs have similar possible side effects to beta-blockers, including dizziness. As alcohol can also cause these side effects, most doctors recommend against drinking while taking these drugs.

People with a history of alcohol use disorder or binge drinking should speak with a doctor before taking beta-blockers or any other drugs. In some cases, moderating alcohol intake may help with heart health.

It is not advisable to continue drinking when taking beta-blockers, especially not without talking to a doctor first. However, a single drink of alcohol with a beta-blocker is not likely to cause serious side effects, particularly in people who tolerate beta-blockers well.

People who wish to keep drinking should talk with a cardiologist to weigh the costs and benefits and explore alternative options.