Supplements and beta-blockers: metoprolol, carvedilol and what to ask

October 23, 2026By VitOptics Staff

Short answer: Metoprolol (Lopressor, Toprol-XL) and carvedilol (Coreg, Coreg CR) are beta-blockers. Their labels give food directions but no separation time for vitamins or minerals, and none of their drug-interactions sections names a vitamin, a mineral or CoQ10. MedlinePlus names one herbal product for carvedilol, St. John's wort, and says not to start it without discussing it with your healthcare provider. Never stop a beta-blocker suddenly or swap it for a supplement: MedlinePlus warns that if you suddenly stop taking metoprolol, you may experience serious heart problems.

MedlinePlus describes both drugs as working by relaxing blood vessels and slowing heart rate to improve blood flow and decrease blood pressure. Both are prescribed for high blood pressure and heart failure, and metoprolol also for chest pain (angina). With a supplement in the picture, the useful questions are which form you take, how it is meant to be taken with food, and which herbs and other medicines change things.

Which beta-blocker, and which form?

Metoprolol comes as a regular tablet, an extended-release tablet and an extended-release capsule, according to MedlinePlus. On DailyMed, Lopressor is metoprolol tartrate tablets, Toprol-XL is metoprolol succinate extended-release tablets, and Kapspargo Sprinkle is metoprolol succinate extended-release capsules. Lopressor HCT combines metoprolol with hydrochlorothiazide, a diuretic (water pill); our guide to diuretics and supplements covers the mineral questions that brings.

Carvedilol comes as a tablet (Coreg) and an extended-release capsule (Coreg CR). The name on your prescription label tells you which one you have, and the directions below differ by form.

Food and timing: what the labels say

Metoprolol tartrate (Lopressor). The Lopressor prescribing information says it "should preferably be administered with or following meals." MedlinePlus says to take the regular tablet once or twice a day with meals or immediately after meals.
Metoprolol succinate (Toprol-XL). Taken once a day. The Toprol-XL label says the tablets can be divided but not crushed or chewed, and advises taking them regularly, "preferably with or immediately following meals."
Carvedilol tablets (Coreg). The Coreg label says to take it with food "to slow the rate of absorption and reduce the incidence of orthostatic effects", the dizziness that can come with standing up. MedlinePlus says to take the tablet twice a day with food.
Carvedilol extended-release (Coreg CR). The Coreg CR label says to take it once daily in the morning with food, swallowed whole and not crushed or chewed. The label describes one alternative way to take it; ask your pharmacist.

None of these labels sets a separation time for supplements the way thyroid medicine's directions do (see our levothyroxine timing guide). So the questions are about what is in your products more than about the clock. If you take a daily supplement pack with a meal, ask your pharmacist whether it can go with the same meal as your beta-blocker.

One form has an extra rule. MedlinePlus says not to drink alcohol, or take prescription or nonprescription medications that contain alcohol, if you take metoprolol extended-release capsules, and the Kapspargo Sprinkle label explains that the drug "is released faster from KAPSPARGO Sprinkle in the presence of alcohol." The instruction is worded around medicines, but the same check makes sense for any liquid supplement or herbal extract: read its ingredient list for alcohol, and ask your pharmacist if you aren't sure.

St. John's wort, hawthorn and licorice

MedlinePlus's carvedilol page lists one nonprescription or herbal product that may interact with carvedilol: St. John's wort. It asks you to let your doctor and pharmacist know if you take it before you start carvedilol, and says: "Do not start this medication while taking carvedilol without discussing with your healthcare provider." Its metoprolol page names no specific herbal product, but asks you to tell your doctor and pharmacist about every vitamin, nutritional supplement and herbal product you take or plan to take.

NIH's National Center for Complementary and Integrative Health (NCCIH) says St. John's wort "can weaken the effects of many medicines", and its examples include some heart medications, such as digoxin and ivabradine. On a label it may also appear as hypericum or Hypericum perforatum.

Two more herbs are worth a question before you try them:

Hawthorn. NCCIH says hawthorn is promoted for the heart and blood vessels and that the evidence in people with heart failure is conflicting. It describes one study in which a specific hawthorn preparation "may have caused early risk of heart failure progression in patients," adding that "one possibility is that hawthorn might have interacted with drugs the patients were taking." Since both of these beta-blockers are also prescribed for heart failure, raise any "heart" herb with your prescriber first. NCCIH also notes an FDA warning that some supplements sold as "tejocote root" (Mexican hawthorn) contained yellow oleander, a toxic plant, so bring the exact product to your pharmacist.
Licorice root. NCCIH says glycyrrhizin, a component of licorice root, can cause serious adverse effects, including irregular heartbeat, especially in large amounts or over the long term, and that even small amounts have been linked to severe adverse effects in people who eat a lot of salt, have high blood pressure, or have heart or kidney conditions. Products labeled deglycyrrhizinated licorice don't contain it.

