Honey and Metoprolol: Safety, Interactions, and Practical Guidance

It is generally considered safe to consume ordinary table honey while taking metoprolol, and typical amounts of honey do not appear to interfere with metoprolol’s effectiveness or absorption. ^[1] Metoprolol can be taken with or without food, and routine dietary sugars like those in honey do not show a clinically meaningful interaction with the drug’s absorption in commonly used formulations. ^{[2] [3]}

---

Quick Summary

• Ordinary honey in usual dietary amounts does not change metoprolol’s activity in the body. ^[1]
• Metoprolol may be taken with meals, and standard guidance does not list common foods like honey as a concern. ^{[2] [3]}
• Rare caution: Avoid “mad honey” (a toxic variety containing grayanotoxins) because it can cause dangerously slow heart rate and low blood pressure, which could add to metoprolol’s effects. ^{[4] [5] [6]}
• Alcohol caveat: If you use the extended‑release capsule form of metoprolol, avoid alcohol, which can alter release and side effects; this is unrelated to honey but important for safety. ^{[7] [8]}

---

Does Honey Affect Metoprolol Absorption or Effectiveness?

Food and Metoprolol

Metoprolol is commonly taken with meals, and guidance supports dosing with or after food for convenience and tolerability. ^{[2] [3]} Early pharmacokinetic studies show that food can enhance bioavailability with conventional tablets, but this is a normal, non-problematic effect and is not specific to honey. ^[9] In certain controlled‑release systems, food did not meaningfully change metoprolol absorption profiles. ^{[10] [11]}

Honey Specifically

Human data evaluating repeated daily honey intake found no change in CYP3A enzyme activity (one of the metabolic pathways assessed using the probe drug midazolam) at amounts typically consumed, suggesting no relevant metabolic induction or inhibition from honey in everyday use. ^[1] While metoprolol is primarily metabolized by CYP2D6, the study supports that routine honey consumption does not broadly alter hepatic/intestinal metabolism in a way that would be expected to reduce metoprolol’s effectiveness. ^[1]

---

Toxic “Mad Honey” Is Different

“Mad honey” (also known as “bitter honey”) made from rhododendron nectar contains grayanotoxins that can cause bradycardia (slow heart rate), hypotension (low blood pressure), and heart block effects that may compound metoprolol’s action. ^{[4] [12]} Case reports link mad honey ingestion to syncope and atrioventricular block, with symptoms improving after stopping the honey. ^{[5] [6]} Because metoprolol already lowers heart rate and blood pressure, combining it with mad honey could be risky. ^{[4] [5] [6]}

---

Practical Tips

• Ordinary grocery‑store honey: Safe in typical amounts when taking metoprolol. ^[1]
• Take metoprolol with or without food: Follow your prescribed timing; many people take it with a meal for consistency. ^{[2] [3]}
• Avoid mad honey: Do not consume honey from unknown sources that may come from rhododendron regions (e.g., certain noncommercial honeys from the Black Sea area) due to the risk of grayanotoxin. ^{[4] [5] [6]}
• Monitor for symptoms: If you experience unusual dizziness, fainting, or very slow pulse after any honey product, stop the product and seek medical advice. ^{[4] [5]}
• Alcohol note for extended‑release capsules: Avoid alcohol because it can alter drug release and increase side effects; this advice is specific to the capsule formulation and is separate from honey. ^{[7] [8]}

---

Frequently Asked Questions

Can I put honey in tea or on toast while taking metoprolol?

Yes, regular honey in tea or food is fine and does not typically affect metoprolol’s absorption or action. ^{[1] [2]}

Should metoprolol be taken with food?

Metoprolol may be taken with or immediately after food, and many instructions suggest dosing with meals to help with consistent daily timing. ^{[2] [3]} Certain formulations show no significant change in absorption with food, so your dosing schedule can be guided by your clinician’s instructions and what you tolerate best. ^{[10] [11]}

Are there any food or drink restrictions I should know?

The main restriction is alcohol when using extended‑release capsules, as it can affect the way the medicine is released and increase side effects. ^{[7] [8]} Routine foods, including honey, are not listed as problematic. ^{[2] [3]}

---

Structured Overview

Topic	What the Evidence Shows	Practical Takeaway
Ordinary honey	No change in human CYP3A activity with typical daily honey consumption. [1]	Safe in usual dietary amounts.
Food with metoprolol	Food can enhance bioavailability for conventional tablets; controlled‑release systems often unaffected. [9] [10] [11]	Taking with meals is acceptable and often preferred.
Mad honey	Causes bradycardia, hypotension, and AV block due to grayanotoxins; symptoms resolve after stopping. [4] [5] [6]	Avoid noncommercial “mad honey,” especially with beta‑blockers.
Alcohol (ER capsules)	Alcohol should be avoided with metoprolol extended‑release capsules. [7] [8]	Do not combine alcohol with ER capsules; unrelated to honey but important.
General dosing guidance	Metoprolol can be taken with meals; routine diet is acceptable. [2] [3]	Keep dosing consistent daily, with or after food if preferred.

---

Bottom Line

For most people, regular honey is safe to enjoy while taking metoprolol, and there is no evidence that typical honey intake interferes with metoprolol’s absorption or effectiveness. ^[1] Continue to avoid alcohol if you use metoprolol extended‑release capsules and steer clear of noncommercial “mad honey” due to its potential to dangerously lower heart rate and blood pressure. ^{[7] [8] [4] [5] [6]}