Thomas Lee, M.D. and Richard Lee, M.D.
Q. I take the beta blocker propranolol twice a day, once in the morning and again in the evening. The drug information label says I should not take propranolol with alcohol. But I like to have two glasses of wine in the evening. Do I need to change medications, or is there a way to handle the wine and propranolol together?
A. Propranolol (Inderal, generic) is metabolized quite quickly, so it doesn’t last a whole day. That’s why you need to take it twice a day. Alcohol and propranolol together can lead to increased levels of propranolol in the blood. The easiest way for you to deal with this is to ask your doctor to switch you to a once-a-day beta blocker, like nadolol (Corgard, generic) or slow-release metoprolol (Toprol-XL), which you will take in the morning.
People have different definitions of a “glass” of wine. The standard definition of a drink is 5 fluid ounces of wine, a 12-ounce can of beer or a 1.5-ounce shot of 80-proof liquor. Many experts agree that up to two alcoholic drinks per day for men, and one for women, is heart healthy. More than that starts to be unhealthy for the heart. That’s why it’s important to realize that most wine glasses hold much more than 5 fluid ounces. Some red wine glasses hold as much as 20 ounces or even more! Thus you should know how much wine you mean by two glasses, because you might be drinking more wine than is recommended regardless of which beta blocker you take.
— Thomas Lee, M.D. and Richard Lee, M.D.
Co-Editors in Chief, Harvard Heart Letter