Antibiotics and Alcohol

What Happens When You Drink On Antibiotics?

“Can I drink alcohol with antibiotics?” is a frequent question to health care professionals. Many prescription bottles come labeled with a sticker that warns against alcohol drinking with the antimicrobial. Understanding the evidence behind this warning is vital, given the prevalence of prescribing and antimicrobials’ diverse classes and various properties.

The CDC (Centers for Disease Control and Prevention) reported that roughly 270 million antibiotics were prescribed for outpatients in 2016. In its report on harmful interactions with alcohol, the NIH (National Institutes of Health) listed nitrofurantoin, metronidazole, griseofulvin, ketoconazole, isoniazid, cycloserine, and azithromycin. The National Consumers League and the FDA (Food and Drug Administration) warned consumers to avoid alcohol with linezolid, metronidazole, griseofulvin, and antimycobacterial.

According to research published on the NCBI page, [1] concomitant use of alcohol with antimicrobials is believed to either lower efficacy or lead to toxicity. The classic example of a feared medication interaction with alcohol is the “disulfiram-like” reaction. Symptoms may include the following:

Furthermore, alcohol can cause hepatic stress or injury with or without potentially using hepatotoxic medications. These concerns may be responsible for alcohol warnings that accompany many antimicrobials.

Mixing Alcohol and Antibiotics Effects

When alcohol is consumed, it can have various side effects on the body, regardless of whether antibiotics are involved. Here are some common side effects of antibiotics and alcohol consumption:

• Alcohol is a depressant that affects the CNS (central nervous system.) It can impair coordination, reduce reaction time, decrease judgment, and cause difficulty concentrating. It may also cause drowsiness or sleep disturbances.
• Alcohol can irritate the stomach lining, causing nausea, vomiting, and pain. It can also increase stomach acid production, potentially contributing to heartburn or gastritis.
• Alcohol is a diuretic, meaning it promotes increased urine production. This can result in dehydration and symptoms like dry mouth, thirst, fatigue, and headache.
• Alcohol is primarily metabolized in the liver, and excessive or long-term alcohol consumption can cause liver damage, such as alcoholic hepatitis, cirrhosis, or fatty liver disease.
• Drinking alcohol can affect the cardiovascular system, causing increased heart rate and blood pressure and increasing the risk of illnesses like heart disease or stroke.
• Alcohol can interact with various medications, including those unrelated to antibiotics. It can potentiate or diminish the effects of certain drugs, leading to unpredictable reactions or reducing the efficacy of medicines.
• Antibiotics and alcohol consumption can impair judgment, leading to risky behaviors, accidents, or poor decision-making.
• Regular or excessive alcohol drink can lead to alcohol dependency and addiction, profoundly affecting physical and mental health.

Can You Drink While On Antibiotics?

When drinking alcohol while taking antibiotics, the specific antibiotic and individual factors determine the potential side effects. However, here are some general side effects that may occur:

• Increased risk and severity of gastrointestinal side effects.
  • Certain antibiotics and alcohol can cause gastrointestinal upset, including nausea, vomiting, diarrhea, and stomach pain. Combining them can intensify these symptoms and lead to more discomfort.
• Enhanced central nervous system effects.
  • Both alcohol and some antibiotics can affect the central nervous system. Combining them can increase the risk of dizziness, drowsiness, confusion, and impaired coordination.
• Liver strain and potential liver damage.
  • The liver processes alcohol and certain antibiotics. Consuming alcohol while taking antibiotics can stress the liver more and increase the risk of liver damage or toxicity.
• Potential interactions with other medications.
  • If you are taking other medicines alongside antibiotics, alcohol can also interact with those medications. It can heighten the risk of adverse effects or alter the way different drugs are metabolized in the body.
• Increased dehydration.
  • Both alcohol and antibiotics can have a dehydrating effect on the body. Combining them can lead to further dehydration, worsening side effects, and impacting overall health.
• Allergic reactions.
  • While rare, some antibiotics can cause allergic reactions. Alcohol can exacerbate the immune response and increase the risk of allergic reactions when combined with certain antibiotics.

How Long After Taking Antibiotics Can You Drink Alcohol?

If you have antibiotics on schedule and want to drink alcohol, it is generally advisable to prioritize your health and follow the guidance provided by your healthcare provider or pharmacist. However, if you still choose to drink alcohol, here are some points to consider:

• Consult with your healthcare provider.
  • Speak with a pharmacist or a professional healthcare provider about your desire to drink alcohol while on antibiotics. They can offer tailored recommendations based on your situation and the antibiotics you are taking. They may recommend adjusting your medication schedule or giving guidance on the timing and quantity of alcohol consumption.
• Consider the severity of your condition.
  • Assess the severity of your infection or condition for which you take antibiotics. If it is a severe infection that requires prompt and effective treatment, it may be best to abstain from alcohol until you complete the course of antibiotics.
• Moderate alcohol consumption.
  • Suppose your healthcare provider gives you the green light to consume alcohol while on antibiotics. It is crucial to drink in moderation. Stick to low-risk amounts and avoid excessive drinking, as excessive alcohol consumption can further compromise your immune system and overall health.
• Monitor your body’s response.
  • Pay close attention to how your body system reacts to the combination of antibiotics and alcohol. If you experience any concerning symptoms or heightened side effects, stop drinking alcohol immediately and seek medical advice.

NIAAA Harmful Interactions. Mixing Alcohol With Medicines Fact Sheet.

Download the below PDF for a copy of NIAAA’s Harmful Interactions. Mixing Alcohol with Medicines Fact Sheet. The National Institute on Alcohol Abuse and Alcoholism made this file publicly available for downloading to help alcohol use disorder awareness.