Is Metoprolol Safe With Berberine?

In our latest question and answer, the pharmacist discusses the safety of taking metoprolol and berberine together.

Question

Can metoprolol 50mg be taken with berberine and saffron (in an eye supplement) to help prevent macular degeneration?

Asked by THH On Jan 07, 2023

Answered by
Medical Content Reviewed By HelloPharmacist Staff

Published Jan 09, 2023
Last updated May 05, 2024

Key points

  • Both berberine and saffron may have mild blood pressure lowering effects, and could potentiate the effects of antihypertensives, like metoprolol.
  • Be sure to look out for signs and symptoms of low blood pressure, like dizziness and lightheadedness.

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

  • Repeated administration of berberine inhibits cytochromes P450 in humans, PubMed
  • Berberine for the treatment of hypertension: A systematic review, PubMed

About the Pharmacist

Dr. Brian Staiger, PharmD

Dr. Brian has been practicing pharmacy for over 13 years and has wide-ranging experiences in many different areas of the profession. From retail, clinical, program development, and administrative responsibilities, he's your knowledgeable and go-to source for all your pharmacy and medication-related questions! Dr. Brian Staiger also has herbalist training and educational certificates in the field of medical ethnobotany. Feel free to send him an email at [email protected]! You can also connect with Dr. Brian Staiger on LinkedIn.

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