Beta-blockers (drug interactions)
Beta-blockers are a class of medications commonly prescribed to treat hypertension and various heart conditions by blocking the effects of adrenaline on the body. While they are effective in managing these health issues, their interactions with other substances—both medications and supplements—can significantly influence their efficacy and safety. Notably, beta-blockers such as propranolol, metoprolol, and timolol may impair the body's utilization of coenzyme Q10 (CoQ10), a substance vital for heart function. Supplementing with CoQ10 has shown promise in alleviating some side effects associated with beta-blockers.
Additionally, chromium supplementation may help counteract the reduction of HDL cholesterol levels linked to beta-blocker use. Caution is advised when combining beta-blockers with certain natural supplements, as some, like hawthorn, garlic, and ginkgo biloba, can enhance their effects and lead to potentially dangerous drops in blood pressure or increased bleeding risks. Conversely, omega-3 fatty acids and magnesium are among the natural substances that can positively interact with beta-blockers. Understanding these interactions is crucial for patients and healthcare providers to optimize treatment and minimize adverse effects.
Beta-blockers (drug interactions)
DEFINITION: Medications used to treat hypertension and a variety of heart conditions.
INTERACTIONS: Chromium, coenzyme Q10, Coleus forskohlii
DRUGS IN THIS FAMILY: Acebutolol hydrochloride (Sectral), atenolol (Tenormin), Betaxolol hydrochloride (Kerlone), bisoprolol fumarate (Zebeta), carteolol (Cartrol), carvedilol (Coreg), esmolol hydrochloride (Brevibloc), labetalol hydrochloride (Normodyne, Trandate), metoprolol (Lopressor, Toprol XL), nadolol (Corgard), penbutolol (Levatol), pindolol (Visken), propranolol hydrochloride (Betachron E-R, Inderal, Inderal LA), sotalol (Betapace), timolol maleate (Blocadren)
Coenzyme Q10 (CoQ10)
Effect: Supplementation Possibly Helpful
There is some evidence that beta-blockers (specifically propranolol, metoprolol, and alprenolol) might impair the body’s ability to utilize the substance CoQ10. This is particularly of concern because CoQ10 appears to play a significant role in normal heart function. Depletion of CoQ10 might be responsible for some of the side effects of beta-blockers. In one study, CoQ10 supplements reduced side effects caused by the beta-blocker propranolol. The beta-blocker timolol may interfere with CoQ10 production to a lesser extent than other beta-blockers.
Chromium
Effect: Possible Helpful Interaction
Beta-blockers have been known to reduce HDL cholesterol (high-density lipoprotein, also known as good cholesterol) levels. According to one study, chromium supplementation can offset this adverse effect.
Coleus forskohlii
Effect: Theoretical Interaction
The herb Coleus forskohlii relaxes blood vessels and might have unpredictable effects on blood pressure if combined with beta-blockers.
Beta-blockers interact both positively and negatively with myriad other prescription medications and natural substances. Some examples of natural substances with adverse effects include hawthorn, which can increase a beta-blocker's effectiveness and lower blood pressure to dangerous levels. Garlic and ginkgo biloba may cause increased blood-thinning effects. St. John’s Wort and licorice root can also affect how beta-blockers work in the body. Natural supplements that positively interact with beat-blockers include omega-3 fatty acids and magnesium.
Bibliography
"Beta Blockers." Mayo Clinic, www.mayoclinic.org/diseases-conditions/high-blood-pressure/in-depth/beta-blockers/art-20044522. Accessed 5 Sept. 2024.
"Common Herbal Dietary Supplement–Drug Interactions." American Family Physician, 2017, www.aafp.org/pubs/afp/issues/2017/0715/p101.html. Accessed 5 Sept. 2024.
Folkers, K. "Basic Chemical Research on Coenzyme Q10 and Integrated Clinical Research on Therapy of Diseases." In Coenzyme Q: Biochemistry, Bioenergetics, and Clinical Applications of Ubiquinone, edited by G. Lenaz. New York: John Wiley & Sons, 1985.
Hamada, M., et al. "Correlation Between Serum Coq10 Level and Myocardial Contractility in Hypertensive Patients." In Biomedical and Clinical Aspects of Coenzyme Q, vol. 4, edited by K. Folkers. Amsterdam: Elsevier Science, 1984.
Roeback, J. R., et al. "Effects of Chromium Supplementation on Serum High-density Lipoprotein Cholesterol Levels in Men Taking Beta-blockers." Annals of Internal Medicine, vol. 115, 1991, pp. 917-924.
Shin, Jaekyu, Nancy K. Hills, Patrick R. Finley. "Combining Antidepressants with β-Blockers: Evidence of a Clinically Significant CYP2D6 Drug Interaction." Pharmacotherapy, 28 Apr. 2020, doi.org/10.1002/phar.2406. Accessed 12 Dec. 2022.