What Happens When You Mix Alcohol and Antibiotics? Risks and Safety

Last Updated: April 25, 2024

Dr. Norman Chazin Reviewed by Dr. Norman Chazin
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Numerous drugs interact with alcohol, including antidepressants, antihistamines, barbiturates, benzodiazepines, allergy medications, muscle relaxants, non-narcotic pain relievers, anti-inflammatory agents and opioids. Additionally, a wide range of over-the-counter medications, herbal supplements, and antibiotics also have potential interactions with alcohol.

The combination of alcohol and antibiotics can pose significant risks, not only because it can alter both the effectiveness of the medication and the metabolism of alcohol but also because drinking alcohol can directly impact the conditions being treated with these medications.

Continue reading to learn about the dangers of mixing alcohol and antibiotics, its side effects, and safety tips for a proper treatment course.

What are Antibiotics?

Alexander Fleming’s accidental discovery of penicillin’s antibacterial properties marked the beginning of modern medicine, significantly reducing mortality from bacterial infections.

Antibiotics are a powerful class of medications that work by targeting bacteria, either by:

  • Bactericidal properties directly kill the bacteria by disrupting vital functions
  • Bacteriostatic properties interfere with bacterial metabolic processes, inhibiting growth and reproduction

Different antibiotics have different mechanisms of action, allowing for an extensive range of coverage against various types of bacteria.  Misuse or overuse of antibiotics can lead to antibiotic resistance, where bacteria become less susceptible to the effects of antibiotics, making infections more complicated to treat.

As bacteria antibiotic resistance is a public health concern and has caused more than 1.2 million annual deaths worldwide, antibiotics should only be used when necessary and for the prescribed course, even if symptoms improve before completion.

Why You Shouldn’t Mix Alcohol and Antibiotics

Every medication comes with a label containing detailed instructions on following proper treatment. Many, if not all, antibiotics have “avoid alcohol” stickers on the prescription bottles. The reasons are outlined below:

Reduced Antibiotic Effectiveness

Infections can lead to severe complications, especially when left untreated or inadequately managed. They can spread rapidly throughout the body, causing systemic inflammation, organ damage, and even sepsis.

Drinking alcohol, particularly in heavy amounts, alongside antibiotics is considered an inadequate treatment management as it can interfere with the antibiotics’ ability to fight bacterial infections. Alcohol may alter the metabolism or activity of antibiotics, potentially reducing their therapeutic efficacy.

Increased Risk of Side Effects

Antibiotic treatment has associated side effects such as gastrointestinal disturbances, allergic reactions, or liver toxicity. Heavy alcohol intake is widely known as the main factor of liver disease, along with other cardiovascular diseases.

Combining alcohol with antibiotics can intensify these adverse side effects, causing severe fatigue, a throbbing headache, dizziness, anxiety, chest pain, and rapid heartbeat. Alcohol and antibiotics can also worsen digestive issues, which can cause blood or mucus in stool, severe diarrhea, intense stomach cramping or pain, fever, or uncontrollable vomiting.

Liver Strain and Toxicity

Both alcohol and certain antibiotics are metabolized in the liver.

Consuming alcohol while taking antibiotics such as Duloxetine (Cymbalta) can place additional strain on the liver, potentially leading to liver damage or toxicity. This can be particularly concerning for individuals with pre-existing liver conditions or those taking medications that are known to be metabolized by the liver.

Risk of Dangerous Interactions

Some of the antibiotics and alcohol interactions may not cause life-threatening scenarios. However, combining alcohol with certain antibiotics like metronidazole, tinidazole, or linezolid causes a reaction known as a disulfiram-like reaction.

This reaction happens when certain antibiotics block aldehyde dehydrogenase, the enzyme metabolizing alcohol in the body. As a result, alcohol builds up in the bloodstream, causing severe nausea, vomiting, headache, rapid heart rate, and sometimes dangerously high blood pressure.

Additive Effects

As a central nervous system depressant, alcohol can slow down brain activity and impair cognitive and motor function.