CoQ10, magnesium and fish oil

None of the drug-interactions sections in the Lopressor, Toprol-XL, Kapspargo Sprinkle, Coreg or Coreg CR labels names CoQ10, magnesium or fish oil, and the MedlinePlus pages for metoprolol and carvedilol don't name them either. That isn't the same as a clearance, so here is what NIH sources do say.

CoQ10. NCCIH lists warfarin and insulin, not beta-blockers, among the medicines CoQ10 may interact with. It also says the small amount of evidence available suggests CoQ10 "probably doesn't have a meaningful effect on blood pressure." If you take a statin as well, our statins guide covers what is known about CoQ10 there.
Magnesium. The examples in the NIH Office of Dietary Supplements (ODS) magnesium fact sheet are oral bisphosphonates and tetracycline and quinolone antibiotics, plus diuretics and proton pump inhibitors, which can affect magnesium status. Beta-blockers aren't among them, but ODS gives these as examples, not a full list. If your pill includes hydrochlorothiazide, ODS notes that thiazide diuretics can increase the loss of magnesium in urine.
Fish oil. The ODS omega-3 fact sheet says doses of 2 to 15 g a day of EPA and/or DHA might increase bleeding time. That matters most if you also take a blood thinner, a combination our guide to supplements and blood thinners covers.

Other medicines that change the picture

Some antidepressants. The Lopressor and Toprol-XL labels say: "Drugs that are strong inhibitors of CYP2D6 such as quinidine, fluoxetine, paroxetine, and propafenone were shown to double metoprolol concentrations." The Coreg label says potent CYP2D6 inhibitors such as fluoxetine and paroxetine have not been studied with carvedilol but would be expected to raise the blood level of one form of it. If you take an antidepressant, our guide to antidepressants and supplements covers the supplement side.

Diabetes medicines and low blood sugar. The labels for both drugs say beta-blockers may hide early warning signs of low blood sugar, such as a fast heartbeat, and increase the risk of severe or prolonged low blood sugar, especially in people with diabetes and in people who are fasting, not eating regularly or vomiting. The Coreg label adds that beta-blockers may enhance the blood-sugar-lowering effect of insulin and oral diabetes medicines. MedlinePlus asks you to let your doctor know if you are unable to eat or drink normally while taking either drug. If you also take metformin, see our guide to metformin and vitamin B12, and mention any product sold for blood sugar in the same conversation. If you take insulin or a sulfonylurea such as glipizide, our guide to insulin, sulfonylureas and supplements covers what their labels say about low blood sugar and supplements. If you take an SGLT2 inhibitor such as Jardiance, Farxiga or Invokana, our guide to SGLT2 inhibitors and supplements covers what those labels say about low blood sugar.

Other blood pressure medicines. The Toprol-XL and Coreg labels name two calcium channel blockers, diltiazem and verapamil, among the medicines to watch with a beta-blocker. If you take amlodipine, our guide to amlodipine and supplements covers its own supplement questions.

Never stop suddenly, and never swap

MedlinePlus says: "Do not stop taking metoprolol without talking to your doctor. If you suddenly stop taking metoprolol you may experience serious heart problems." The Coreg patient information says that stopping suddenly could cause chest pain or a heart attack, and that if your doctor decides you should stop, the dose may be lowered slowly first. The Lopressor label tells prescribers to reduce the dose gradually over 1 to 2 weeks.

No supplement replaces a beta-blocker. Don't skip or space out doses to make room for a new product, and don't stop the prescription because you have started something "natural."

What to ask at your next refill

Which form do I take (tartrate, succinate, tablet, capsule or extended-release), and how should I take it with meals?
Here are the labels of everything I take. Is St. John's wort, hawthorn, licorice or anything else on them a concern with my beta-blocker?
If I take metoprolol extended-release capsules, do any of my liquid products contain alcohol?
Do my other medicines, such as an antidepressant, a diabetes medicine or a water pill, change which supplements fit?
Can my daily supplements go with the same meal as my beta-blocker?

MedlinePlus suggests keeping a written list of all of the prescription and nonprescription medicines, vitamins, minerals and dietary supplements you take, and bringing it each time you visit a doctor. Our guide on how to check for duplicate supplement ingredients shows how to lay the labels side by side first.

Where VitOptics fits

VitOptics builds personalized daily supplement packs from a free, three-minute assessment. The assessment asks for your prescription medicines by name, along with your conditions and the supplements you already take, so a beta-blocker on your list is part of the check from the start. Automated checks review the recommendation; some profiles need additional review by a person on our team. A second automated check reads the whole pack before release.

Your result lists every formula, the amount of each ingredient and the reason it is there, and it names one time of day for the whole pouch. Show it to your doctor or pharmacist with your prescription list before you start, the same way you would any new label.

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Sources

This article is for educational purposes and is not medical advice. Supplements are not intended to diagnose, treat, cure or prevent any disease.

Prepared with AI assistance using the sources linked in this article.

Last updated: October 23, 2026

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