Antibiotics and Alcohol: Can One Mix Them?

Last Updated: June 10, 2020

Authored by Nena Messina, Ph.D.

Can one drink alcohol while taking antibiotics? Mixing alcohol and antibiotics is an immensely broad topic. Having a glass of wine and necking a couple of Zynox pills can be very different from mixing a few shots of vodka with Flagyl. The severity of side effects and symptoms will vary greatly, depending on the amount and type of a drink consumed, and the same goes for different antibiotic classes. It’s common knowledge, though, that the combination brings adverse effects along and should be avoided at all costs.

The Truth About the Antibiotics and Alcohol Interaction

A person who had consumed negligible amounts of alcohol while under the influence of antibiotics might not experience any harmful effects on their body, according to the healthcare experts at the Columbia University in New York. This, of course, does not deter the severity of this potentially deadly combination. Alcohol impairs the body’s self-healing ability by depriving it of its water and tiring it out. Drinking may not make the medications ineffective, but it slows down the recovery process. Alcohol and most antibiotics have similar side effects, including dizziness, drowsiness, and upset stomach. These side effects are intensified when alcohol and antibiotics are taken together.

Does Alcohol Interfere with Antibiotics?

Yes. It is dangerous to drink while on antibiotics due to the intense and damaging harm that can be done to the body’s organs. Drinking while on antibiotics can have a severe impact on the liver, where alcohol and antibiotics are broken down. Apart from the liver, one’s brain functioning is slowed down as well, since both alcohol and antibiotics are central nervous system depressants.
It is quite a simple affair. Most antibiotics affect the central nervous system (CNS) and lead to side effects like drowsiness, dizziness, sedation, or confusion. Alcohol is also a CNS depressant. When taken with antibiotics, the side effects intensify. This combination, therefore, is dangerous enough on its own, not to mention when one is driving or is within the sensitive age groups.
Most alcoholic content in the liver is broken down by an enzyme alcohol dehydrogenase (ADH). If one drinks copious amounts of alcohol—an intoxicating volume—with the antibiotic, ADH may be inhibited. This means neither the alcohol nor the drug can be broken down efficiently and excreted from the body. The build-up can raise the alcohol level in the blood to dangerous proportions and increase the possibility of drug toxicity.
On the other hand, if a person has been chronically abusing drinking, the same enzyme in his or her liver has already been hindered. Such individuals are then at an increased risk of damaging their organism, which at that point has decreased properties of self-healing.

Managing Effects of Mixing Antibiotics with Alcohol

Call 911. This is the right action one should take should he or she suspect someone is exhibiting the adverse symptoms of mixing antibiotics with alcohol.
Why can’t one drink alcohol and antibiotics? The common adverse symptoms of antibiotics and alcohol interaction are breathlessness, headache, chest pain, irregular heartbeat, dizziness, and nausea and vomiting. But, not everybody exhibits all the symptoms. The symptoms may also vary in degree from person to person. Also important is how effectively the liver can metabolize the substances.
While it is unlikely that antibiotics and alcohol interactions can lead to death, some symptoms like an irregular heartbeat, breathlessness, nausea, and vomiting call for immediate medical intervention. These symptoms, if left untreated, can be fatal. For instance, an irregular heartbeat can trigger a cardiac arrest, while dehydration caused by vomiting can cause blood pressure to drop to dangerously low levels.
It is illegal for a person who is exhibiting these symptoms to operate a vehicle, even if in an emergency. That means the patient can’t drive him or herself to the hospital. If the antibiotics are lying around, the designated driver should collect a sample and show it to the doctor. This would help doctors in deciding upon the appropriate treatment.

What Antibiotics Should Not Be Mixed With Alcohol?

