Drug & supplement interaction

Beer + Hydralazine, Hydrochlorothiazide, Reserpine

Hydralazine, Hydrochlorothiazide, Reserpine brand names: Ser-Ap-Es, Unipres, Uniserp.

Moderate Interaction
The bottom line Moderate

Hydralazine, Hydrochlorothiazide, Reserpine falls into 2 drug categories that Beer can interact with; the most serious is rated moderate. Concomitant use may increase the risk of acute hypotension.

Read the full interaction report
SeverityModerate
LikelihoodProbable
Interactions2
EvidenceC
What do Severity, Likelihood & Evidence mean?
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Interaction report

Beer and Hydralazine, Hydrochlorothiazide, Reserpine

These two interact in 2 distinct ways. Each one is explained separately below.

Why Are There 2 Interactions?

Beer interacts with whole categories of medication. Hydralazine, Hydrochlorothiazide, Reserpine falls into 2 of those categories, so it can interact with Beer in 2 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

VASODILATORS

1 of 2

Why this applies to Hydralazine, Hydrochlorothiazide, Reserpine

Hydralazine, Hydrochlorothiazide, Reserpine falls under VASODILATORS — the group Beer interacts with.

Concomitant use may increase the risk of acute hypotension.
Acute alcohol intoxication can increase the risk of hypotension and additive effects with vasodilators.
Severity Moderate Likelihood Probable Evidence C

Interaction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports..

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

This combination pill packs three blood-pressure-lowering medicines into one: hydralazine relaxes your blood vessels, hydrochlorothiazide is a water pill that lowers fluid volume, and reserpine calms the nervous system's grip on your vessels. Each of these already nudges your pressure down. Alcohol from beer also widens blood vessels, so drinking adds to that effect and can drop your pressure too far.

When that happens, you may feel dizzy, lightheaded, or faint, especially when you stand up quickly. The risk is highest with larger amounts of beer rather than a sip or two. This is a well-recognized, sensible caution. Please don't change anything on your own. A quick chat with your pharmacist or doctor about safe drinking limits is the smart move.

References
  1. Fraser AG. Pharmacokinetic interactions between alcohol and other drugs. Clin Pharmacokinet 1997;33:79-90. PubMed
Moderate

ANTIHYPERTENSIVE DRUGS

2 of 2

Hydralazine, Hydrochlorothiazide, Reserpine also falls under ANTIHYPERTENSIVE DRUGS.

Theoretically, concomitant use may interfere with blood pressure control.
Clinical research suggests that consumption of alcohol can increase both systolic and diastolic blood pressure. However, acute alcohol intoxication can also increase the risk of hypotension and additive effects with antihypertensive drugs.
Severity Moderate Likelihood Probable Evidence B

Interaction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports..

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

This combination pill packs three blood pressure lowering ingredients: hydralazine (relaxes blood vessels), hydrochlorothiazide (a water pill), and reserpine (calms the nervous system). Drinking beer alongside it can push your blood pressure in unpredictable directions. Over time, regular drinking actually tends to raise blood pressure, which works against your medicine. But a drink on any given evening can add to the medicine's effect and drop your pressure too low.

If that happens, you may feel dizzy, lightheaded, or faint, especially when standing up quickly. Reserpine can already cause drowsiness, so alcohol may make that worse. Please don't change anything on your own. Chat with your pharmacist or doctor about whether any alcohol fits safely with your plan.

References
  1. Fraser AG. Pharmacokinetic interactions between alcohol and other drugs. Clin Pharmacokinet 1997;33:79-90. PubMed
  2. Zilkens, R. R., Burke, V., Hodgson, J. M., Barden, A., Beilin, L. J., and Puddey, I. B. Red wine and beer elevate blood pressure in normotensive men. Hypertension 2005;45(5):874-879. PubMed
  3. Potter, J. F., Watson, R. D., Skan, W., and Beevers, D. G. The pressor and metabolic effects of alcohol in normotensive subjects. Hypertension 1986;8(7):625-631. PubMed
  4. Puddey, I. B., Beilin, L. J., Vandongen, R., Rouse, I. L., and Rogers, P. Evidence for a direct effect of alcohol consumption on blood pressure in normotensive men. A randomized controlled trial. Hypertension 1985;7(5):707-713. PubMed
  5. Puddey, I. B., Beilin, L. J., Vandongen, R., and Rouse, I. L. A randomized controlled trial of the effect of alcohol consumption on blood pressure. Clin Exp Pharmacol Physiol 1985;12(3):257-261. PubMed

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Beer Also Interacts With Other Medications

Beer has 654 major, 271 moderate known drug interactions in our database — the Hydralazine, Hydrochlorothiazide, Reserpine one above is among them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Beer

Covers the 2,830 medications we’ve checked against Beer. Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With Hydralazine, Hydrochlorothiazide, Reserpine

This page covers Beer only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Hydralazine, Hydrochlorothiazide, Reserpine page lists 231 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), American Hellebore (major), American Mistletoe (major), Asarabacca (major) and Dolomite (major).

By severity: 10 major · 196 moderate · 25 minor.

From our pharmacist’s overview on the Hydralazine, Hydrochlorothiazide, Reserpine page

“Ser-Ap-Es combines three blood pressure drugs, hydralazine, hydrochlorothiazide, and reserpine, so this list deserves real attention before you add a supplement. Most of the 231 ingredients on file either push blood pressure down further than intended or pile onto the diuretic and drag potassium and fluid levels with it.”

Reviewed by 2 · Jul 18, 2026

Open the Hydralazine, Hydrochlorothiazide, Reserpine interaction page

How much people look this up

Where Beer and Hydralazine, Hydrochlorothiazide, Reserpine Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Beer
Top 25%

#319 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Hydralazine, Hydrochlorothiazide, Reserpine
Top half

#1,215 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Beer

What is Beer?

Beer
  • Social and recreational drinking
  • Relaxation
  • Heart health (popular belief)
  • Bone health (popular belief)
  • Source of antioxidants and B vitamins

Beer is an alcoholic beverage that contains some minerals, B vitamins, and plant compounds from hops and grain, but it is not a health supplement. Any possible benefits come only from light-to-moderate intake, and they are easily outweighed by the well-known harms of alcohol. The safest amount of alcohol for health is none, and beer should be avoided in pregnancy and breastfeeding.

Read the full Beer monograph & all interactions
Keep checking

Other Drugs & Beer

Browse every other medication we’ve checked against Beer — both the ones with a known interaction and the ones without. Select any drug for the full detail.

654Major
271Moderate
0Minor
1,904No known interaction
Major

654 interactions

Showing 60 of 654 major interactions — see all 654 on the Beer page.

Moderate

271 interactions

Showing 60 of 271 moderate interactions — see all 271 on the Beer page.

No interaction 1,904 drugs checked — show the list

We also checked Beer against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 1,904 medications checked with no known interaction — see the full Beer list.

Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

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Pharmacist Counseling Corner

Taking Beer and Hydralazine, Hydrochlorothiazide, Reserpine Together: Common Questions

Can you take Beer with Hydralazine, Hydrochlorothiazide, Reserpine?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
Why are there 2 interactions listed for Beer and Hydralazine, Hydrochlorothiazide, Reserpine?
Hydralazine, Hydrochlorothiazide, Reserpine belongs to more than one drug category, and Beer interacts with each of those categories a little differently. We list every one so nothing is missed — your overall risk is driven by the most serious of them.
How serious is the Beer and Hydralazine, Hydrochlorothiazide, Reserpine interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.