Propranolol and sotalol metabolism after a drinking party

The effects of alcohol consumed during an evening party on the metabolism and response of β-adrenergic blocking drugs were investigated in healthy subjects. The drugs were given 12 hr after the first drink. The plasma clearance rate of propranolol, metabolized in the liver, increased, while that of sotalol, which is eliminated unchanged, was reduced. Plasma propranolol levels, but not those of sotalol, were related to blood alcohol content. The blood pressure–reducing effect of propranolol diminished after alcohol and that of sotalol increased. Both drugs reduced the heart rate after alcohol although they were unable to cancel out entirely the alcohol-induced increase in the heart rate. The results show that drinking may alter the metabolism of β-blocking drugs. Drinking habits must be considered in therapy with β-blocking drugs or when seeking reasons for angina pectoris or arterial hypertension that does not respond to therapy. Clinical Pharmacology and Therapeutics (1981) 29, 705–710; doi:10.1038/clpt.1981.99