Blood Thinners and Alcohol Interaction

Last Updated: April 10, 2020

Authored by Nena Messina, Ph.D.

Alcohol can interfere with blood thinners. People who take anticoagulants do so to reduce the risk of excessive clotting. Without proper action of these drugs, people at risk may get a heart attack or a stroke. While many people do not consider this, alcohol is a drug, too. Like other drugs, it can also interact with the medicines a person takes. That can impact this mechanism.

Since many people drink alcohol in their daily life, it is important to understand how alcohol and blood thinners interact with each other and affect the body. Can one drink alcohol with blood thinners? What effect do blood thinners have with alcohol? What signs can warn an individual about the adverse impact of their simultaneous use? What should alcoholics do if they need to take this medicine?

Drinking When on Blood Thinners

Can one drink alcohol while taking blood thinners? Taking a moderate amount of alcohol with them is not generally harmful. This is because of the impact of a moderate amount of alcohol now and then is not significant to cause harm to the body.

Taking them together has a synergistic effect in blocking the clotting mechanism of the blood. Without proper clotting mechanisms in place, the body may have an increased predisposition to uncontrollable bleeding. In general, mixing alcohol and blood thinners is not a good idea.

Alcohol as a Blood Thinner

Consuming alcohol can cause serious complications in the long run.

Clotting factors are necessary for homeostasis, which is the balance of different body functions to ensure normal living. When clotting factors are reduced, the body cannot heal the numerous micro-injuries it suffers regularly. With enough damage to the liver, the internal vessels may start bleeding inside the body and cause massive hemorrhage and shock.

different alcoholic drinks

Although alcohol reduces clotting, it should not be used as a substitute for anticoagulants. Prescription anticoagulants have proper medical methods to track their dosage and effectiveness. This tracking ensures that the balance between clotting and bleeding is maintained. Substituting medications would lead to disruption of this balance as there would be no way to track and manage it.

Risks of Simultaneous Consumption

People who are occasionally drinking alcohol on blood thinners are not at much risk. Occasional drinking works fine with anticoagulants. However, heavy drinkers may be at risk of serious complications like excessive bleeding and death.

Doing this regularly might make the blood so thin that gums, small cuts, and incisions will bleed much more than they normally do. Old people are especially susceptible to injuries and bleeding. Excessive drinking with anticoagulants in these people can easily cause massive blood loss and death.

Dangerous Signs for Doctor’s Consultation

There are numerous side effects of blood thinners and alcohol. Drinking heavy amounts of alcohol while on blood thinners will result in a large amount of bleeding. Dangerous signs include:

  • bruises on skin
  • skin discoloration
  • blood in urine, vomit or stool
  • excessive bleeding from an injury
  • drop in blood pressure
  • dizziness
  • headache
  • fainting
  • nausea and vomiting
  • abdominal pain
  • shortness of breath
  • chest pain
  • confusion
  • altered level of consciousness

man with abdominal pain

If any of these signs are noticed, the person experiencing them should be rushed to the emergency department at a nearby hospital. Often, these signs are subtle and easy to miss. A person might be bleeding internally and would not realize it. Therefore, people taking both drugs simultaneously should be actively looking out for these signs to prevent dangerous complications.

Effect of Alcohol on Cardiovascular System

Alcohol has many effects on the cardiovascular system. Low-to-moderate use is associated with reduced risk of developing factors that cause atherosclerosis, narrowing of vessels, and inflammation. Despite that, the harmful effects of its consumption are numerous, ranging from serious physiological effects, mitochondrial dysfunction, inflammatory response, oxidative stress, programmed cell death, and anatomical damage to the cardiovascular system.

Hypertensive people taking anticoagulants should actively avoid alcohol as it may cause bleeding in the brain due to its effect on clotting and blood pressure.

Options for Alcoholics

If someone has a history of drug abuse or family members who are alcoholics, they should explore resources about alcohol abuse. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) is an exceptional resource consolidating everything related to alcoholism. NIAAA helps heavy drinkers to reduce their consumption to moderate levels, which is difficult to achieve without help. In addition to that, people who have been living in a family of drinkers, and an increased risk of becoming alcoholics themselves can find help and guidance from ACOA (Adult Children of Alcoholics). ACOA is an organization that provides a forum for people who desire to recover from the effects of growing up in an alcoholic family.

man at psychotherapy session

So, to sum up, a moderate amount of drinking reduces clotting but cannot be substituted for prescribed anticoagulants. Simultaneous blood thinners and alcohol use can cause internal bleeding in heavy or regular drinkers due to their synergistic effects. People taking anticoagulants should reduce alcohol consumption. They should also be on the lookout for signs of internal bleeding. Alcoholics with anticoagulant prescription should actively seek help in rehab institutions. Professional medical treatment will help to reduce their risk of developing severe complications.

Page Sources

  1. Bos S, Potze W, Siddiqui MS, Boyett SL, Adelmeijer J, Daita K, Lisman T, Sanyal AJ. Changes of in vitro potency of anticoagulant drugs are similar between patients with cirrhosis due to alcohol or non-alcoholic fatty liver disease. Thromb Res. 2017 Feb;150:41-43.
  2. Joshua A. Roth, Katharine Bradley, Kenneth E. Thummel, David L. Veenstra, Denise Boudreau. Alcohol misuse, genetics, and major bleeding among warfarin therapy patients in a community setting. Pharmacoepidemiol Drug Saf. 2015 Jun; 24(6): 619–627.
  3. Lydia M. Efird, Donald R. Miller, Arlene S. Ash, Dan R. Berlowitz, Al Ozonoff, Shibei Zhao, Joel I. Reisman, Guneet K. Jasuja, Adam J. Rose. Identifying the Risks of Anticoagulation in Patients with Substance Abuse. J Gen Intern Med. 2013 Oct; 28(10): 1333–1339.
  4. Blood Thinner Pills: Your Guide to Using Them Safely. Department of Health and Human Services. Agency for Healthcare Research and Quality.

Published on: December 10th, 2019

Updated on: April 10th, 2020

About Author

Nena Messina, Ph.D.

Nena Messina is a specialist in drug-related domestic violence. She devoted her life to the study of the connection between crime, mental health, and substance abuse. Apart from her work as management at addiction center, Nena regularly takes part in the educational program as a lecturer.


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