Metronidazole And Alcohol: Drinking On Flagyl

Last Updated: April 10, 2020

Authored by Isaak Stotts, LP

The Metronidazole and alcohol myth has been widespread, with numerous opinions on the possibilities of interaction between both substances. Those with Metronidazole and alcohol experience have played their part in providing extensive information on the occurrence of such interactions. Others have asked recurrently, why can’t one drink alcohol with Metronidazole?

Drinking liquor on Flagyl may happen with or without one’s knowledge. While some accidentally drank ethanol while taking Metronidazole, others may have taken substances that contained significant amounts of ethanol, such as cough medications and others. So, what happens if one drinks ethanol while taking Metronidazole?

Mixing Metronidazole And Alcohol – Is It Safe?

Flagyl is an antibiotic that is used commonly in treating infections such as STIs. The frequency of metronidazole and ethanol mixture, as well as its side effects, proposes that it may not be wise to mix both substances. Some antibiotics do not show any form of reaction when mixed with ethanol. What happens if a person consumes alcohol while taking Flagyl? How safe is it?

Flagyl pill

Hence, individuals who may have a genetic history of seizures may be at risk of combining Flagyl and ethanol. Metronidazole vag gel and alcohol may have a different reaction due to differences in the route of exposure.

Drinking liquor on Metronidazole may cause a reaction due to the mechanisms of action of both substances. Ethanol is metabolized down into a compound known as acetaldehyde. It is toxic and causes adverse effects in the system. Acetaldehyde is further broken down into Acetate by an enzyme called acetaldehyde dehydrogenase. The metronidazole alcohol mixture introduces the drug into the reaction where the drug blocks the effects of the enzyme. As a result, Metronidazole stops the breakdown of the toxic acetaldehyde. When the poisonous compound builds up in the system it can lead to various health risks.

Risk Of Mixing Metronidazole And Alcohol

One of the common dangers of alcohol and Flagyl is the disulfiram-like reaction. This is a side effect of Disulfiram mixed with ethanol which results in various health conditions such as:

  • Face flushes
  • Headaches
  • Nausea
  • Low blood pressure
  • Vomiting
  • Palpitations
  • Sweating

A case was reported in 1996, where a sudden death was recorded. The death was traced to the Metronidazole ethanol reaction. The interaction was said to be caused by the accumulation of cardiotoxic, hepatotoxic, and arrhythmogenic substances in the body due to the presence of blockers in the metabolism of ethanol.

The alcohol and Metronidazole reaction is not typical in every case. Some individuals show no signs of Flagyl and alcohol interaction. Physicians are often unable to determine if explicitly a person is susceptible to the Flagyl ethanol effects. Therefore, it is safest to avoid consuming ethanol while taking the medication.

How Long After Metronidazole One Can Drink Alcohol

To avoid Metronidazole-alcohol interaction, it is best to ensure that the system is clear of one of both substances before taking the other. So, how long after taking Metronidazole, can one drink liquor?

pouring wine into the glasses

Cold remedies, cough medications, and others are also considered alcoholic content.

This suggests that one may need to stay off ethanol for three days after the last dose. Metronidazole-alcohol 24 hours mark is typical for creams. When using Metronidazole cream and alcohol, it is recommended that the user avoids the use of alcohol for at least 24 hours before considering taking the medication.

Individuals with a high tolerance for ethanol will need to wait a bit longer than average to ensure that alcohol deposits are entirely broken down before indulging in the medication.

Safe Dose of Alcohol to Take with Metronidazole

Many medications are problematic when taken with ethanol, even in small doses, such as blood thinners and alcohol. It is best to assume that there is no particularly safe amount of ethanol. The smallest unit of ethanol will undergo the same metabolic process to produce the same results. These results may be more pronounced in some individuals than others. The risk of Metronidazole 500mg and alcohol is still dependent on the breakdown of ethanol. Individuals who apply the cream or gel forms of the antibiotic are advised to wait for at least 24 hours before indulging in alcohol consumption.

capsules and glass with alcohol

When to See a Doctor

Metronidazole side effects with ethanol may differ in various individuals, also in the duration of time that it takes for these reactions to manifest. Metronidazole gel alcohol effects may be milder than oral medication due to its topical application.

Antidipsotropic Properties of Metronidazole

The category of drugs known as antidipsotropic are medications administered to help stop an ethanol addict from drinking. When taken with ethanol, the combination creates very unpleasant interactions which can help individuals with chronic drinking problems to quit drinking. Does Flagyl have antidipsotropic properties? Yes, it does. The Flagyl-alcohol interaction may cause antidipsotropic properties such as increased heart rate, nausea, vomiting, and other side effects.

Using Metronidazole Safely

Metronidazole with alcohol may present with numerous health conditions due to toxicity. Caution should be taken when indulging in both substances so that the intervals are well spaced. Talk to a medical professional about the medication and the risks of reaction with ethanol as well as to get additional information on alcohol. In cases where both substances are erroneously taken together, consult a doctor immediately.

Page Sources

  1. Cina SJ, Russell RA, Conradi SE. Sudden death due to metronidazole/ethanol interaction. Am J Forensic Med Pathol. 1996 Dec;17(4):343-6.
  2. Fjeld H, Raknes G. Is combining metronidazole and alcohol really hazardous? Tidsskr Nor Laegeforen. 2014 Sep 16;134(17):1661-3.
  3. Williams CS, Woodcock KR. Do ethanol and metronidazole interact to produce a disulfiram-like reaction? Ann Pharmacother. 2000 Feb;34(2):255-7.
  4. Visapää JP, Tillonen JS, Kaihovaara PS, Salaspuro MP. Lack of disulfiram-like reaction with metronidazole and ethanol. Ann Pharmacother. 2002 Jun;36(6):971-4.

Published on: December 10th, 2019

Updated on: April 10th, 2020

About Author

Isaak Stotts, LP

Isaak Stotts is an in-house medical writer in AddictionResource. Isaak learned addiction psychology at Aspen University and got a Master's Degree in Arts in Psychology and Addiction Counseling. After graduation, he became a substance abuse counselor, providing individual, group, and family counseling for those who strive to achieve and maintain sobriety and recovery goals.


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