MODERATE — Monitor Closely
🟡 CAUTION — Licorice root causes pseudoaldosteronism (sodium retention, potassium wasting, blood pressure elevation) that directly opposes Metoprolol. Avoid licorice root if taking antihypertensive medications, or use DGL (deglycyrrhizinated licorice) which lacks this effect.
Evidence level: STRONG
Licorice root causes your body to retain sodium and lose potassium, raising blood pressure independently of the pathways Metoprolol targets. Metoprolol slows your heart rate and reduces cardiac output to lower blood pressure, but it has no mechanism to counteract the fluid overload and electrolyte imbalance that licorice creates.
Glycyrrhizin in licorice root inhibits 11-beta-hydroxysteroid dehydrogenase type 2, causing cortisol to activate mineralocorticoid receptors (pseudoaldosteronism). This causes sodium retention, potassium wasting, and blood pressure elevation — directly opposing the antihypertensive action of Metoprolol.
Stop licorice root while on Metoprolol. This interaction is particularly concerning because Metoprolol is frequently prescribed after heart attacks and for heart failure — conditions where uncontrolled blood pressure and low potassium are especially dangerous. The potassium loss from licorice can also increase the risk of irregular heartbeats, which beta-blockers like Metoprolol are often used to prevent. Use DGL licorice as a safe alternative.
Take Metoprolol at the same time daily. Food generally doesn't significantly affect beta-blocker absorption. Licorice Root — potassium-rich foods (bananas, oranges) are generally fine with beta-blockers (unlike ACE inhibitors). Avoid excessive caffeine intake, which can counteract blood pressure benefits.
Higher risk for: those with asthma or COPD, bradycardia, diabetes (may mask hypoglycemia symptoms), elderly, concurrent calcium channel blocker use, or peripheral vascular disease.
Rising blood pressure despite medication, headache, swelling in legs/ankles, muscle weakness or cramps, irregular heartbeat (from low potassium).
No urgent need to discuss, but always keep your doctor informed of your full supplement and medication list. An up-to-date list helps them make the best treatment decisions.
Beta blocker interactions can affect heart rate and blood pressure. Discuss with your doctor: alternative blood pressure medications (ACE inhibitors, ARBs) may have fewer interactions. Monitor heart rate and report any dizziness or fatigue.
Licorice root causes your body to retain sodium and lose potassium, raising blood pressure independently of the pathways Metoprolol targets. Metoprolol slows your heart rate and reduces cardiac output to lower blood pressure, but it has no mechanism to counteract the fluid overload and electrolyte imbalance that licorice creates.
Take Metoprolol at the same time daily. Food generally doesn't significantly affect beta-blocker absorption. Licorice Root — potassium-rich foods (bananas, oranges) are generally fine with beta-blockers (unlike ACE inhibitors). Avoid excessive caffeine intake, which can counteract blood pressure benefits.
Rising blood pressure despite medication, headache, swelling in legs/ankles, muscle weakness or cramps, irregular heartbeat (from low potassium).
Beta blocker interactions can affect heart rate and blood pressure. Discuss with your doctor: alternative blood pressure medications (ACE inhibitors, ARBs) may have fewer interactions. Monitor heart rate and report any dizziness or fatigue.
No urgent need to discuss, but always keep your doctor informed of your full supplement and medication list. An up-to-date list helps them make the best treatment decisions.
Or browse the full interaction database (121,000+ pairs).