Is Metoprolol Safe With Berberine?
In our latest question and answer, the pharmacist discusses the safety of taking metoprolol and berberine together.
Can metoprolol 50mg be taken with berberine and saffron (in an eye supplement) to help prevent macular degeneration?
Jan 07, 2023- Berberine may lower blood pressure and increase metoprolol levels in your body, which could cause dizziness, lightheadedness, or a slowed heart rate.
- These interactions are considered relatively minor, but you should watch for low blood pressure symptoms if you take berberine with metoprolol.
- Tell your doctor about all supplements you take, including berberine, so they can monitor you appropriately.
Answer
Thanks for reaching out. I'm more than happy to answer this for you.
First and foremost, I have actually answered the question regarding the use of metoprolol with saffron before.
The only concern there, and it's a minor one, is that studies have shown saffron may have a mild blood-pressure lowering effect. Therefore, when combined with other drugs that lower blood pressure, like metoprolol, there is a risk of blood pressure dropping too low, which could cause side effects that are experienced with that (such as dizziness and lightheadedness).
The concern with berberine is much the same.
Berberine With Metoprolol
Although berberine is most often used as a dietary supplement to help support blood sugar, like saffron, studies have shown that berberine can have a mild blood pressure lowering effect. This can increase the risk that blood pressure drops too low.
Additionally, some studies suggest that berberine may inhibit a metabolizing enzyme (CYP2D6) that is at least partially responsible for metoprolol metabolism, which could cause an increase in metoprolol blood levels.
So, we've actually got multiple interactions going on here:
- Berberine may have mild blood-pressure lowering effects
- Berberine may increase metoprolol concentrations
Both of these things could potentiate the effects of metoprolol, which again, could potentially cause 'hypotension' or low blood pressure.
These interactions I've outlined are both considered to be relatively minor, but good to keep in mind. If you do combine berberine with metoprolol, keep an eye out for the potential side effects, like low blood pressure, dizziness, slowed heart rate and lightheadedness.
These interactions are documented in more detail on the interaction detail pages from our 'drug-herbal interaction checker'.
Final Words
I hope this answer helped!
My advice is to let your doctor know of all the medication you take, including supplements.
Berberine and saffron are considered to be relatively safe and could help support some of your medical conditions.
The interactions I spoke about are purely precautionary, and in all likelihood, aren't too serious. Nevertheless, the potential side effects are important to know about.
Thanks for reaching out!
References & sources
Glossary — Terms in This Answer
- Metoprolol
- A medication that lowers blood pressure and is commonly used to treat heart conditions.
- Blood pressure lowering effect
- The ability of a substance to reduce the force of blood pushing against artery walls.
- Berberine
- A plant compound often taken as a dietary supplement to help control blood sugar levels.
- Metabolizing enzyme
- A protein in the body that breaks down medications so they can be eliminated.
- CYP2D6
- A specific enzyme in the liver that breaks down many medications, including metoprolol.
- Potentiate
- To make the effects of a drug stronger or more pronounced.
- Hypotension
- A medical condition where blood pressure drops dangerously low.
- Dietary supplement
- A product taken by mouth containing vitamins, minerals, herbs, or other substances intended to supplement the diet.
Dr. Brian Staiger, PharmD
Doctor of Pharmacy, board certified clinical pharmacist (BCPS), American Herbalist Guild, Medication Therapy Management certified
Brian Staiger, PharmD, BCPS, is a licensed pharmacist with more than 13 years of experience across retail pharmacy, clinical pharmacy, medication safety, pharmacy program development, and healthcare administration. He is the founder of HelloPharmacist.com, where he helps patients...
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