Cocaine makes beta blockers less effective at treating blood pressure or heart rate issues because it has the opposite effect of beta blockers. People prescribed beta blockers for cardiovascular issues already have an increased risk of experiencing a cardiovascular event like a heart attack or blood clot, and cocaine heightens the risk. Using cocaine defeats the heart-protective benefits of beta blockers.

Relationship Between Cocaine and Beta-Blockers

Cocaine is thought to be the most potent, naturally occurring stimulant. It works by flooding the brain with norepinephrine and dopamine. This flood results in a sense of euphoria and well-being but also affects the cardiovascular system by increasing heart rate, blood pressure, and heartbeat. It can also constrict blood vessels (known as vasospasm) in the heart, lowering levels of available oxygen and potentially causing permanent tissue damage. Low oxygen levels in the heart can lead to chest pain, heart attack or death. Cocaine use is a common reason for younger people reporting to an emergency room with chest pain or cardiovascular issues.

Beta-blockers stop the impact of epinephrine, which is a hormone more commonly known as adrenaline. In doing so, they open up blood vessels, make the heart beat less vigorously and lower blood pressure. Beta blockers are commonly prescribed to treat heart issues or high blood pressure and are a staple for people who had a heart attack.

Not only does cocaine counteract the benefits of beta-blockers, but the combination can also lead to a paradoxical effect. During cocaine intoxication, beta blockers have the potential to further constrict blood vessels in the heart. This constriction leads to even less oxygen in the heart muscles and increased blood pressure, straining the cardiovascular system. Beta blockers can have the effect opposite of what was intended when combined with cocaine.

Cocaine use makes beta blockers less effective due to opposing effects on the cardiovascular system, and beta blockers may paradoxically worsen the cardiac effects during cocaine intoxication.

Side Effects of Mixing Cocaine and Beta Blockers

Some people may think that taking a beta blocker will allow them to manage the symptoms of cocaine use or come down from a cocaine high. However, doing so is very dangerous and should not be done. There are significant risks associated with combining beta blocker and cocaine.

When someone mixes cocaine and beta blockers, the combination can lead to effects including:

  • Worsening constriction of blood vessels (vasospasm) in the heart. This effect leads to lower blood flow and oxygen, increasing the risk of tissue damage, heart attack or death. Vasospasm may be silent (no noticeable side effects) or cause chest pain.
  • Paradoxical increase in blood pressure that adds stress to the cardiovascular system and can be dangerous. High blood pressure symptoms are usually silent, but in extreme cases, it may result in difficulty breathing, chest pain, confusion or a severe headache.

If you are prescribed beta blockers for a cardiovascular issue, remember that cocaine can damage the cardiovascular system. Beta blockers are not effective at protecting the heart when cocaine is used.

If you use cocaine and are considering taking a beta blocker on your own to counter cocaine symptoms, know that the combination causes a paradoxical increase in blood pressure and further constriction of blood vessels in the heart. This mixture is a potentially dangerous combination.  If you experience chest pain while using cocaine, do not self-treat but seek medical attention immediately.

Historically, the use of propranolol, a beta blocker, was the first-line treatment when a person showed up to the hospital with cocaine-related cardiovascular issues. However, this practice was abandoned due to increased death rates noted in animal studies when cocaine and propranolol are mixed. Due to this finding, many healthcare providers began moving away from beta-blocker use in cocaine toxicity, though it remains a controversial subject.

Key Points: What To Know About Cocaine and Beta Blockers

Taking beta blockers alongside cocaine is dangerous. Some crucial aspects of the combination to keep in mind include:

  • Cocaine increases stress on the cardiovascular system, while beta blockers reduce stress
  • Cocaine can constrict blood vessels in the heart leading to low oxygen levels that cause chest pain, heart attack, or death
  • When beta blockers are taken during cocaine intoxication, they can increase blood pressure and further constrict blood vessels in the heart
  • Cocaine also counteracts the heart-protective effects of beta blockers, making them less effective at preventing cardiovascular issues
  • Never attempt to manage your own symptoms of cocaine toxicity, seek professional emergency treatment

If you or a loved one live with a cocaine addiction, seek professional addiction treatment. Call The Recovery Village today to speak to a representative about how personalized treatment can help patients address their addiction and any co-occurring disorders. Start your healthier future today.

  1. Center for Behavioral Health Statistics and Quality. “Behavioral health trends in the United States: results from the 2014 National Survey on Drug Use and Health.” September 2015. Accessed April 5, 2019.
  2. ANI Pharmaceuticals, Inc. “Propranolol Package Insert.” February 14, 2019. Accessed April 5, 2019.
  3. Van Amburgh, Jenny. “The Ongoing Debate of Beta-Blockers for Cocaine-Associated Chest Pain.” Medscape, November 29, 2016. Accessed April 5, 2019. 


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