
Beta-blockers are medications used in the treatment of hypertension and heart disease.
Coffee and other beverages or foods that are high in caffeine, such as soda, high-energy drinks, tea, and dark chocolate, reduce the efficacy of beta-blockers by counteracting their antiadrenergic effect.
Beta-blockers reduce blood pressure by reducing the action of excitatory neurotransmitter, adrenaline, on the heart and bringing down blood pressure. However, caffeine increases blood pressure by accentuating adrenaline action on the heart.
Coffee increases the rate at which beta-blockers are metabolized in the body. This may cause the medication to remain active in the body for a shorter period.
Though initially, coffee increases blood pressure, regular consumption of coffee may not have this effect.
Hence, it is advised to avoid excess caffeine while on beta-blockers.
Coffee increases blood pressure in the following ways:
- Caffeine, the predominant substance of coffee, is a stimulant that is commonly used to improve energy and mental activity.
- Caffeine boosts epinephrine release in the body.
- Epinephrine is an active vasoconstrictor, causing constriction of the arteries in the body, making the heart work harder, and increasing blood pressure, pulse rate, and respiratory rate.
- Caffeine can promote dehydration, which can lead to high blood pressure.
- Total peripheral resistance around the heart is increased due to constriction of arteries, which eventually increases blood pressure.
Which foods and drugs interact with beta-blockers?
The food and drugs that interact with beta-blockers include the following:
Food
Foods to avoid are:
- Certain fruit juices, such as grapefruit, apple, and orange juices, have been proven to reduce the absorption of the beta-blockers acebutolol and atenolol.
- Potassium-rich foods are to be avoided because beta-blockers increase potassium levels (hyperkalemia), which leads to other medical conditions, such as rapid heartbeats and kidney failure.
- Alcohol can reduce the efficacy of beta-blockers, so it is advised to avoid or limit your consumption while taking these medications.
Drugs
Beta-blockers, like all drugs, can interact with a variety of different medications, such as:
- Antiarrhythmic medications are used to treat irregular heartbeats
- Other antihypertensives (blood pressure medications)
- Antipsychotic medications used to treat serious mental health disorders
- Clonidine is used to treat high blood pressure and migraines
- Mefloquine drug used to treat or prevent malaria
It is advised to consult a doctor to know all the drug interactions to prevent unwanted events.
5 ways to treat caffeine overdose
Five ways to treat a caffeine overdose include:
- Caffeine consumption is generally regarded as safe, but it can have neurologic, cardiac, and gastrointestinal adverse effects.
- Caffeine can be hazardous, with an estimated fatal dose of 5 to 10 grams in healthy persons.
- Lower doses could be harmful in people with preexisting cardiac disease and those who take other stimulants or intoxicants, especially if they are dehydrated.
- Caffeine intoxication should be evaluated in previously healthy patients who deny using cocaine or amphetamines but exhibit hyperadrenergic symptoms.
- Caffeine intoxication can be mistaken for a variety of diseases, including mania, enthusiastic delirium, cocaine intoxication, and thyroid storm.
Caffeine increases the activity of adrenaline and with an overdose of it, vasoconstriction disrupts the circulatory system, while bronchoconstriction depresses the respiratory system.
The primary aim to treat caffeine intoxication is to restore circulation and breathing, which is achieved through:
- Administration of intravenous fluids
- Maintenance of body temperature
- Calming the patient with a benzodiazepine, such as a valium or versed
- Administration of antiemetic for nausea and vomiting
- Administration of nitroglycerin for severe hypertension that does not respond to benzodiazepine-induced relaxation

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Yew D. Caffeine Toxicity Treatment & Management. Medscape. https://emedicine.medscape.com/article/821863-treatment#d10
Wiysonge CS, Volmink J, Opie LH. Beta-blockers and the treatment of hypertension: it is time to move on. Cardiovasc J Afr. 2007;18(6):351-352. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4170499/
Ram CV. Beta-blockers in hypertension. Am J Cardiol. 2010 Dec 15;106(12):1819-25. https://www.ajconline.org/article/S0002-9149(10)01631-0/fulltext
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