The National Institute on Alcohol Abuse and Alcoholism lists the antibiotics known to cause adverse side effects when taken with alcohol.
There is a vast amount of antibiotics available on the market, each targeting a specific health condition. Metronidazole (Flagyl) is typically prescribed for dental or vaginal infections and to treat leg ulcers or pressure sores. Tinidazole (Tindamax) performs many of the same functions as Metronidazole and, additionally, is prescribed to treat certain gut bacterial infections. Cefotetan is usually prescribed for infections of the lungs, gut, bones, joints, blood, urinary tract, and skin. These antibiotics react with alcohol to produce side effects like severe abdominal cramps, nausea, headache, vomiting, facial flushing, chest pain, and rapid heart rate.
Incidentally, these symptoms are similar to the side effects of a drug called Disulfiram, which is used to treat alcohol dependency. When on Disulfiram, the counter effectiveness is so strong that even one drink is enough to trigger these unpleasant effects. It is crucial is to dissuade alcoholics from drinking more after they have experienced these symptoms.
Individuals are urged not to drink while taking Metronidazole, Tinidazole, and Cefotetan, ideally abstaining from drinking in the 72-hour window following the last dose.
The following antibiotics should never be taken while drinking:

  • Metronidazole
  • Tinidazole
  • Isoniazid
  • Ethionamide
  • Cycloserine
  • Cefotetan
  • Thalidomide

Drinking on antibiotics is never a good idea. Medications such as Cycloserine and Ethionamide can cause CNS toxicity and increase the risk of seizures and psychosis. Taken with alcohol, Thalidomide too depresses the CNS and can suppress motor abilities. Isoniazid can seriously deter health in people who chronically abuse the substance and can skyrocket their risk of liver damage.

Why Can’t One Drink Alcohol with Amoxicillin?

Amoxicillin is an antibiotic in the penicillin group used for infections in areas such as the sinuses, ears, skin, and many other bacterial infections. It is also used before dental procedures to prevent certain types of infections occurring in the first place.
Side effects of mixing Amoxicillin with alcohol include:

  • Amplified dizziness
  • Reduced effectiveness of the drug
  • Extended treatment duration
  • Boost of bacterial growth in the infected area

Combining alcohol with this medication can also lead to side effects, including shortness of breath, headaches, chest pain, irregular heartbeat, nausea, and vomiting. Due to these associated risks, it is required for the patient to stay away from drinking for at least 72 hours after the medication was taken.
It may come as a surprise, but some cold medicines and mouthwash liquids contain small amounts of ethanol, which can interfere with the antibiotics in one’s body. There is plenty of discussion about whether such products can cause adverse side effects when taken in combination with antibiotics, such as Amoxicillin. The next section will examine this relationship in more detail.

Effects of Combining Alcohol with Doxycycline

Doxycycline is an antibacterial medicine. It targets infections most commonly affecting urinary tract infections, such as Gonorrhea, Chlamydia, eye infections, gum disease, Malaria, Lyme disease, etc. This is an extremely strong medication.
One thing antibiotics and alcoholic drinks have in common is that they both destroy the healthy bacteria in one’s stomach. If taken simultaneously, the effects are even more harmful. Taking Doxycycline and alcohol together can, therefore, cause stomach pain, cramps, diarrhea, and vomiting.
As we all know, alcohol neutralizes the effects of many medicine types on the market. Drinking while on Doxycycline is no exception. This counterproductive combination, however, can never be precisely predicted as it’s difficult to determine what a safe amount of alcohol is. No two people have the same reaction to alcohol. Some of the factors that play into one’s alcohol retention are:

  • Gender
  • Age
  • Height,
  • Weight

It is common advice among health professionals not to drink at all while taking this antibiotic.

Chronic Alcoholics Mixing Alcohol With Antibiotics

Some antibiotics do not trigger harmful effects in non-alcoholics or the occasional drinker. However, they can cause dangerous side effects in people who are chronic daily users of alcohol or are alcoholics.
Taking antibiotics while drinking carries aggravated risks if the person is a chronic alcoholic. Drugs such as Rifampin, Pyrazinamide, and Voriconazole can increase the risk of liver damage in chronic alcoholics while Didanosine may raise the risk of developing pancreatitis in such people. These drugs should either be avoided or prescribed with caution for alcoholics or people who have been drinking daily for a long time. The doctor needs to be aware if his or her patient is an alcoholic to prescribe a safe treatment and prevent dangerous reactions from occurring.

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Published on: March 9th, 2018

Updated on: June 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.


Leave a comment

  • Rita
    I drink beer…can I mix it with a Doxycycline?
  • Sam
    Can I have alcohol after seven hours of taking a dose of doxycyline 200 mg capsules