Alcohol can enhance the blood pressure-lowering effect of metoprolol, potentially causing excessive drops in blood pressure, dizziness, and fainting. It can also worsen metoprolol's side effects of fatigue and drowsiness. In some cases, alcohol may also raise blood pressure, creating unpredictable effects.
How This Interaction Works (Mechanism)
Both metoprolol and alcohol lower blood pressure through different mechanisms. Metoprolol blocks beta-1 adrenergic receptors, reducing heart rate and cardiac output. Alcohol causes vasodilation and reduces sympathetic nervous system activity in the short term. Together, these effects can cause orthostatic hypotension (a sudden drop in blood pressure upon standing). Alcohol can also mask the symptoms of hypoglycemia, which is relevant for diabetic patients on beta-blockers.
Source: American College of Cardiology Drug Interaction Guidance, 2025
Limit alcohol intake while taking metoprolol. If you drink, do so in moderation (no more than one to two drinks). Stand up slowly from sitting or lying positions to avoid dizziness. Monitor your blood pressure at home if possible. Avoid driving or operating heavy machinery until you know how the combination affects you. Contact your doctor if you experience frequent dizziness or fainting.
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Sources and standards behind this page
What a drug interaction does, and how strongly it is supported, is documented in public labeling and federal safety references rather than in any one summary, and the sources below are the primary ones. They are linked so a reader can check a claim without taking this page's word for it.
- DailyMed carries the current FDA labeling for every marketed drug product, including the warnings and drug interaction sections.
- Drugs@FDA is the federal database of approved drug products and their approval documents.
- FDA: Drug interactions, what you should know explains how drug-drug, drug-food and drug-condition interactions are described on labels.
- FDA Drug Safety Communications publishes the agency's safety alerts and label changes as they are issued.
- FDA MedWatch is the program for reporting and reviewing adverse events, including suspected interactions.
- openFDA provides public access to FDA labeling and adverse event data.
- MedlinePlus drug information is the National Library of Medicine's consumer reference for what a medicine is and how it is taken.
- NIAAA: Harmful interactions documents which medicines interact with alcohol and how.
- NCCIH: Herb-drug interactions summarises the evidence on interactions between herbal products and medicines.
- National Library of Medicine maintains the drug and health databases the sources above draw on.
This page describes how this interaction works and where it is documented. It is not medical advice: a prescriber or pharmacist decides what applies to a particular patient and medication.
Frequently Asked Questions
Metoprolol and Alcohol have a moderate interaction that requires caution. While some patients may take both under medical supervision, the combination can cause adverse effects. Talk to your doctor before combining these medications, and do not adjust doses on your own.
Alcohol can enhance the blood pressure-lowering effect of metoprolol, potentially causing excessive drops in blood pressure, dizziness, and fainting. It can also worsen metoprolol's side effects of fatigue and drowsiness. In some cases, alcohol may also raise blood pressure, creating unpredictable effects.
Yes. Anytime you are taking multiple medications, supplements, or substances, you should inform your doctor and pharmacist. They can evaluate your specific risk factors (age, kidney function, other medications, medical conditions) and determine whether the Metoprolol and Alcohol combination is safe for you, or whether adjustments are needed.
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