-small-thumbnail.jpg?v=1731071636)
Approximately 65% of adults in America drink alcohol at least occasionally, and alcohol use is more common in men, younger adults, and White people. Those who drink consume an average of 4 drinks per week, although there is considerable variation between individuals.[1]
With such widespread use, inevitably, some people looking to drink alcohol will also be taking some form of prescription or over-the-counter drugs. Some of these medicines may coexist well with alcohol, but others can interact in dangerous ways.
- Taking alcohol and other drugs at the same time can change how the body metabolizes both substances. Alcohol can also change how the body reacts to certain drugs.
- The risks of taking alcohol and other medications at the same time vary significantly between drugs but may include liver damage, impaired breathing and respirations, gastrointestinal bleeding, and nausea or vomiting.
- Alcohol shouldn’t be consumed at the same time as other drugs unless you have been told by your medical practitioner that it is safe to do so. If you are unsure, it is best to abstain from alcohol while taking other medications.
.jpg?v=1739966486)
How alcohol interacts with medications
Since alcohol is so common, it is easy to forget that it is a drug and has effects on the body, even at small or moderate doses.
Alcohol can alter how medications are processed (metabolized) within the body, which increases or decreases the amount of that medication in the blood.[2] These interactions can be equivalent to taking too much of the drug (risking increased side effects or overdose) or too little (rendering it ineffective).
The interactions can also exist in reverse, where a medication slows down the body’s ability to metabolize alcohol. This can lead to a higher blood alcohol concentration than what is expected for the amount of alcohol consumed.
Finally, alcohol can change how the body reacts to other medications. This can cause new or increased side effects, which can potentially be lethal.
Here are some common drug categories and how alcohol can interact with them:
- Central nervous system (CNS) depressants: decreased breathing and respiration
- Over-the-counter pain relievers: liver damage and gastrointestinal bleeding
- Blood thinners: reduced blood pressure and increased bleeding risk
- Antibiotics: liver damage, nausea and vomiting, and reduced drug effects
Alcohol interactions with specific medications
The interactions between alcohol and other drugs vary widely. It’s also not directly related to whether a drug is available over-the-counter (OTC) or requires a prescription. Alcohol can be safely taken in moderate amounts with some prescription medications, while it is dangerous when combined with others; similarly, it may not cause interactions with some OTC drugs, but with other OTC medications, alcohol should be avoided.
Always read the labels of any medications you are taking, paying close attention to the instructions for use, contraindications, and interactions.
Here’s how some of the most common drugs can interact with alcohol.
1. Ibuprofen and alcohol
Ibuprofen is a non-steroidal anti-inflammatory drug (NSAID). It is available over-the-counter for pain relief, often under the brand names Advil, Midol, or Motrin.
It is generally considered safe to drink in moderation while taking ibuprofen but both substances can irritate the stomach lining which can sometimes lead to gastrointestinal bleeding.[3]
Taking large doses of alcohol and ibuprofen can cause strain on the liver and kidneys.[4][5]
2. Acetaminophen (Tylenol) and alcohol
Acetaminophen, also known as paracetamol, is the most common over-the-counter painkiller in the US.[2] It is best known under the brand names Tylenol or Panadol.
It is generally safe to consume moderate amounts of alcohol at the same time as taking moderate amounts of acetaminophen. If either substance is used to excess, however, there is the risk of severe liver damage.[6] Also, because acetaminophen and alcohol are both metabolized by the liver, those with liver dysfunction should usually not take either one and taking them together can cause severe liver problems.
3. Prednisone and alcohol
Prednisone is a corticosteroid commonly prescribed for a range of conditions, including allergies, autoimmune diseases, and inflammation.
There are no direct interactions between alcohol and prednisone, so the FDA doesn’t include any warnings about taking the two at the same time within the prescribing information. [7]
There are some concerns about combining the two substances, however, as they can each reduce the immune response and increase blood sugar.[8][9] Anyone planning to drink alcohol while taking prednisone should discuss this with their doctor.
4. Amoxicillin and alcohol
Amoxicillin is a penicillin-based antibiotic used to treat a wide range of bacterial infections. It does not interact with alcohol, but both substances can have negative effects on the digestive system.[10][11]
5. Doxycycline and alcohol
Doxycycline is an antibiotic used to treat a variety of bacterial infections. It can also be used as a preventative medicine against malaria.
