Nadolol for Migraine Prevention? Green Tea May be Problematic

Teri Robert @trobert Health Guide
  • Green tea has been touted to have many positive effects on health, and some people with Migraine use it to ease Migraine symptoms and provide comfort during a Migraine.


    A small recent study in Japan shows that green tea may reduce the effectiveness of nadolol, an antihypertensive medications sometimes prescribed off-label for Migraine and headache prevention, by reducing plasma concentrations.


    Sotiris Antoniou, Royal Pharmaceutical Society (England) spokesman and a consultant pharmacist in cardiovascular medicine, commented that leaving a four-hour period between taking nadolol and drinking green tea may avoid the problem, but also said:

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    "This has yet to be confirmed and is only extrapolated from our experience with grapefruit for this type of interaction...


    What is clear as healthcare providers is that we need to ask patients about their consumption of various fruits and supplements such as grapefruit and green tea, and this needs to be documented in the clinical notes, and where appropriate provide information on avoiding green tea or grapefruit, or better where possible to prescribe an alternative drug that is not affected by the consumption of green tea."2

    The study:

    • This was a small study with just 10 participants.
    • Participants were given one dose of 30 mg of nadolol daily with green tea or water for 14 days.
    • Green tea significantly reduced plasma levels of nadolol participants who drank green teal.
    • The effects of nadolol on systolic blood pressure (upper number) were significantly reduced in participants who drank green teal.
    • Study results suggested that great tea reduces plasma concentrations of nadolol.
    • The reduction of plasma levels may be the result of inhibition of the uptake of nadolol in the intestine.

    Summary and comments:

    With only 10 participants, this study is too small to be considered significant and reliable by most researchers. However, given the results, especially the impact on systolic blood pressure, it shouldn't be ignored.


    Patients who are taking nadolol for hypertension or for Migraine and headache prevention may wish to discuss the study findings with their doctors, especially if they're finding nadolol to be ineffective. It's unknown whether green tea has the same impact on other medications or if other teas have this effect.



    1 Misaka, S.; Yatabe, J.; Müller F.; Takano, K.; Kawabe K.; Glaeser, H.; Yatabe, MS; Onoue, S.; Werba, J. P.; Watanabe, H.; Yamada, S.; Fromm, M. F.; Kimura, J. "Green tea ingestion greatly reduces plasma concentrations of nadolol in healthy subjects." Clinical Pharmacology & Therapeutics accepted article preview 13 January 2014. doi: 10.1038/clpt.2013.241

    2 Roberts, Michelle. "Green tea 'cam impede nadolol blood pressure medicine.'" BBC Health News. January 13, 2014.

    3 Mole, Beth. "Green tea may sabotage blood pressure medication." Science News. January 13, 2014.

    Live well,

    PurpleRibbonTiny Teri1


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    © Teri Robert, 2014
    Last updated February 11, 2014.

Published On: February 11, 2014