Can You Drink on Propranolol?
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You’re at a dinner party, and the host passes around a bottle of wine. Normally, you’d pour a glass, but tonight you hesitate — you just started taking a new medication, and you're not sure if it's safe to mix with alcohol.
Almost all of us have taken medication at one point or another, but it may not have occurred to us that alcohol could cause an interaction. Today we’re looking at a common heart medication called propranolol. It’s prescribed for a number of reasons, but it acts on the heart — and so does alcohol.
So do these two substances work together to keep your ticker ticking, or do they make a dangerous cocktail? Let’s take a look at the science and learn how to stay safe!
Propranolol is a class of medication known as a beta-blocker. It works by slowing your heart rate and reducing how hard your heart has to work. Beta blockers work by blocking beta receptors in the heart — hence the name!
Beta receptors are responsible for receiving natural excitatory chemicals in our body, like adrenaline (also known as epinephrine) and norepinephrine. These chemicals are part of our body’s “fight or flight” response, which increases our heart rate, makes our heart pump harder, and raises our blood pressure. When beta receptors are blocked, our heart stays calmer and doesn’t get as excited by these chemicals.
Propranolol is not an emergency heart rate medication. Instead, it’s typically used in long-term management of disorders that affect the heart.
Because it’s commonly prescribed for those with heart conditions, it’s a common misconception that propranolol is a blood thinner when, in fact, it is not.
Blood thinners reduce the risk of blood clots, while propranolol works on the heart's rhythm and pressure. Many people with heart conditions or hypertension are at risk of blood clots, and they may also be on blood thinners to manage this condition. However, propranolol is in a class of its own.
Much like propranolol, alcohol is a chemical that affects the body. While propranolol is used to treat medical conditions, alcohol is a chemical we choose for its temporary sedative and mood-boosting effects. Let’s look at a quick overview of alcohol’s chemical process.
Alcohol is a central nervous system depressant: it slows our body’s nerve impulses. This doesn’t just mean that everything slows down. In fact, some of these slow-downs cause other things to speed up — such as the heart.
Alcohol can cause an increase in heart rate by stimulating the release of adrenaline in the body — yes, the same thing propranolol blocks! It also increases heart rate by lowering blood pressure and interfering with the electrical signals in our heart directly.
You may be thinking, “Wow, it sounds like alcohol can help lower my blood pressure!” Not so fast. Moderate alcohol temporarily lowers blood pressure for up to 12 hours after drinking, but then raises it after that for at least 24 hours. Heart rate is also consistently increased for at least 24 hours after drinking. Binge drinking and chronic alcohol use are both associated with high blood pressure. So don’t think you can replace your alcohol with propranolol just yet.
When alcohol and propranolol are used together, they can interact in ways that may be harmful to your health. The interactions have different implications based on your reason for taking propranolol, and understanding each one is important for making the most informed health decisions.
We’ve discussed the potential effects of mixing alcohol and propranolol, but it’s possible you’ve already mixed these two substances and now you’re in the aftermath — the dreaded hangover. We know that alcohol causes a chemical response in our body, and we know that hangovers are our body’s response to alcohol. So how does the chemistry of hangovers affect the chemistry of propranolol?
Hangovers occur after alcohol’s effects have worn off, and they typically involve symptoms like headache, dehydration, fatigue, and anxiety. They’re caused by the chemical rebounds of alcohol’s effects on our brain chemistry, and the aftereffects of our body’s physical response to alcohol, like excessive urination and poor sleep.
Taking propranolol during a hangover can be complex. The effects and aftereffects of alcohol continue to affect your heart rate and blood pressure for at least 24 hours. The liver is still working hard to process the leftovers of alcohol metabolism, and introducing propranolol may stress it.
Hangovers stress your body (especially your cardiovascular system), potentially making the symptoms that propranolol treats more pronounced. On the other hand, some hangover symptoms, like dehydration, can be worsened by propranolol. Propranolol’s ability to lower blood pressure and heart rate could intensify feelings of dizziness or lightheadedness during a hangover.
If propranolol is a regular part of your medication routine, missing a dose can be risky, especially if you're taking it for heart-related conditions. However, the added physical stress of a hangover might require a different approach. Take it easy, stay hydrated, and replenish electrolytes during a hangover. Drinking water and consuming electrolyte-rich foods or drinks can mitigate some of the dehydrating effects of both substances.
It’s also important to be honest with your healthcare provider. Tell them how much you drink and seek their personalized advice about how to balance your propranolol use with your drinking habits. If you don’t really know how much you drink, consider using the Reframe app’s drink tracker to get a clear picture.
Your overall health plays a significant role in how both propranolol and alcohol affect you. For example, propranolol can mask the signs of low blood sugar or trigger asthma attacks. Alcohol can trigger episodes of atrial fibrillation (AFib), a common condition for which propranolol is prescribed.
Using alcohol and propranolol together isn’t necessarily dangerous. It depends on a lot of factors, such as amount used, underlying health issues, reasons for taking propranolol (and their severity), and other medications you use. Ultimately, only your doctor can assess all these factors and give you the most personalized advice.
But keep this in mind: most of the conditions treated by propranolol are negatively impacted by alcohol. If you’re concerned that alcohol is interfering with your ability to manage your health, consider using the Reframe app to develop a personalized plan to quit or cut back on alcohol consumption.
1. What is propranolol?
Propranolol is a medication used to lower and stabilize heart rate. It belongs to a family of medications called beta-blockers.
2. Why is propranolol prescribed?
It is generally used to treat high blood pressure, heart arrhythmias, chest pain, and anxiety.
3. Do propranolol and alcohol interact?
They share some side effects. Side effects like dizziness, drowsiness, and fatigue may compound. In other ways, they counteract each other with unpredictable results — especially when it comes to heart rate.
4. Is it safe to drink while on propranolol?
If you’re taking propranolol, alcohol should be avoided. It’s probably not emergently dangerous, but it depends on your health and dosage of both substances. In any case, it’s not a great idea to use them together, especially in the long term or while binge drinking. And keep in mind, there is no “safe” amount of alcohol!
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