Heart / High Blood Pressure Medications with Alcohol
Medically reviewed by Leigh Ann Anderson, PharmD. Last updated on Nov 23, 2019.
Many of us combine alcohol with our heart medications. But can you safely drink alcohol with high blood pressure or other heart medications? This is a drug interaction question you might ask your doctor or pharmacist because use of heart medication is so common. Let's look more closely.
Cardiovascular (heart) medications are widely prescribed to prevent or treat disorders of the cardiovascular system, such as:
- high blood pressure
- angina (chest pain)
- irregular heartbeat (arrhythmias)
- pulmonary hypertension (high pressure in the lung arteries)
- congestive heart failure
- heart attack
In one study, Breslow and colleagues reported that out of roughly 17,000 drinkers, heart medications were the drug class with the highest percentage of possible alcohol interactions, at about 24 percent. Alcohol and blood pressure medication interactions comprised a large percentage of this group.
Alcohol itself may also lower blood pressure itself in some patients. Theoretically, a high blood pressure medication and alcohol consumption might worsen low blood pressure and lead to side effects like dizziness, lightheadedness, drowsiness, fainting, or falling.
When you mix alcohol with blood pressure medication, for example vasodilators and alpha-blockers, you may experience orthostasis, which is low blood pressure that occurs when you stand up from a sitting or lying down position. These effects may be worse at the beginning of treatment. Orthostasis can lead to a fall and possible injury, and is a serious concern in older patients.
Learn More: See the Drugs.com Drug Interaction Checker
Additionally, there are numerous liver enzyme interactions with heart medications, potentially altering levels of the drug in your bloodstream. Liver enzymes are often responsible for breaking down medicines for excretion from the body. If you have liver disease (for example: cirrhosis) from excessive alcohol use, it may affect how your heart drugs are broken down. Higher levels of medications can worsen side effects.
Some drug classes that can be affected by alcohol include:
- Alpha-blockers, used for high blood pressure, can have a significant interaction with alcohol.
- The combination can lead to excessive hypotension (low blood pressure) and sedation. For example, when the centrally-acting alpha-blocker clonidine (Catapres) or the peripherally-acting alpha-blocker doxazosin (Cardura) are mixed with alcohol there is a risk for excessive low blood pressure, lightheadedness, drowsiness, and an increased risk for a fall.
- Ask your doctor before using an alpha-blocker with alcohol; you may be advised to avoid or limit use.
- Nitroglycerin and isosorbide are vasodilator and antianginal agents used to help prevent chest pain or pressure from angina.
- Sedation and hypotension (low blood pressure) may result when one of these preparations is co-administered with alcohol.
- Beta-blockers, for example atenolol or metoprolol, may lead to additive blood pressure lowering when combined with alcohol. Headache, dizziness, lightheadedness, fainting, and changes in pulse or heart rate may occur, especially at the beginning of treatment or with dose changes.
Table 1. Common Cardiovascular (Heart) Medications
|Generic Name||Common Brand Names||Drug Class|
|amlodipine||Norvasc||Calcium channel blockers|
|atenolol||Tenormin||Cardioselective beta blockers|
|carvedilol||Coreg||Non-cardioselective beta blockers|
|clonidine||Catapres||Centrally-acting alpha agonists|
|diltiazem||Cardizem, Cartia XT||Calcium channel blockers|
|isosorbide||Isordil||Nitrate / antianginals|
|metoprolol||Lopressor, Toprol XL||Cardioselective beta blockers|
|nebivolol||Bystolic||Cardioselective beta blockers|
|nicardipine||Cardene IV||Calcium channel blockers|
|nitroglycerin||Nitrolingual, NitroDur||Vasodilators / antianginals|
|propranolol||Inderal, Inderal LA||Non-cardioselective beta blockers|
|verapamil||Calan SR, Isoptin SR, Verelan PM||Calcium channel blockers|
*Note: This is not a complete list; always check with your pharmacist for possible drug-alcohol interactions. Tell your healthcare providers about all the other medications you use, including prescription, over-the-counter (OTC) drugs, vitamins, dietary supplements and herbal products.
Moderate alcohol consumption may be allowable with many heart medications. However, it’s important to check with your doctor and pharmacist when a new medicine is prescribed to check for any alcohol-related drug interactions.
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- Harmful Interactions. Mixing Alcohol With Medicines. National Institute on Alcohol Abuse and Alcoholism. Accessed Nov. 23, 2019 at https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/harmful-interactions-mixing-alcohol-with-medicines
- Breslow RA, Dong C, White A. Prevalence of Alcohol-Interactive Prescription Medication Use Among Current Drinkers: United States, 1999 to 2010. Alcohol Clin Exp Res. 2015; 39:371-79. Accessed Nov. 11, 2019.
- Weathermon R, Crabb DW. Alcohol and medication interactions. Alcohol Res. Health. 1999;23(1):40-54. Accessed Nov. 11, 2019.
- Hansten PD, Horn JR. Top 100 Drug Interactions 2017; p. 8. A Guide to Patient Management. H&H Publications, Freeland, WA. Accessed Nov. 11, 2019
- Alcohol Facts & Statistics. National Institute on Alcohol and Abuse and Alcoholism (NIAAA). National Institutes of Health (NIH). Accessed Nov. 10, 2019 at https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/alcohol-facts-and-statistics
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.