Propranolol and Alcohol

Propranolol and Alcohol Interaction & Dangers

Drinking alcohol while taking propranolol can have seriously dangerous effects. Propranolol is a type of medication called a beta-blocker. It’s typically used to treat irregular heartbeats, high blood pressure, angina, migraines, and hypertrophic subaortic stenosis. It’s also prescribed to those who’ve suffered heart attacks to improve cardiac healing.

Mixing propranolol and alcohol can induce certain side effects. People with slow heart rhythms or low blood pressure should avoid taking propranolol.  

treatment options

What is Propranolol?

Propranolol is part of a class of medications called beta-blockers. A beta-blocker's job is to subvert beta receptors (tiny proteins) while latching onto chemical messengers from the nervous system. Beta-blockers prevent the receptors and messengers from binding together to slow the heart, relax blood vessels, and lower blood pressure.

Propranolol, therefore, works by bringing down the heart rate, improving blood flow, and decreasing blood pressure to regularize cardiac complications. It comes in the form of a tablet, a solution, and an extended-release oral capsule.

Propranolol is generally safe, but you should consult your doctor before taking it. You should not take propranolol if you are allergic to propranolol or have asthma or another lung condition. If you’re a smoker, have an abnormally slow heart rate, or have a serious heart condition, you should consult your doctor, too.

Propranolol isn’t the only beta-blocker, however. More than a dozen beta-blockers have been approved for use in the United States. They fall into three categories: 

  • Nonselective (like propranolol)
  • Cardioselective (like atenolol and metoprolol)
  • Third-generation (like labetalol, nebivolol, and carvedilol)

It’s easy to identify beta-blockers by their generic names. Like propranolol, all beta-blockers end in “lol.”

side effects

Side Effects of Propranolol

Taking propranolol may cause side effects. They’re usually not life-threatening side effects, but they can cause discomfort. These 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

Most people who take beta-blockers like propranolol will experience at least one of the above side effects. While these side effects are typically tolerable, about one in five users will switch to another beta-blocker or drug.

alcohol

Side Effects of Drinking Alcohol

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

These are also some long-term side effects of drinking too much alcohol, according to the NIAAA:

  • Alcoholic hepatitis
  • Fibrosis
  • Cirrhosis
  • Toxicity of the pancreas
  • Heart problems and possible heart failure
  • Cardiomyopathy
  • Arrhythmias (an irregular heartbeat)
  • Stroke
  • High blood pressure
  • Fatty liver

Drinking too much also tends to weaken the immune systems. This makes the body an easier target for diseases such as pneumonia and tuberculosis. There is also a strong scientific consensus regarding an association between alcohol consumption and several types of cancer.

interactions

How Do Alcohol and Beta-Blockers Interact?

Alcohol and beta-blockers do not interact well with one another. For one, research suggests that alcohol can affect your blood pressure, which beta-blockers work to lower. Specifically, alcohol compounds the blood-pressure reduction effects of beta-blockers. This means that drinking alcohol while taking beta-blockers can cause your blood pressure to drop even further.

Likewise, alcohol may decrease the effects of beta-blockers. If you’re taking a beta-blocker like propranolol to treat a cardiac concern, drinking alcohol may, therefore, render your prescription futile.

It’s simply best to avoid drinking alcohol while taking prescription medications altogether.

risks

Dangers of Mixing Alcohol and Propranolol

Mixing alcohol with certain medications like propranolol is ill-advised. Side effects of drinking alcohol with propranolol include:

  • Fatigue or drowsiness
  • Nausea and/or vomiting
  • Headaches
  • Fainting or loss of coordination
  • Difficulty breathing


Like many medications, alcohol can make you feel fatigued, drowsy, nauseous, lightheaded, and more. Therefore, drinking alcohol with certain medications that also have these side effects can intensify the effects.

Alcohol consumption can also lessen the effectiveness of medications. It may also make some medications harmful or toxic to your body. The impact that mixing propranolol and alcohol has on you will vary depending on factors like your biological sex and age. This is because women tend to reach a higher level of blood alcohol concentration (BAC) faster than men, and aging slows your body’s ability to break down alcohol.

Because propranolol and alcohol can interact negatively, it’s important to consult your doctor about any alcohol-related concerns with your prescription.

Resources

“Alcohol's Effects on the Body.” National Institute on Alcohol Abuse and Alcoholism, U.S. Department of Health and Human Services, 13 Mar. 2020, www.niaaa.nih.gov/alcohols-effects-health/alcohols-effects-body

“Hangovers.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 16 Dec. 2017, www.mayoclinic.org/diseases-conditions/hangovers/symptoms-causes/syc-20373012

“Harmful Interactions.” National Institute on Alcohol Abuse and Alcoholism, U.S. Department of Health and Human Services, 5 June 2019, www.niaaa.nih.gov/publications/brochures-and-fact-sheets/harmful-interactions-mixing-alcohol-with-medicines

Husain, Kazim, et al. “Alcohol-Induced Hypertension: Mechanism and Prevention.” World Journal of Cardiology, Baishideng Publishing Group Inc, 26 May 2014, www.ncbi.nlm.nih.gov/pmc/articles/PMC4038773/

Nierenberg, Cari. “Holiday Drinking: How 8 Common Medications Interact with Alcohol.” LiveScience, Purch, 25 Nov. 2013, www.livescience.com/41481-how-common-medications-interact-alcohol.html

“Propranolol (Cardiovascular): MedlinePlus Drug Information.” MedlinePlus, U.S. National Library of Medicine, www.medlineplus.gov/druginfo/meds/a682607.html.  

“Propranolol (Oral Route) Side Effects.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 1 June 2020, www.mayoclinic.org/drugs-supplements/propranolol-oral-route/side-effects/drg-20071164?p=1

“Propranolol.” Global, www.cardiosmart.org/Healthwise/d000/32/d00032

Publishing, Harvard Health. “Ask the Doctor: Beta Blockers and Alcohol.” Harvard Health, www.health.harvard.edu/heart-health/beta-blockers-and-alcohol

Publishing, Harvard Health. “Beta Blockers: Cardiac Jacks of All Trades.” Harvard Health, www.health.harvard.edu/heart-health/beta-blockers-cardiac-jacks-of-all-trades.

Updated on: September 22, 2020
Author
AnnaMarie Houlis
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Medically Reviewed: July 7, 2020
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Annamarie Coy,
BA, CADACII/ICADC, ICPR, MATS
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