The FDA does not suggest that patients taking doxycycline should avoid alcohol in its labeling, and evidence on combining them is limited.[12] There is evidence that alcohol can reduce the effectiveness of doxycycline, however, so it should still be avoided during treatment. Alcohol and doxycycline can each cause gastrointestinal upset as well.[10]
6. Escitalopram (Lexapro) and alcohol
Escitalopram is a selective serotonin reuptake inhibitor (SSRI), which can be used to treat major depressive disorder and generalized anxiety disorder. It is commonly known under the brand name Lexapro.
The FDA does not recommend taking alcohol at the same time as antidepressant medications, including escitalopram, because of the negative effect this can have on mood and the increased risk of suicidal thoughts.[13]
7. Bupropion (Wellbutrin) and alcohol
Bupropion, commonly known by the brand name Wellbutrin, is an antidepressant, and it is also used to help patients stop smoking.
Alcohol consumption should be limited or avoided when taking bupropion due to the risk of seizures and the effect bupropion has in reducing alcohol tolerance. [14] However, patients who use alcohol heavily should not stop or dramatically reduce their alcohol use immediately before taking bupropion, as this can also increase the risk of seizures. Discussions with a medical practitioner are essential in this situation.
8. Sertraline (Zoloft) and alcohol
Sertraline is another SSRI that is often used to treat depression, obsessive-compulsive disorder (OCD), posttraumatic stress disorder (PTSD), and some anxiety disorders. It is offered under the brand name Zoloft.
Sertraline does not usually interact chemically with alcohol.[15] In fact, the oral solution version of sertraline contains alcohol. Despite this, as is the case with other antidepressants, drinking alcohol is not recommended while taking sertraline due to the effect it can have on mood and suicidal thoughts.
9. Trazodone and alcohol
Trazodone is also an antidepressant, although it works differently than an SSRI. It can be used to treat depression or insomnia because one of its main side effects is sedation. Trazodone and alcohol can intensify the effects of each other. [16] Taking them together can increase significant side effects, such as sleepiness or dizziness.
Talk to your doctor before drinking alcohol while taking trazodone.
10. Gabapentin and alcohol
Gabapentin was originally developed as a muscle relaxant and an anticonvulsant, but it is now also used for nerve pain and off-label for alcohol withdrawal, anxiety, and depression.[17]
Drinking alcohol while taking gabapentin can also increase notable side effects, like sleepiness or dizziness.[18] Talk to your doctor before drinking alcohol while taking gabapentin.
11. Adderall and alcohol
Adderall is an amphetamine used to treat attention deficit hyperactivity disorder (ADHD) and narcolepsy.
The FDA does not include specific warnings about drinking alcohol while taking Adderall in its labeling, but there have been reports of heart attacks in healthy people who have combined the two substances.[19][20] It is advisable not to drink while taking Adderall.
12. Alprazolam (Xanax) and alcohol
Alprazolam is a benzodiazepine used to treat anxiety disorders and panic disorders. It is marketed under the brand name Xanax.
As with all benzodiazepines, alcohol is not recommended with alprazolam.[21] Alcohol and benzodiazepines act as CNS depressants. Combining the two can dangerously suppress breathing and lead to potential overdose.
13. Cyclobenzaprine and alcohol
Cyclobenzaprine is a muscle relaxant used to treat muscle spasms. It is sometimes used to promote rest.
Cyclobenzaprine and alcohol can increase the effects of each other, so it is advisable not to consume any alcohol until you know how your body reacts to the drug. [22]
How to stay safe
If you are not sure whether you can consume alcohol with your medications, the safest option is to abstain, either until you have finished your course of medicine or have received confirmation from your doctor that it is safe to do so.
Even if a particular medicine does not interact dangerously with alcohol, it is generally advised to limit alcohol intake to moderate levels when you are taking other drugs. Alcohol reduces your sleep quality and lowers your immune responses, which may slow the recovery from other conditions.[23]
Moderate drinking is defined as no more than two alcoholic drinks per day for men and no more than one per day for women.[24]
When to seek medical help
Because of the variety of different possible combinations, the symptoms of a drug interaction with alcohol vary considerably. Nausea, stomach upset, dizziness, or sleepiness are all relatively common interaction effects, but you should always contact your doctor if these are more than mild in severity.
Serious interactions between alcohol and other substances include seizures, very low heart rate or breathing rates, and unconsciousness or coma. In the event of any of these symptoms, call 911 immediately for urgent assistance.
Where possible, tell emergency responders all medications the person has been taking and how much alcohol they have consumed.
-guide-detail.jpg?v=1722501965)
-guide-detail.jpg?v=1722501423)