Metoprolol and Alcohol Interactions

What is Metoprolol (Beta-Blocker)?

Metoprolol is in a group of medications called beta-blockers. Metoprolol relaxes the blood vessels and slows the heart rate. This helps to improve blood flow and decrease blood pressure.

Metoprolol is sold under the brand names FIRST-Metoprolol, Kapspargo Sprinkle, Lopressor, Metoprolol Succinate ER, Metoprolol Tartrate, and Toprol-XL. It comes in immediate-release or extended-release tablets. Other common beta-blockers include propranolol and atenolol.

High blood pressure (hypertension) is a common disease. When left untreated, it can cause damage to the following:

• Brain
• Heart
• Blood vessels
• Kidneys

Other areas of the body can also be affected by high blood pressure.

Damage to these vital organs can lead to the following side effects and medical conditions:

• Heart disease 
• Heart attack
• Heart failure
• Stroke
• Kidney failure
• Loss of vision

In addition to taking medications like metoprolol, making lifestyle changes can also help to maintain healthy blood pressure.

Metoprolol has a black box FDA warning listed in the drug information.

A black box warning is the most serious disclaimer from the FDA. It notifies doctors and patients about drug effects that could be dangerous or severe.

Patients shouldn’t stop taking metoprolol suddenly. If metoprolol is stopped suddenly, patients may experience the following serious side effects:

• Chest pain 
• An increase in blood pressure
• Heart attack 

If you want to stop taking the drug, speak to your doctor or health care provider for medical advice. Your dosage may be gradually decreased under medical supervision.

Uses of Metoprolol

Metoprolol is used alone or with other medications (such as diuretics) to treat high blood pressure. 

The drug is also used to prevent angina, otherwise known as chest pain. It’s also used to improve survival following a heart attack. Metoprolol may also be used with other medications to treat cardiovascular disease.

Less commonly, metoprolol is used to prevent migraines and headaches and to treat an irregular heartbeat. Metoprolol is also occasionally used to address movement disorders resulting from medications for mental illness.

Tell your doctor if you have any symptoms of a thyroid disorder (hyperthyroidism), heart problems, liver disease, or low blood sugar, as metoprolol may mask symptoms of these diseases.

Metaprolol may cause allergic reactions. Tell your doctor if you're currently or plan on becoming pregnant or breast-feeding, as this medication can pass into breast milk.

Side Effects of Metoprolol

Metoprolol can cause side effects. Seek medical advice from your doctor if any of these common side effects and symptoms are severe or do not go away:

Some side effects of metoprolol can be more serious. The following symptoms are rare, but if you experience any of these serious side effects, call your doctor or for medical attention immediately:

• Shortness of breath
• Wheezing
• Swelling of the hands, feet, ankles, or lower legs 
• Weight gain
• Fainting 
• Rapid, pounding, or irregular heartbeat 

Metoprolol may also cause other side effects. If you experience any unusual health problems while taking these prescription drugs, call your doctor.

Metoprolol and Alcohol Interaction

Drinking alcohol while taking beta-blockers like metoprolol isn’t recommended by doctors. Beta-blockers reduce your blood pressure and give you a slow heart rate, lessening the force of each beat. If your heartbeat is too slow, this is known as bradycardia.

Alcohol can also reduce your blood pressure. When you combine drinking alcohol with metoprolol, the additive effect on the blood pressure can cause it to drop to a dangerously low level. This condition is called hypotension.

Dangers of Mixing Metoprolol and Alcohol

The drug interactions between metoprolol and alcohol can give you low blood pressure at a dangerous rate. This can lead to the following side effects and symptoms:

• Dizziness
• Lightheadedness 
• Fainting, especially if you get up too fast 
• Rapid heart rate 
• Nausea 
• Headache
• Inability to concentrate

Drinking alcohol can also provide adverse effects on the health conditions treated with beta-blockers. These include:

• Heart conditions
• Tremors
• Anxiety
• Glaucoma

Metoprolol Interactions With Other Drugs

If you take other blood pressure medications combined with beta-blockers and alcohol, your risk of low blood pressure increases. This is especially true for the following classes of drugs.

Alpha-Blockers

Alpha-blockers medication causes vasodilation in small blood vessels. The medicine does this by blocking the effects of norepinephrine. Alpha-blockers also treat the symptoms of benign prostatic hypertrophy (BPH). This is a condition in men in which the prostate gland is enlarged and may be cancerous.

Examples of alpha-blockers include:

• Doxazosin (Cardura) 
• Prazosin (Minipress) 
• Terazosin (Hytrin)

Calcium Channel Blockers

Calcium channel blockers cause vasodilation by preventing calcium from entering the cells in your blood vessels.

Examples of calcium channel blockers include:

• Amlodipine (Norvasc) 
• Diltiazem (Cardizem, Tiazac) 
• Nifedipine (Procardia) 
• Verapamil (Calan)

If you consume alcohol while taking beta-blockers and develop any of the symptoms or side effects above, visit your doctor or health care provider. You can receive medical advice on your symptoms and can discuss whether drinking is safe.

Metaprolol can also have adverse effects when combined with:

• Monoamine oxidase inhibitors (MAOIs)
• CYP2D6 Inhibitors (such as fluoxetine and paroxetine)
• Clonidine
• Heart rhythm drugs (such as quinidine and propafenone)
• Antihistamines (such as diphenhydramine)

Treatment Options for Alcohol Abuse & Addiction

Alcohol addiction can occur when someone drinks heavily. It is one of the most significant public health problems in the United States. Many people struggle to control their drinking at some point during their lives.

However, no matter how serious the drinking problem may seem, most people experiencing an alcohol use disorder can benefit from treatment. Many people that undergo treatment for alcohol addiction significantly reduce their drinking or become abstinent.

There are a variety of methods for treating alcohol use disorders. But, there is no one-size-fits-all solution. What may be beneficial for one person may not for another. Understanding the options of treatment is an essential first step.

Here are some common treatments of alcohol use disorders.

Around 17 million adults aged 18 or older have an alcohol use disorder. One in ten children lives in a home with a parent who has a drinking problem. 

Treatment for Alcohol Problems: Finding and Getting Help, National Institute on Alcohol Abuse and Alcoholism, 2014.

Behavioral Treatment

Behavioral treatments focus on changing drinking behaviors through counseling. Behavioral treatments involve working with a health care provider or professional to adjust someone’s behaviors that result in heavy drinking. 

Behavioral treatment often helps patients do the following:

• Develop the skills required to stop or reduce drinking
• Build a strong and stable social support system
• Set reachable goals
• Cope with or avoid triggers that may lead to a relapse

Medication

There are three medications approved in the United States that help people stop or reduce drinking alcohol. These medications are prescribed by a primary care physician or another medical professional. These medicines may be used alone or during medication assisted treatment (MAT). 

All approved medications are non-addictive. The three medicines are:

• Naltrexone
• Acamprosate
• Disulfiram

Support Groups

Alcoholics Anonymous (AA) and other support groups offer peer support for quitting or cutting back on alcohol. 

Support groups are often combined with medical treatment led by health professionals, providing an additional layer of support.