Key takeaways:
Regularly drinking alcohol can raise your blood pressure and make it harder for your medications to work.
Heart arrhythmias, falls, and severe drowsiness are a few examples of what can happen if you mix alcohol with blood pressure medications.
Healthcare professionals recommend avoiding alcohol while taking blood pressure medications.
Many people have questions about blood pressure medications when they first start taking them. One of those questions is usually, “Can I drink alcohol while taking this?” The answer can depend on a variety of factors. The safety of drinking alcohol with blood pressure medication can vary depending on your medical history, age, and other medications you may be taking. But there’s some general information to be aware of when considering if you should mix alcohol with your blood pressure medication.
You may have heard that 1 or 2 drinks per day — particularly red wine — is good for your heart. But this may not necessarily be true. There have been studies that showed people who drank a moderate amount of red wine every day had better heart health. But these people also did other things that are known to lower your risk for heart disease, like exercising and eating a healthy diet. Drinking alcohol in moderation, regardless of what you are drinking, continues to be the best advice.
When you drink more than the recommended amount, alcohol temporarily raises your blood pressure. But those temporary rises in blood pressure may turn into persistent high blood pressure if you regularly drink heavily or binge drink.
Drinking alcohol can also indirectly lead to high blood pressure through weight gain.
There are certain classes of blood pressure medications — like beta blockers — that are riskier to mix with alcohol than others. That’s why it’s important to be honest with your provider about how much you drink regularly. This might make a difference in which medication they prescribe for you. It’s also possible that they may ask you to hold off starting a blood pressure medication until you cut down the amount you are drinking per day.
Healthcare providers and pharmacists often get this question shortly before holidays or when a person is going to be attending a special event like a wedding.
Unfortunately, the research currently available focuses mostly on how binge drinking affects blood pressure medications. Whether or not it’s safe for you to have 1 or 2 drinks depends on your individual medical history and which blood pressure medication you are taking.
There are always risks with drinking alcohol while taking any medication. Generally, the more you drink, the greater those risks become. It’s important to note that alcohol may affect each person differently. So even though you may take the same medication and drink the same amount, you could experience different problems from this interaction.
Typical side effects of blood pressure medications include dizziness or lightheadedness. Most people only experience these when first starting the medication or when raising the dose of their current prescription. Drinking alcohol makes you more likely to experience these side effects and for them to be more severe.
Other side effects that could be more intense include sleepiness, dizziness, and fainting. Feelings of dizziness or passing out can happen without warning. These side effects can make you more likely to have an accident and raise your risk of falling.
It’s possible for more serious problems to occur when you combine alcohol and blood pressure medications. Drinking while taking certain antihypertensives known as “alpha blockers” can cause dangerously low blood pressure. Alcohol can also cause heart rhythm problems (arrhythmias) when mixed with many common medications, including lisinopril (Zestril) and losartan (Cozaar).
It’s hard to predict how much alcohol is needed to cause these complications, but your risk of experiencing them goes up with every drink you have. Before you have a drink, it’s best to discuss with your provider whether any amount of alcohol is safe for you.
Angiotensin-converting enzyme (ACE) inhibitors are considered a first-choice medication for treating high blood pressure in many people. The most common medication in this class is lisinopril. Alcohol isn’t listed as a drug interaction for these medications, but research shows that drinking may interfere with how these medications work.
Angiotensin II receptor blockers (ARBs) are another first-choice option for treating hypertension. Within this class of medications, the most common medication is losartan.
Currently, there’s no research available on how alcohol affects ARBs. But the general consensus from most providers is that drinking in excess on a regular basis will cause your blood pressure to rise, making it harder for these medications to do their job.
Calcium channel blockers (CCBs) are split into two subgroups: dihydropyridines and nondihydropyridines.
Dihydropyridine CCBs are used more often and include medications like amlodipine (Norvasc). The effect of alcohol in people taking dihydropyridine CCBs for high blood pressure hasn’t been studied much. The research that is available is inconclusive on how this medicine interacts with alcohol. It’s best to limit your drinking while taking medications like amlodipine to prevent possible dizziness and passing out.
Your provider may recommend nondihydropyridine CCBs, such as verapamil (Calan) and diltiazem (Cardizem), if you have both high blood pressure and heart rhythm problems. Unlike amlodipine, nondihydropyridine CCBs have a direct interaction with alcohol. When taking either verapamil or diltiazem, your body takes longer to digest and remove the alcohol from your bloodstream. This means each drink has a stronger effect than it would for people not taking these medications. You are likely to feel “drunk” longer and may be at a higher risk for alcohol poisoning.
Beta blockers are blood pressure medications such as metoprolol (Lopressor) and atenolol (Tenormin). Studies on how alcohol affects beta blockers are limited and outdated. But many providers will tell you to avoid drinking while taking them because of the way these medications work. They work by slowing down your heart rate. Side effects like dizziness, lightheadedness, and fainting are common.
When you mix alcohol with this class of medication, you are likely to feel the side effects mentioned above more intensely. There’s also concern that alcohol makes beta blockers less effective at lowering blood pressure.
Yes. Some people are more at risk for problems when mixing alcohol with blood pressure medications, including:
People who take multiple medications
If you are in one of these groups, you may have more side effects or side effects that are more severe.
There are risks when mixing any blood pressure medication with alcohol. Alcohol makes it harder for high blood pressure medication to work. Drinking alcohol can also cause serious side effects when mixed with alpha blockers, beta blockers, or nondihydropyridine CCBs. No matter what blood pressure medication you are taking, it’s important to ask your provider if there’s a safe amount of alcohol you can drink.
There are risks with drinking alcohol while taking blood pressure medication. Mixing alcohol can decrease how well your medication works and put you at risk for dizziness, fainting, and heart rhythm problems. Even though research is limited on this subject, most providers suggest limiting or trying to avoid drinking if you are taking blood pressure medications. It’s best to discuss this issue with your provider so they can let you know if alcohol is safe for you.
American Heart Association. (2019). Is drinking alcohol part of a healthy lifestyle?
Bauer, L. A., et al. (1992). Verapamil inhibits ethanol elimination and prolongs the perception of intoxication. Clinical Pharmacology & Therapeutics.
British Heart Foundation. (n.d.) Angiotensin receptor blockers (ARBs).
Centers for Disease Control and Prevention. (2019). Binge drinking.
Centers for Disease Control and Prevention. (2020). Dietary guidelines for alcohol.
National Institute on Alcohol Abuse and Alcoholism. (n.d.) Older adults.
National Institute on Alcohol Abuse and Alcoholism. (1999). Are women more vulnerable to alcohol’s effects?
National Institute on Alcohol Abuse and Alcoholism. (2014). Mixing alcohol with medicines.
Peng, S., et al. (2005). Influence of alcohol consumption on effectiveness of antihypertensive in male patients with essential hypertension. Wei Sheng Yan Jiu.
Texas Heart Institute. (n.d.) Beta-blockers.