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Steroids And Alcohol: What To Avoid With Anabolics?

Last Updated: January 24, 2022

Authored by Sharon Levy, MD, MPH

Reviewed by Tania Kelly

Steroids are the drugs used in the treatment and management of almost all areas of medicines. There can be natural steroids or synthetic drugs that are used in various ailments. Although they can be life-saving drugs in many conditions and can significantly increase the quality of life in severely ill patients, they are not without their unwanted effects. One should take precautions while taking anabolics with any other medicine or drug. They are extensively metabolized in the liver leading to drug interaction between steroids and other drugs. There are more than 500 drugs interaction of steroids known. Many drugs limit the breakdown of anabolics by the liver resulting in abnormally high levels in the blood while others may increase their metabolic rate thus requiring more than the normal dose. It may increase the plasma half-life of medicines leading to overdose symptoms which can be potentially fatal.

Can You Drink Alcohol While Taking Steroids: Is It Safe?

Drinking on most medications has the potential to cause negative side effects in the patient who uses them. So can you drink alcohol while taking steroids? While alcohol and steroids don’t interact directly, they can potentiate each other’s side effects leading to severe illness. However, the risks are not considered to be as great as with many other medicines. Most doctors who prescribe AAS drugs acknowledge that drinking in moderation while on the medication is okay.

The concern arises when the patients abuse one or both substances. For example, someone who takes anabolic steroid injections twice or more will often have an increased risk of dangerous mental and physical side effects when drinking. Moderation is key when it comes to steroids and alcohol. Alcohol affects everyone differently and everyone has different alcohol metabolism. The risks of drinking while being on anabolic depend on many factors such as age, medical condition, and the interacting drug. Consulting a health professional regarding steroids and alcohol assessment, one’s medical condition, average alcohol intake, and daily steroid dose can help in assessing the risks for the person’s health.

Alcohol and some pills on the table.

Health Risks And Dangers Posed By Mixing Steroids And Alcohol

Understandably, people taking AAS drugs may not wish to abstain from alcohol while using them. Drinking is often a part of socializing, and pairing the right drink with a meal can greatly enhance it. However, once users understand the risks, they may wish to cut back their imbibing or stop it completely.

Mixing AAS Drugs and Alcohol Can Cause a Wide Variety of Problems, Including:

  • Liver toxicity and damage
  • Immunosuppression
  • Kidney damage
  • Erratic and violent behavior
  • Loss of gains at the gym

Due to the steroid mechanism of action, the development of these side effects can be unpredictable. It is important that users understand them in full before they take on the risk of drinking while on anabolics. In case, abuse of any of both substances becomes an addiction, it is critical to seek proper substance abuse treatment.

Liver Toxicity

Both alcohol and anabolic steroids are hepatotoxic. Taking alcohol and steroids can be fatal.  This means that they have the ability to damage the liver cells when the organ is processing the substances. Using them at the same time means putting extra strain on the liver, increasing the risk of damage. Some AAS medications are more hepatotoxic than others, so users should research their AAS medication of choice before drinking. No matter what AAS drug a person is on, having more than a few drinks a week with steroids and alcohol will greatly increase the risk of damage. Thus, while one can drink on anabolics, this means occasionally, not habitually. Straining the liver with drinking on anabolics is best avoided completely if possible.

Immunosuppression

Both steroids and alcohol can reduce the function of the immune system. Steroids always inhibit the immune system, including AAS drugs. Alcohol, on the other hand, has been shown to boost the immune system depending on the type consumed potentially. However, this is only when drinking in moderation. Excessive drinking of any substance harms the immune system. Combining two immunosuppressive substances has the potential to harm the user greatly. Given that athletes need always to be their best, using both alcohol and steroids is counterintuitive. They risk getting sick often and performing less than their best as a result.

Behaviors Health Disorders

One of the lesser-known consequences of drinking alcohol and steroids is the impact it has on mental health. Athletes focus heavily on the physical self, and thus, are not always thinking about the mental health consequences of their actions. However, mental health side effects, including mood swings and violent behavior, are attributed to both anabolics and drinking. Due to the way AAS drugs impact testosterone and estrogen, users can cycle between feelings of euphoria, rage, and deep depression. This can result in them acting out in unpredictable and harmful ways.

Undermining Workout Results

Finally, there is the fact that mixing steroids and alcohol can undermine the results the user is working so hard to achieve. Everyone has heard the term beer belly, and this is very much a reality. However, it can be caused by any form of alcohol and the effects can be seen everywhere, not just in the abdomen.

Alcohol has a negative impact on the hypothalamic-pituitary-gonadal (HPG) axis. This is a hormonal and endocrine system that regulates the male reproductive system. Alcohol interacts with the system by lowering testosterone and allowing estrogen to become relatively higher. This can make the body more prone to retaining fat and reducing muscle mass. As a result, mixing alcohol and steroids can, in effect, render the AAS drugs useless.

