Drug Interactions With Alcohol
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Last Updated - 6/17/2022View our editorial policy
Mixing prescription medications with alcohol can be harmful and dangerous. In some cases, this combination can decrease the effectiveness of your prescription and, in others, lead to internal bleeding, overdoses or even death.
What Happens When You Combine Alcohol With Prescription Drugs?
Combining alcohol with prescription drugs is never recommended. This mixture can have severe effects, depending on the medication you take. In some cases, this combination can produce additive effects like extreme drowsiness, dizziness or sleepiness, making driving very unsafe. In other instances, alcohol can decrease the effectiveness and reliability of your prescription medication. In the most severe cases, this combination can result in overdose or even death.
FDA-approved medications are safe and effective when taken as prescribed. However, due to the broad scope of interactions possible after mixing prescriptions and alcohol, doing so is never recommended.
Prescription Drugs That Should Never Be Mixed With Alcohol
Combining certain medications with alcohol can be more dangerous than others. While many more drugs interact with alcohol than listed, it is essential never to mix alcohol and depressants, benzodiazepines, opioids, stimulants and antipsychotics.
Always consult your doctor or pharmacist for more information about your specific situation.
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When antidepressants and alcohol are combined, alcohol can heighten feelings of depression or hopelessness, drowsiness, dizziness or the risk of overdose. Other interactions are specific and depend on the depression medication you take. For example, Cymbalta and alcohol have a higher likelihood of liver damage, and Wellbutrin with alcohol can increase alcohol’s effect.
Depressant medications are usually used for sleep, anxiety, muscle spasms or seizures. These include benzos (Xanax, Ativan, etc.), barbiturates or sleep medications (Ambien, Lunesta, etc.). Alcohol is also a depressant, so using it while on one of these medications can have an additive effect and result in even more drowsiness, dizziness, slow or difficult breathing and increased overdose risk. Because of this, you should never combine these medications.
Benzos are depressants similar to alcohol, so you should never mix these medications with alcohol. If a benzo like Klonopin, Xanax or Ativan is taken with alcohol, they can have an additive effect resulting in even more:
- Higher risk of overdose
- Slow or difficult breathing
- Impaired motor control
- Memory problems
Like benzos, mixing opioids like Percocet or Vicodin with alcohol can have an additive effect and should never be taken together. This combination can cause:
- Higher chance of overdose
- Slow or difficult breathing
- Impaired motor control
- Memory problems
Stimulants are often used to treat ADHD or narcolepsy and include medications like Adderall, Vyvanse or Strattera. However, stimulants can mask the alcohol’s effects and lead to drinking more than usual. The result is dizziness, drowsiness or alcohol poisoning. Other interactions are specific to the stimulant taken and include:
- Trouble concentrating with alcohol and Ritalin, Concerta or Focalin
- Heart problems with alcohol and Adderall, Dexedrine or Vyvanse
- Liver damage with alcohol and Strattera
Like when antidepressants and alcohol are mixed, antipsychotics can also increase drowsiness, dizziness, overdose risk and feelings of depression and hopelessness. Additionally, other interactions depend on which antipsychotic medication is combined with alcohol. For example, Seroquel with alcohol can worsen motor control more than either one alone.
Flu And Cold Medication
Flu and cold medications contain many ingredients to help ease your symptoms when you are sick. However, they can also interact with alcohol in different ways. For example, the antihistamines in some flu and cold medications may make you drowsy, compounding the drowsiness you may feel with alcohol. Meanwhile, acetaminophen in many flu and cold medicines can cause liver damage when taken with alcohol, especially at high doses.
Antihistamines are frequently taken to help ease allergy symptoms but can be problematic when taken with alcohol. Some antihistamines like diphenhydramine (Benadryl) can cause drowsiness, exacerbating the sedation you feel with alcohol and making you very drowsy. Alcohol can also worsen the underlying nasal stuffiness that a person often takes allergy medication to treat.
Over-the-counter painkillers like acetaminophen and ibuprofen can be dangerous to take with alcohol. Alcohol can increase the risk of liver damage when taken with acetaminophen. Further, drinking can increase your bleeding risk when taken with ibuprofen and naproxen.
Prescription painkillers like opioids are also very dangerous to take with alcohol due to the risk of overdose. The FDA includes a boxed warning on opioids to avoid drinking while taking an opioid medication.
Effects of Mixing Alcohol and Illicit Drugs
Mixing alcohol with illicit drugs also carries significant risks. Opiates, like heroin, are central nervous system depressants, as is alcohol. The combination of these substances can lead to respiratory failure or death. Stimulants, like meth and cocaine, can mask alcohol effects which may lead you to drink more than you usually would and heighten alcohol’s effects, possibly even resulting in alcohol poisoning.
Can You Overdose on Alcohol and Medications?
It is possible to overdose on alcohol and medications: your doctor or pharmacist can give you information about your specific medication and the risks of drinking. In some cases, the alcohol can contribute to a medication overdose, as with opioids. If you suspect someone has mixed alcohol and opioids and has overdose symptoms like bluish skin or slowed breathing, call 911.
Long-Term Health Risks of Drinking Alcohol While Taking Medications
In some cases, drinking alcohol while taking medications can lead to long-term consequences. This can include the risk of a disulfiram-like reaction when taking certain drugs like the antifungal/antibiotic metronidazole, which can sometimes be fatal. Drinking while taking opioids can lead to overdose while drinking with common medications like the diabetes drug metformin can lead to a rare but potentially fatal side effect called lactic acidosis. The best way to avoid repercussions from drinking is to ask your doctor or pharmacist if it is safe to drink while taking your medication.
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Frequently Asked Questions
What steps can I take to avoid dangerous drug interactions involving alcohol?
To avoid alcohol-related drug interactions, you should avoid drinking unless your doctor or pharmacist tells you it is OK to drink while taking your medication.
How can I ensure that my medications are safe to take with alcohol?
Your doctor and pharmacist can provide you with information about whether your medications are safe to take with alcohol.
What should I do if I accidentally consume alcohol while taking medication?
If you accidentally drink alcohol while taking medication, it is important not to panic. You should stop drinking and monitor yourself for side effects while the alcohol works its way out of your body. If your doctor or pharmacist has informed you that your medication has a drug interaction with alcohol, you should tell them as soon as possible about the alcohol consumption. Although in some cases, the alcohol may not be a problem, other times, they may need to monitor you or adjust the dose of your medication more closely.
Are there any safe ways to consume alcohol while taking medication?
The safest way to consume alcohol while taking a medication is to first check with your doctor and pharmacist that it is OK to drink while taking the drug. They will inform you whether it is safe to drink and the safest ways to do so.
National Institute on Alcohol Abuse and Alcoholism. “Harmful Interactions.” 2014. Accessed August 5, 2023.
Department of Justice, Drug Enforcement Administration. “Drug Fact Sheet: Depressants.” April 2020. Accessed August 5, 2023.
Deng, Yuzhoujia; Wang, Chengshuo; Shen, Shen; et al. “Effects of Acute Alcohol Intake on Nasal Patency.” American Journal of Rhinology & Allergy, November 29, 2021. Accessed August 5, 2023.
Food and Drug Administration. “Table of Opioid Label Changes.” Accessed August 5, 2023.
Drugs.com. “Ethanol and metronidazole Interactions.” Accessed August 5, 2023.
Drugs.com. “Ethanol and metformin Interactions.” Accessed August 5, 2023.