Beta blockers are a group of drugs most commonly used to treat heart and blood vessel disorders, including angina (chest pain), high blood pressure, and atrial fibrillation.
Beta blockers work by blocking beta receptors, which are mainly found in the heart, kidneys, blood vessels, and respiratory system. When these receptors are blocked from the action of neurotransmitters such as epinephrine, the heart rate decreases, blood pressure decreases, and chest pain improves.
If you are taking beta blockers, drinking alcohol can have potentially dangerous effects because of their ability to affect heart rate and rhythm and lower blood pressure. This interaction can increase dizziness, lightheadedness, and heart rate changes, which can be unpredictable.
This article explains what beta blockers are, how to use them, what dosage they take, and what are the risks.
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Understanding Beta Blockers
What does it treat?
Although not all beta-blockers are approved for all indications, some common and approved indications for beta-blockers include:
- High blood pressure: Lowering your blood pressure can reduce your risk of cardiovascular disease, such as stroke and myocardial infarction (heart attack).
- Angina or chest pain: Beta blockers may help reduce how often you experience chest pain and may help you tolerate more exercise.
- Myocardial infarction or heart attack: Beta blockers are used in people who survive the acute phase of a heart attack and are otherwise stable.
- Atrial fibrillation: Beta blockers may help control irregular heart rhythms.
- Migraines: Some beta blockers are used to prevent migraines or to prevent migraines in general.
- Infantile hemangioma: Beta blockers can treat this type of birthmark, which appears at birth or in the first few months of a newborn's life. It is caused by clusters of extra blood vessels that form incorrectly and grow more than necessary.
- Essential tremor: Inderal LA (propranolol) is sometimes used to treat tremor, which is characterized by involuntary, rhythmic or oscillatory movements of the arms and hands.
Off-label use
There are other indications for which beta blockers are still used, although they are not approved by the US Food and Drug Administration (FDA), depending on the prescriber's expertise and experience. This is called off-label use. Off-label use is often still being studied for its effectiveness and for associated conditions that may be improved by beta blockers. For example:
- Pyogenic granuloma is another type of hemangioma that occurs mainly in children under 5 years of age.
- Chronically non-healing wounds may benefit from treatment to promote healing and skin regeneration.
- Anxiety disorders such as PTSD (post-traumatic stress disorder), stage fright, and phobias
- Slows tumor growth in various cancers
Dosage and Brand Name
The following table shows examples of beta blockers and their typical dosage ranges. The appropriate dosage of beta blockers varies greatly from person to person and is determined by indications, age, tolerance, and other factors. You should consult your healthcare provider before starting a beta blocker and while continuing to take the drug to achieve the optimal dosage.
Brand name | Common name | Dosage range (oral, total daily dose in milligrams (mg)) |
doesn't exist | Acebutolol | 400~1200mg |
Tenormin | Atenolol | 50~200mg |
doesn't exist | Bisoprolol | 5~20mg |
Lopressor, Toprol XL | Metoprolol | 100~450mg |
Korgard | Nadolol | 40~240mg |
Non-Society | Navivolol | 2.5 ~ 10mg |
Inderal LA, Inopran XL | Propranolol | 80~320mg |
What are the risks of taking beta blockers and alcohol together?
There are several reasons why it is not advisable to take alcohol and beta blockers together. These negative aspects can have dangerous short-term effects, and if repeated over months or years, can lead to negative long-term effects.
- Blood pressure: Alcohol has a blood pressure-lowering effect. If you drink alcohol while taking a blood pressure-lowering beta-blocker, the combined effect can be so strong that your blood pressure can drop dangerously low.
- Heart rate: Alcohol can increase your heart rate and cause irregular heartbeats, which can worsen conditions like atrial fibrillation that can be treated with beta-blockers.
- Drug interactions: If you take Inderal LA (propranolol), alcohol can increase the levels of this medication in your blood, which may increase side effects such as dizziness, lightheadedness, and changes in heart rate.
The degree of these effects depends on how you take the beta blocker, the dose you take, and how much alcohol you drink. An occasional drink or two is unlikely to cause significant harm, but check with your healthcare provider first.
Treatment alternatives to beta blockers
Because beta blockers are used to treat a wide variety of conditions, alternative treatment options for beta blockers are numerous. Alternative treatments for some common beta blocker indications include:
- Angina: Calcium channel blockers such as Norvasc (amlodipine), Cardizem (diltiazem), or long-acting nitrates such as Monoket (isosorbide mononitrate)
- High blood pressure: Thiazide diuretics such as chlorthalidone or hydrochlorothiazide, ACE inhibitors such as Zestril (lisinopril) or Lotensin (benazepril), or ARBs such as Cozaar (losartan) or Benica (olmesartan)
- Atrial fibrillation: Antiarrhythmic drugs such as flecainide, betapase (sotalol), and phaseron (amiodarone), and calcium channel blockers
- Anxiety disorders such as PTSD or stage fright: Antidepressants or anti-anxiety medications, such as SSRIs, such as Zoloft (sertraline), Lexapro (escitalopram), Cymbalta (duloxetine), or Effexor (venlafaxine).
summary
A lifestyle with less alcohol consumption is generally recommended, but this may be more important for those taking medications such as beta blockers, which can have compounding effects such as increased heart rate and decreased blood pressure due to the effects of alcohol.
The degree of these effects will vary depending on the use of beta blockers, dosage, indications, and alcohol consumption. An occasional drink or two is unlikely to cause significant harm, but you should discuss your blood pressure control and alcohol consumption with your healthcare provider to determine the healthiest plan for you.