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Updated on October 1, 2023
8 min read

Is It Safe to Mix Propranolol and Alcohol?

What is Propranolol?

Propranolol is a type of medication called a beta-blocker. It's available as a tablet, solution, and an extended-release oral capsule.

It's a prescription medication under the brand names Inderal, InnoPran XL, and Hemoangeol. Propranolol typically treats:

  • Irregular heartbeats
  • Anxiety
  • Tremors
  • High blood pressure
  • Angina
  • Migraines
  • Arterial hypertension
  • Hypertrophic subaortic stenosis

Understanding how beta-blockers work is essential when considering alcohol intake while on medication.

Other Approved Beta-blockers in the US

Other beta-blockers that have been approved for use in the United States include:

  • Nonselective (like propranolol)
  • Cardioselective (like atenolol and metoprolol)
  • Third-generation (like labetalol, nebivolol, and carvedilol)
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How Does Propranolol Work?

Propranolol blocks certain natural chemicals, like epinephrine, in your body. Epinephrine, or adrenaline, is a hormone that plays an important role in managing your blood pressure. This allows your heart and blood vessels to relax.

Taking beta-blockers like propranolol reduces your heart rate and lowers blood pressure. This lessens the strain on your heart and improves blood flow.

Lowering high blood pressure can help prevent:

  • Strokes
  • Heart attacks
  • Kidney problems
  • Chest pain

How to Safely Take Propranolol

Follow the following tips to avoid accidents or adverse reactions from the drug:

  • Take propranolol as directed
  • Don't take more of it longer than your doctor prescribed
  • Read and follow Propranolol's guide and directions carefully and ask your doctor for questions
  • Swallow the extended-release capsules and tablets whole
  • You can take the extended-release capsule with or without food and before bedtime
  • Take the medication in the same way each time
  • Don't mix the oral solution with water to make swallowing easier
  • Don't shake the medication before use
  • If you miss a dose, take the tablet as soon as possible unless it's nearly time for your next dose
  • Never double your dose to compensate for a skipped or forgotten dose.

Propranolol Dosage

Propranolol's dosage will differ for each person and the condition you're treating. The amount you take also depends on the following factors:

  • Your age
  • The strength of the medication
  • The number of doses you take each day
  • The time allowed between doses
  • The length of time you're prescribed to take the medication

Only change your dosage if your doctor tells you to. Consult your doctor for any questions or changes in your prescription.

Typical Dosage for Anxiety

The typical dosage for social or performance anxiety is 10 to 40 mg. Follow your doctor's orders and the directions on the label.

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What are the Side Effects of Propranolol?

Taking propranolol may cause side effects. They're usually not life-threatening, but they can be uncomfortable.

Propranolol side effects include:

  • Fatigue or drowsiness
  • Weight gain
  • Shortness of breath or difficulty breathing
  • Chest pain
  • Tingling sensation
  • Coldness in hands or feet
  • Lightheadedness or dizziness
  • Headaches
  • Insomnia
  • Unusual dreams
  • Nausea
  • Constipation or diarrhea
  • Depression
  • Low libido
  • Allergic reactions

Severe Side Effects of Propranolol

Although it happens rarely, propranolol has serious side effects. Check with your doctor immediately if you start to experience the following:

  • Serious skin reactions such as blistering, peeling, rashes, red skin lesions, etc.
  • Dilated neck veins
  • Extreme fatigue
  • Irregular breathing
  • Fast heart rate or irregular heartbeat
  • Swelling in the face or other extremities
  • Weight gain
  • Nosebleeds that last for more than 10 minutes
  • Signs of low platelets in your blood such as bruising or unexplained bruises
  • Signs of liver problems such as dark urine, pale stool, and jaundice

Considerations with Beta-Blockers

Beta-blockers may also hide signs of low blood sugar levels. Most people who take beta-blockers like propranolol will experience at least one of these side effects.

These side effects can worsen if you drink alcohol while on propranolol or other beta-blockers.

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Who is at Risk When Taking Propranolol?

Propranolol can interact with certain medications and conditions. This can worsen existing symptoms or increase your risk of experiencing severe side effects.

You should consult your doctor if you:

  • Are allergic to propranolol
  • Have asthma or another lung condition
  • Have glaucoma
  • Are a smoker
  • Have a slow heart rate
  • Have a serious heart condition
  • Drink alcohol or have alcohol use disorder (AUD)

Dietary Considerations with High Blood Pressure Treatment

Treatment for high blood pressure includes weight control and dietary changes. This is especially true for foods high in salt. Check with your doctor before changing your diet.

What Drugs Can Interact with Propranolol?

Propranolol can interact with other medications and cause unpleasant side effects. These medications include, but aren't limited to:

  • Migraine medications such as Rizatriptan (Maxalt)
  • Heart rhythm medications such as Amiodarone (Pacerone)
  • Antidepressants such as Fluoxetine (Prozac)
  • Blood thinners like Warfarin (Coumadin)
  • Cimetidine

How Do Alcohol and Beta-Blockers Interact?

Mixing beta-blockers and alcohol can have dangerous interactions. Alcohol interacts with the blood pressure-reducing effects of beta-blockers and causes your blood pressure to drop further.

If you're taking propranolol to treat heart problems, drinking alcohol may counter its effects. It’s simply best to avoid drinking alcohol while taking prescription medications altogether.

