Metoprolol and alcohol interaction

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Metoprolol and Alcohol Interaction: Blood Pressure and Cardiovascular Effects

Research shows that consuming alcohol after taking metoprolol does not eliminate the drug’s ability to lower blood pressure in healthy individuals. However, people with hypertension who regularly drink alcohol may have less effective blood pressure control, suggesting that alcohol could interfere with the long-term management of hypertension when using metoprolol or similar medications .

Central Nervous System Effects: Balance and Cognitive Function

Studies indicate that metoprolol, a lipophilic beta-blocker, can increase the negative effects of alcohol on balance and cognitive function. When healthy subjects took metoprolol before drinking alcohol, they experienced greater disturbances in body equilibrium and a larger decline in cognitive performance compared to alcohol alone. This effect was not seen with atenolol, a hydrophilic beta-blocker, suggesting that the interaction is more pronounced with beta-blockers that can cross into the brain .

Cardiac Protection and Arrhythmia Prevention

Animal studies suggest that metoprolol may help prevent certain alcohol-induced heart problems. In rats, pretreatment with metoprolol before alcohol exposure significantly reduced the risk and duration of alcohol-induced atrial fibrillation, a type of irregular heartbeat. This points to a possible protective effect of metoprolol against alcohol-triggered arrhythmias . Additionally, metoprolol may counteract the development of alcohol-induced cardiac hypertrophy (enlarged heart) by blocking the sympathetic nervous system’s response to alcohol .

Overdose Considerations

There is a reported case of metoprolol overdose in a patient who consumed the drug while under the influence of alcohol. The patient developed 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 metoprolol toxicity, but caution is advised when both substances are involved .

Conclusion

Metoprolol and alcohol can interact in several ways. While alcohol does not block metoprolol’s blood pressure-lowering effect, it can worsen balance and cognitive impairment when combined with metoprolol. Metoprolol may offer some protection against alcohol-induced heart rhythm problems, but combining the two can be risky, especially in overdose situations. People taking metoprolol should be cautious with alcohol consumption and consult their healthcare provider for personalized advice.

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Most relevant research papers on this topic

The interaction of alcohol and beta-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·

2citations

·R. Maheswaran 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.

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.

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.

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.

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.

Effect of metoprolol in hypertrophic obstructive cardiomyopathy patients after alcohol septal ablation

Metoprolol treatment did not improve exercise capacity, hemodynamic and laboratory parameters, or quality of life in hypertrophic obstructive cardiomyopathy patients after alcohol septal ablation.

RCT

2023·

0citations

·Hana Hnátová et al.

Effects of Orotic Acid-Induced Non-Alcoholic Fatty Liver on the Pharmacokinetics of Metoprolol and its Metabolites in Rats.

Non-alcoholic fatty liver disease (NAFLD) can reduce hepatic clearance of drugs, leading to elevated drug concentrations and increased exposure.

Non-RCTAnimal Study

2019·

10citations

·Won Seok Bang et al.

Metoprolol Mitigates Ischemic Heart Remodeling and Fibrosis by Increasing the Expression of AKAP5 in Ischemic Heart

Metoprolol alleviates ischemic cardiac remodeling and fibrosis by increasing cardiac AKAP5 expression and AKAP5-PP2B interaction.

Non-RCTAnimal StudyRigorous Journal

2022·

2citations

·F. Zhu et al.

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