Alcohol interaction with metoprolol

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Alcohol and Metoprolol: Effects on Blood Pressure and Heart Function

Research shows that consuming alcohol after taking a single dose of metoprolol does not eliminate the drug’s ability to lower blood pressure in healthy individuals. However, people with high blood pressure who regularly drink alcohol may have less effective blood pressure control, suggesting that chronic alcohol use could interfere with the benefits of antihypertensive medications like metoprolol .

Alcohol, Metoprolol, and the Nervous System

Studies in animals indicate that alcohol can activate the sympathetic nervous system, leading to changes in heart structure such as cardiac hypertrophy. Metoprolol, especially at higher doses, can counteract some of these changes by blocking the effects of adrenaline and noradrenaline, suggesting a protective role against alcohol-induced heart changes . Additionally, metoprolol pretreatment in animal models has been shown to reduce the risk and duration of alcohol-induced atrial fibrillation, indicating that beta-blockers may help prevent certain alcohol-related heart rhythm problems .

Central Nervous System Effects: Balance and Cognitive Function

When metoprolol is taken with alcohol, it can increase alcohol-induced disturbances in balance and cognitive function. This effect is more pronounced with lipophilic beta-blockers like metoprolol and pindolol, which can cross into the brain more easily, compared to hydrophilic beta-blockers like atenolol. The combination does not change blood alcohol levels, but it may make the effects of alcohol on the brain stronger and last longer .

Metoprolol Overdose and Alcohol

There is a reported case of metoprolol overdose in a person who consumed the drug while under the influence of alcohol. The patient experienced serious symptoms such as slow heart rate and low blood pressure, requiring emergency treatment. While this case highlights the dangers of overdose, it does not provide evidence that alcohol directly increases the risk of overdose, but it does show that alcohol use can be involved in risky behaviors leading to overdose .

Conclusion

Alcohol does not appear to block the blood pressure-lowering effects of metoprolol after a single dose, but regular alcohol use may reduce overall blood pressure control. Metoprolol can help protect the heart from some harmful effects of alcohol, such as cardiac hypertrophy and arrhythmias. However, combining metoprolol with alcohol can increase balance and cognitive disturbances, especially with certain types of beta-blockers. Caution is advised when using metoprolol and alcohol together, particularly for those with cardiovascular conditions or at risk of overdose.

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Most relevant research papers on this topic

THE INTERACTION OF ALCOHOL and ^‐BLOCKERS IN ARTERIAL HYPERTENSION

Alcohol does not abolish the antihypertensive effect of metoprolol on supine systolic blood pressure, but further investigation is needed.

RCT

1990·

6citations

·Rajan Maheswaran et al.

Metoprolol suppresses the development of ethanol-induced cardiac hypertrophy in the rat.

Metoprolol suppresses the development of ethanol-induced cardiac hypertrophy in rats, suggesting a beta-adrenoceptor mediated link in this process.

Non-RCTAnimal Study

1990·

21citations

·M. Adams et al.

Influence of Beta-Blocker on Equilibrium Disturbance after Alcohol Ingestion

Lipophilic beta-blockers, metoprolol and pindolol, exacerbate alcohol-induced equilibrium disturbances, while atenolol does not affect alcohol's effect on the central nervous system.

Non-RCT

1988·

0citations

·A. Mizuno et al.

Measurements, Thermodynamic Modeling, and a Hydrogen Bonding Study on the Solubilities of Metoprolol Succinate in Organic Solvents

Metoprolol succinate's solubility in various alcohols is mainly due to intra- and intermolecular hydrogen bonds in metoprolol succinate-solvent complexes.

2018·

14citations

·Jianli Shen et al.

Novel beta-blocker pretreatment prevents alcohol-induced atrial fibrillation in a rat model

Metoprolol pretreatment before alcohol consumption significantly reduces alcohol-induced atrial fibrillation in rats, suggesting it as a promising prophylaxis regimen for alcohol-induced atrial fibrillation.

2020·

3citations

·H. Hassan et al.

A case report on metoprolol overdose

Metoprolol overdose can lead to bradycardia, hypotension, and cardiovascular collapse, and is treated with gastric lavage and glucagon.

Case Report

2020·

0citations

·M. Uddin et al.

Poly(vinyl alcohol)-based membranes for metoprolol transdermal delivery

Poly(vinyl alcohol)-based membranes with Tween 80 show linear release profiles for metoprolol transdermal delivery, demonstrating a constant drug release over time.

In Vitro Study

2020·

4citations

·C. Algieri et al.

Fatality resulting from metoprolol overdose.

An intentional overdose of metoprolol can result in death, with blood ethanol levels being the other significant toxicologic finding.

Case Report

1987·

21citations

·T. P. Rohrig et al.

Neutrophil stunning by metoprolol reduces infarct size

Metoprolol reduces infarct size in acute myocardial infarction patients by targeting neutrophils and inhibiting platelet-neutrophil interactions, offering potential for new therapeutic strategies.

In Vitro StudyHighly Cited

2017·

186citations

·J. García‐Prieto et al.

Metoprolol elicits neurobehavioral insufficiency and oxidative damage in nontarget Nauphoeta cinerea nymphs

Metoprolol exposure induces neurobehavioral insufficiency and oxido-inflammatory injury in nontarget Nauphoeta cinerea nymphs, potentially impacting their health and productivity.

Non-RCTAnimal Study

2023·

2citations

·Gbemisola T Oyedele et al.

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