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Does Green Tea Interact with Heart Drugs?

How does green tea interact with nadolol? Green tea compounds can lower blood levels of this heart drug, but does not seem to affect metoprolol.
Does Green Tea Interact with Heart Drugs?
Green tea

When you sit down to enjoy a beverage, do you think about whether it might affect the medications you take? Years ago, research on grapefruit juice showed that what you drink can indeed affect your pills. Coffee may also interact with some drugs. To begin with, it reduces absorption of levothyroxine. What’s more, fluoroquinolones such as ciprofloxacin or levofloxacin increase the effects of caffeine in the body. What about a beverage that is supposed to be extremely healthful? Does green tea interact with prescription medicines?

How Does Green Tea Interact with Medications?

Q. After reading about green tea having a positive effect on vision, I wondered if there were any adverse interactions between green tea and prescription drugs. I take several heart drugs since having stents placed in 2012.

My Google search found an article suggesting it might interact with drugs. I’ve recently started drinking green tea, but I’m worried that it could interact with the beta blocker metoprolol I need to take. Should I not drink green tea at all?

A. We have seen only a few studies of the effects of green tea on vision. However, it seems that the polyphenol compounds in green tea can help protect retinal nerve cells (Pakistan Journal of Pharmaceutical Sciences, Nov. 2015). 

Could Green Tea Interact with Metoprolol?

Luckily, green tea and its active ingredient, epigallocatechin-3-gallate (EGCG), do not appear to interact with metoprolol (European Journal of Heart Failure, May, 2008). Green tea does have other interesting interactions, however. It can lower concentrations of the beta blocker blood pressure drug nadolol (European Journal of Clinical Pharmacology, June 2018). This could make the drug less effective.

In addition, green tea compounds might affect blood levels of the cholesterol-lowering drugs simvastatin and rosuvastatin (Journal of Food and Drug Analysis, April 2018). Recent research suggests that EGCG and other polyphenols may affect the microbiome of the digestive tract (Critical Reviews in Food Science and Nutrition, Aug. 26, 2019).

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies. .
  • Jin J et al, "Bioactive compounds in green tea leaves attenuate the injury of retinal ganglion RGC-5 cells induced by H2O2 and ultraviolet radiation." Pakistan Journal of Pharmaceutical Sciences, Nov. 2015.
  • Lorenz M et al, "Positive inotropic effects of epigallocatechin-3-gallate (EGCG) involve activation of Na+/H+ and Na+/Ca2+ exchangers." European Journal of Heart Failure, May, 2008. DOI: 10.1016/j.ejheart.2008.03.004
  • Abe O et al, "Role of (-)-epigallocatechin gallate in the pharmacokinetic interaction between nadolol and green tea in healthy volunteers." European Journal of Clinical Pharmacology, June 2018. DOI: 10.1007/s00228-018-2436-2
  • Werba JP et al, "Update of green tea interactions with cardiovascular drugs and putative mechanisms." Journal of Food and Drug Analysis, April 2018. DOI: 10.1016/j.jfda.2018.01.008
  • Chen T & Yang CS, "Biological fates of tea polyphenols and their interactions with microbiota in the gastrointestinal tract: Implications on health effects." Critical Reviews in Food Science and Nutrition, Aug. 26, 2019. DOI: 10.1080/10408398.2019.1654430
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