Likewise, some antibiotics, particularly those with central nervous system effects (i.e., aminoglycosides, macrolides, quinolones, sulfonamides, penicillin, carbapenems, tetracyclines, oxazolidinones, polymyxins, and metronidazole), can also have sedative properties.

The additive sedative effects of alcohol and antibiotics can seriously impair cognitive function, coordination and motor skills, increasing the risk of accidents, falls, and injuries. Individuals under the reaction of antibiotics and antibiotics must not drive or operate machinery.

Challenges in Antibiotic Prescribing

A bonus point about this topic is how long-term alcohol consumption weakens the immune system, making individuals more vulnerable to bacterial infections and other illnesses.

When heavy drinkers require antibiotic therapy, clinicians face additional challenges. Alcohol-related liver damage can affect the metabolism and clearance of medications, including antibiotics, potentially altering their efficacy or increasing the risk of adverse effects. Also, compromised immune function may need more potent or prolonged antibiotic treatment to clear the infection.

Mixing Alcohol and Antibiotics Health Risks

This chart provides a general overview of potential interactions between alcohol and certain classes of antibiotics. It is essential to consult with a healthcare professional or pharmacist for specific guidance regarding antibiotic use and alcohol consumption.

Antibiotic Interaction with Alcohol Avoid Alcohol
Metronidazole Disulfiram-like reaction: Severe nausea, vomiting, headache Yes
Tinidazole Disulfiram-like reaction: Similar to metronidazole interaction Yes
Linezolid Increased risk of hypertensive crisis and serotonin syndrome Yes
Fluoroquinolones Higher risk of central nervous system effects (dizziness, etc.) Yes
Trimethoprim/Sulfamethoxazole Increased risk of side effects such as nausea, vomiting, and headache Yes
Macrolides (e.g., erythromycin, clarithromycin, azithromycin) Higher risk of gastrointestinal disturbances (nausea, vomiting) Yes
Tetracyclines (e.g., doxycycline, minocycline) Increased risk of gastrointestinal disturbances and liver toxicity Yes
Penicillins (e.g., amoxicillin, penicillin) Excessive alcohol can affect liver metabolism and immune response Limit alcohol intake
Cephalosporins (e.g., cephalexin, ceftriaxone) Excessive alcohol can disrupt liver metabolism and immune response Limit alcohol intake

Alcohol and Antibiotics − Final Considerations

Before having a drink post-treatment, ensure that antibiotics have entirely cleared from your body.

Most antibiotics metabolize within hours, but Metronidazole can remain for up to 3 days. Those with high alcohol tolerance must ensure alcohol fully clears before starting antibiotics. Always take antibiotics under strict medical supervision for safety and efficacy. If unsure, consult your healthcare provider.

Alcohol dependence causes several health complications, as well as social isolation and low self-esteem. Extending a helping hand to those struggling with alcohol abuse can make a big difference. Find support and assistance in the therapy treatments and support groups.

People Also Ask

What happens if I drink alcohol while taking antibiotics?

Drinking alcohol while on antibiotics can reduce their effectiveness, amplify side effects like dizziness or nausea and potentially strain your liver. It’s best to avoid alcohol until you’ve completed the antibiotic course, as advised by your healthcare provider.

Can you drink alcohol while taking amoxicillin?

Drinking alcohol while taking antibiotics can disrupt medication metabolism, leading to severe consequences. For example, the sedative effects of both alcohol and sedative medications can enhance each other, impairing driving or machinery operation. It’s best to avoid alcohol until you’ve completed the antibiotic course, as advised by your healthcare provider.

Which antibiotics should be avoided with alcohol consumption?

Antibiotics such as metronidazole (Flagyl), tinidazole (Tindamax), sulfamethoxazole and trimethoprim (Bactrim) should be strictly avoided with alcohol due to potential interactions that can cause severe reactions, such as nausea, vomiting, headache, rapid heart rate, and, in some cases, even dangerous increases in blood pressure.

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Page Sources

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Retrieved on April 25, 2024.

Published on: March 9th, 2018

Updated on: April 25th, 2024


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