Heart / High Blood Pressure Medications with Alcohol
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. Not all heart medicines require that you give up alcohol. But some do. 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
They might also be used to treat other non-heart conditions like migraine headache or essential tremor.
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 due to vasodilation. A high blood pressure medication combined with drinking alcohol might worsen low blood pressure and lead to side effects like dizziness, lightheadedness, drowsiness, fainting, or a dangerous fall.
When you mix alcohol with a blood pressure medication, for example vasodilators and alpha-blockers, you may experience orthostatic hypotension, 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. Orthostatic hypotension 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 in your blood stream 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 used with alcohol.
- Beta-blockers, for example atenolol or metoprolol, may lead to add to the blood pressure lowering effect when combined with alcohol. Headache, dizziness, lightheadedness, fainting, and changes in your pulse or heart rate may occur, especially at the beginning of treatment or with dose changes.
- Diuretics: For example, hydrochlorothiazide or furosemide (Lasix) can add to the blood pressure-lowering effects when combined with alcohol. Headache, dizziness, lightheadedness, fainting, and/or changes in pulse or heart rate may occur
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 |
| furosemide | Lasix | Loop diuretic |
| hydralazine | Apresoline | Vasodilators |
| hydrochlorothiazide | Microzide | Thiazide diuretic |
| isosorbide | Isordil | Nitrate / antianginals |
| metoprolol | Lopressor, Toprol XL | Cardioselective beta blockers |
| minoxidil | none available | Vasodilators |
| 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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Learn more
- Atorvastatin (Lipitor): Top 12 Drug Facts You Need to Know
- Understanding Opioid (Narcotic) Pain Medications
- Which Drugs Cause Weight Gain?
Treatment options
- Medications for Acute Coronary Syndrome
- Medications for Angina
- Medications for Coronary Artery Disease
- Medications for Heart Disease
- Medications for High Blood Pressure
Care guides
- Acute Coronary Syndrome
- Adult Congenital Heart Disease
- Angina
- Atrial Septal Defect
- Atrial Septal Defect in Children
- Chronic Hypertension
- Congenital Heart Disease in Children
Symptoms and treatments
Medicine.com guides (external)
Sources
- Harmful Interactions. Mixing Alcohol With Medicines. National Institute on Alcohol Abuse and Alcoholism. Accessed March 25, 2022 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 March 25, 2022.
- Weathermon R, Crabb DW. Alcohol and medication interactions. Alcohol Res. Health. 1999;23(1):40-54. Accessed March 25, 2022.
- Hansten PD, Horn JR. Top 100 Drug Interactions 2017; p. 8. A Guide to Patient Management. H&H Publications, Freeland, WA. Accessed March 25, 2022.
- Alcohol Facts & Statistics. National Institute on Alcohol and Abuse and Alcoholism (NIAAA). National Institutes of Health (NIH). Accessed March 25, 2022 at https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/alcohol-facts-and-statistics
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.