Symptoms of Dangerous Interaction

You may experience the following due to very low blood pressure:

  • Dizziness
  • Fainting
  • Blurry vision
  • Confusion
  • Lightheadedness
  • Nausea or vomiting
  • Sleepiness
  • Weakness

Alcohol can also decrease the effects of beta-blockers.

What are the Side Effects of Mixing Propranolol and Alcohol?

Aside from experiencing extremely low blood pressure, the side effects of drinking alcohol with propranolol include:

  • Fatigue or drowsiness
  • Nausea and/or vomiting
  • Headaches
  • Fainting or loss of coordination
  • Breathing problems
  • Tremors
  • Developing a very fast heart rate

Impact of Gender and Age on Alcohol Metabolism

Consuming alcohol while taking propranolol can be harmful or toxic to your body. The impact of mixing these substances can depend on your gender and age.

Women tend to reach a higher level of blood alcohol concentration faster than men, causing them to get drunk more quickly. Additionally, aging slows your body's ability to break down alcohol. Thus, alcohol remains in your system longer.

Additional Considerations and Risks

Alcohol can also worsen existing side effects, such as anxiety and glaucoma. Because of the potential risks and complications from mixing propranolol and alcohol, it's important to consult your doctor about any alcohol-related concerns regarding your prescription.

What are the Side Effects of Drinking Alcohol?

Drinking alcohol can take a toll on your health. However, the magnitude varies depending on your tolerance, weight, food intake, etc.

These are some common side effects of drinking alcohol:

  • Fatigue
  • Dry mouth and dehydration
  • Headaches
  • Dizziness
  • Shakiness
  • Rapid heartbeat
  • Muscle aches
  • Nausea with or without vomiting
  • Stomach pain
  • Poor sleep
  • Increased sensitivity to light and sound
  • Decreased ability to concentrate
  • Depression and/or anxiety
  • Irritability

Long-Term Side Effects of Alcohol

Heavy or binge drinking can lead to severe physical symptoms, including:

Impact on Immunity and Cancer Risks

Drinking too much also tends to weaken the immune system. This makes the body an easier target for pneumonia and tuberculosis. There's also a strong scientific consensus regarding the relationship between alcohol consumption and several types of cancer.

What are Propranolol and Alcohol Overdose Symptoms?

If you're taking propranolol for anxiety, you're unlikely to experience an overdose due to its low dosage. However, drinking alcohol while on propranolol can increase the risk of an overdose.

You might take more propranolol than necessary due to how alcohol reduces its effects. Symptoms of a propranolol overdose include:

  • Breathing difficulties
  • Dizziness and lightheadedness
  • Blurry vision
  • Fainting
  • Dangerously slow heart rate
  • Severe heart conditions or heart disease

If you're worried that you are experiencing a propranolol and alcohol overdose, seek immediate medical attention.

Treatment Options for Propranolol and Alcohol Abuse

Overcoming an alcohol addiction requires professional treatment. However, people react differently to treatment, so exploring various options is essential.

Available treatment options include:

Propranolol Use and Potential Dependency

Although propranolol isn't physically addictive or habit-forming, you can misuse or depend on it. This is especially true for performance or social anxiety.

It's important to inform your healthcare provider if you overuse or rely on propranolol. On the other hand, alcohol is an addictive substance that can lead to long-term health problems and dependence.

Summary

Propranolol is a prescription beta-blocker that treats various medical conditions like high blood pressure and anxiety. It blocks the hormone epinephrine to relax your heart and blood vessels.

Although propranolol is typically safe, it can have uncomfortable and severe side effects. It can also interact with alcohol and other substances, increasing the risk of serious side effects.

The interaction between propranolol and alcohol can also reduce beta-blockers efficacy. So, seek immediate help if you abuse both substances. Various treatment programs can help you live a healthier life.

Updated on October 1, 2023
10 sources cited
Updated on October 1, 2023
All Alcoholrehabhelp content is medically reviewed or fact checked to ensure as much factual accuracy as possible.

We have strict sourcing guidelines and only link to reputable media sites, academic research institutions and, whenever possible, medically peer reviewed studies.
  1. U.S. Department of Health and Human Services. “Alcohol's Effects on the Body.National Institute on Alcohol Abuse and Alcoholism, 2021.

  2. Hangovers.Mayo Clinic, 2017.

  3. U.S. Department of Health and Human Services. “Harmful Interactions.National Institute on Alcohol Abuse and Alcoholism, 2014.

  4. Husain et al. “Alcohol-Induced Hypertension: Mechanism and Prevention.World Journal of Cardiology, 2014.

  5. Nierenberg, C. “Holiday Drinking: How 8 Common Medications Interact with Alcohol.LiveScience, 2013.

  6. U.S. National Library of Medicine. “Propranolol (Cardiovascular).MedlinePlus, 2023.

  7. Propranolol (Oral Route).Mayo Clinic, Mayo Foundation for Medical Education and Research, 2023.

  8.  “Ask the Doctor: Beta Blockers and Alcohol.Harvard Health Publishing, 2013.

  9. Beta Blockers: Cardiac Jacks of All Trades.Harvard Health Publishing, 2011.

  10. Constantine et al. "Addition of Propranolol in Resistant Arterial hypertension Treatment (APROPRIATE study): study protocol for a randomized double-blind placebo-controlled trial." Trials, 2017.

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All content created by Alcohol Rehab Help is sourced from current scientific research and fact-checked by an addiction counseling expert. However, the information provided by Alcohol Rehab Help is not a substitute for professional treatment advice.
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