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• Avoid alcohol.1
• Metoprolol may deplete Co-Q10 levels with long term use.2
• Using chromium with beta blockers can raise serum HDL cholesterol levels.3
• These herbs may adversely affect the action of Metoprolol: black hellebore, calamus, cereus, cola, coltsfoot, devil's claw, European mistletoe, fenugreek, fumitory, digitalis leaf, hedge mustard, figwort, lily of the valley roots, motherwort, pleurisy root, cipro drug action of ambien squill bulb leaf scales, white horehound, mate, scotch broom flower, shepherd's purse, and wild carrot, due to their cardiac properties.4
• Natural licorice products, Ginseng and Ephedra (Ma huang) may cause hypertension and should be avoided with high blood pressure.5
• Herbs with salicylate properties: Meadowsweet, poplar, white willow, and wintergreen, may interact with beta blockers due to the known interaction between salicylates and beta blockers.61 Mindell, E, Hopkins V: Prescription Alternatives. New Canaan, CT: Keats Publishing, Inc, 1998; p. 143.
1 Facts and Comparisons, Clinisphere 2.0, Wolters Kluwer Company, 2000
1 Pronsky, Z Food and Drug Interactions, 11th edition, 1999
2 Shand, D.G.: Clinical pharmacology of the beta-blocking drugs: implications for the postinfarction patient. Circulation, 1983, 67(Supp 1): 12-15.
2 Kishi H, Kishi T, Folkers K: Bioenergetics in clinical medicine III--inhibition of coenzyme Q10-enzymes by clinically used antihypertensive drugs, Res Commun Chem Pathol Pharmacol, 1975, 12(3):533-40.
3 Roeback JR Jr, Hla KM, Chambless LE, Fletcher RH. Effects of chromium supplementation on serum high-density lipoprotein cholesterol levels in men taking beta-blockers. A randomized, controlled trial. Ann Intern Med, 1991;115(12):917-924
4 Newall CA, Anderson LA, Phillipson JD. Herbal Medicines A Guide for Health-care Professionals. London: The Pharmaceutical Press, 1996.
4 PDR for Herbal Medicines, 2nd edition, Medical Economics Company, 2000
5 drug Pronsky, ZM: Food-Medication Interactions, 11th edition, 1999
5 Farese, RV et al., Licorice-induced hypermineralcorticoidism. NEJM. 1991, 325:1,1223-1,227.
5 Brinker, F Herb Contraindications and Drug Interactions, Eclectic Medical Publications, 1998
5 Facts and Comparisons, Review of Natural Products, Clinisphere 2.0, Wolters Kluwer Company, 2000
6 Newall CA, Anderson LA, Phillipson JD. Herbal Medicines: A Guide for Health-care Professionals. London: The Pharmaceutical Press, 1996
6 Blumenthal, M (Ed.): The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. American Botanical Council. Austin, TX. 1998.
6 Facts and Comparisons, Clinisphere 2.0, Wolters Kluwer Company, 2000
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