When Is It Safe To Drink After Taking Steroids?

When is it safe to drink after taking steroids? One cannot directly answer this question. This depends on many factors. First of all, it depends on the type of steroid you are on and how long you have been taking them. Steroids for acute illnesses don’t cause tolerance and may need more time for metabolic clearance. Other factors which include when one can have a drink are the type of condition being treated, length of therapy, age of the patient, any other drug intake, and predisposing health condition. That’s why the general period of safe alcohol intake after steroid dose varies greatly and is different for every person.

Generally, one to two drinks after 6 hours of taking anabolics are considered safe. In short-term treatment with anabolics, binge drinking should be avoided till the metabolic clearance of the steroids which can take days.  If one is taking anabolics for a long time, it may take weeks to months for the body to go back to its normal metabolism and normal alcohol capacity, due to the steroid withdrawal process.

A doctor consults a patient regarding dangerous steroids interactions.

Steroids Interactions With Other Substances And Medications

The liver is the metabolic machinery of the body. Most of the medications and substances put in the body are metabolized in the liver. Anabolics are also metabolized extensively in the liver. Therefore, there are constant interactions between various substances and steroids. They may upregulate or downregulate the metabolism of some substances or these substances can increase the clearance of anabolics in blood and vice versa. These interactions can cause symptoms anywhere from mildly irritating to potentially lethal depending on the type of drug interaction. Here is information and a summary of  steroid interactions with other substances and medications below.

Steroids And Weed

While there is no information on any known direct interaction between steroids and weed, they can worsen each other’s side effects. Marijuana is associated with paranoia, anxiety, and neuropsychiatric side effects. These side effects can get worse with the use of anabolics. Smoking weed for a long time along with steroids can potentiate the osteoporotic effect of steroid use. Thus, it is important for the patient to use these under the guidance of a medical professional and get immediate medical consultation if an adverse effect of any of these medications is experienced by the patient.

Steroids And Antibiotics

Taking Steroids and antibiotics can decrease the efficacy of some antibiotics such as vancomycin. It works by increasing the metabolic rate and plasma clearance of these drugs along with reducing the penetration and decreasing the bactericidal activity. It leads to needing a higher dose of the drug for the same effect. If not properly managed, steroids and antibiotics can even cause drug resistance and worsening of infection in some patients.

Can You Take Steroids and Muscle Relaxers Together?

These drugs are considered safe when taken together and often they are prescribed together for various diseases. There is no known interaction between the available muscle relaxants and the anabolics. So the answer to the question: can you take steroids and muscle relaxers together is yes. You can take them together as long as the health care provider is properly notified and consulted. No known interaction doesn’t mean there can be no adverse effect. This is why patients should take extra precautions.

Viagra On Steroids

Many people take steroids to boost their sex drive and viagra for better sexual function. That being said, there is no evidence of direct interaction of viagra on steroids. One can take viagra on steroids as long as they are perfectly healthy and take them in prescribed doses. Abusing these two drugs together can cause severe health problems including cardiomegaly that enlarges the heart and high blood pressure which can lead to stroke and heart attack. These symptoms can be attributed to the addition of similar action rather than pharmacological interaction.

Ibuprofen and Steroids

There is moderate level interaction between ibuprofen and Steroids. Steroids can increase the gastrointestinal effects of ibuprofen such as git distress, altered bowel habits such as diarrhea and constipation, pain,  inflammation, bleeding, and ulceration. Sometimes more serious adverse effects such as gastric or intestinal perforation can occur.

Benadryl And Steroids

Benadryl and Steroids and other antihistamines are often taken together by patients due to respiratory complaints or asthma. One may want information if they can take them together. No known interaction exists between Benadryl and steroids.  Furthermore, these drugs together are often used therapeutically by medical professionals for the treatment of various ailments.

Being On The Safe Side

Most people don’t realize that taking anabolics for a long time can cause addiction and side effects of steroids. It can weaken one’s immune system and can cause withdrawal symptoms if taken out abruptly. It is necessary to get information and consult professionals for the interactions, addictions, and health effects.

If someone is engaging in dangerous drinking habits while on AAS, they should seek help. Dependence on AAS drugs and addiction to alcohol are both dangerous. Drug rehabilitation facilities can help users get away from anabolic steroids and alcohol to live a better life.

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Published on: August 16th, 2019

Updated on: January 24th, 2022

About Author

Sharon Levy, MD, MPH

After successful graduation from Boston University, MA, Sharon gained a Master’s degree in Public Health. Since then, Sharon devoted herself entirely to the medical niche. Sharon Levy is also a certified addiction recovery coach.

Medically Reviewed by

Tania Kelly

Tania Kelly, author of Keep Calm and Treat Addiction is a credentialed Mental Health Nurse and Tobacco Treatment Specialist, passionate about addiction recovery. As a senior clinician, Tania constantly shares the concepts outlined in her book with health service providers, aiming to demystify addiction treatment and equip others in evidence-based practice.