Contents

Can I drink alcohol while taking antibiotics?

When to avoid drinking alcohol completely

Completely avoid drinking alcohol when taking:

  • metronidazole – an antibiotic sometimes used to clear dental or vaginal infections, or to clear infected leg ulcers or pressure sores
  • tinidazole – an antibiotic sometimes used to treat many of the same infections as metronidazole, as well as to help clear bacteria called Helicobacter pylori (H. pylori) from the gut

Alcohol can cause a serious reaction when combined with these medications. Symptoms of this reaction can include:

  • feeling or being sick
  • tummy pain
  • hot flushes
  • a fast or irregular heartbeat
  • headaches
  • dizziness
  • drowziness

Because of this risk, you should avoid alcohol while you’re taking these medications. You should continue to avoid alcohol for 48 hours after you stop taking metronidazole and 72 hours after you stop taking tinidazole.

Things like mouthwash and other medicines sometimes contain alcohol, so you should also avoid using these while you’re taking metronidazole or tinidazole.

There’s a good reason you shouldn’t drink alcohol while you’re on antibiotics — but it’s probably not what you’ve been told

  • Alcohol and antibiotics are two things most people know not to mix. However, the truth is more complicated.
  • Although drinking while taking most antibiotics doesn’t pose a health risk, it can slow down your healing and lead to unpleasant side effects.
  • Some antibiotics should never be taken with alcohol due to dangerous reactions.

You’ve probably heard that you shouldn’t drink while on antibiotics. While it’s technically a myth that having a sip of something strong while treating an infection always poses a serious risk to your health, there are reasons to avoid mixing booze and antibiotics.

Here are the facts about why and when you should abstain from alcohol while on antibiotics.

First of all, you’re not going to immediately drop dead if you have a drink while on antibiotics.

Your doctor will likely caution you to avoid alcohol while you’re taking your course of antibiotics, but forgetting and having one glass of wine with dinner isn’t going to be the end of you.

According to the UK’s National Health Service, “it’s unlikely that drinking alcohol in moderation will cause problems if you’re taking most common antibiotics.”

Similarly, senior lecturer of medical sciences at The University of Adelaide Dr. Ian Musgrave told HuffPost, “for the vast majority of antibiotics, you don’t have to worry. Seriously, for most antibiotics, it doesn’t matter. Outside of — if you drink too much and then you won’t remember to take your antibiotics — which can then be a problem.”

This misconception was reportedly started by doctors in the 1950s to keep patients from having sex.

They tried to deter Netflix For real, according to Karl S. Kruszelnicki in ABC Science. When penicillin was first used to treat sexually transmitted infections in the 1950s, doctors considered it something of a miracle drug. However, there wasn’t a lot of understanding amongst patients about how antibiotics and STIs worked.

To keep patients from having sex immediately and give the antibiotics a chance to clear them of disease, Kruszelnicki said doctors warned them to not take the drugs with alcohol. The thought was the drinking would make the patients friskier, and that friskiness would lead to them reinfecting their partners or spreading the disease.

But in reality, drinking while taking antibiotics can make you feel even sicker.

Although combining happy hour with antibiotics isn’t going to create some lethal chemical reaction inside you, it will up your chances of experiencing negative side effects from both drugs. Because yes, alcohol is a drug.

According to the Mayo Clinic, many antibiotics can cause side effects like drowsiness, nausea, dizziness, and upset stomach. As you might have noticed, these are also side effects of alcohol consumption. Add in the fact that you’re likely taking antibiotics because you’re already unwell, and that’s a recipe for not feeling awesome after a night out.

“While antibiotics may not interfere with the absorption or action of most antibiotics, you’re nuts to do this. If you’re sick enough to be on antibiotics, you’re too sick to consume alcohol,” chair of Berkeley Wellness’ editorial board Dr. John Swartzberg told Thrillist.

Though alcohol won’t stop your antibiotics from working, it could stall your healing in other ways.

It could potentially make you feel sicker for a longer period of time. FOX Most antibiotics will remain effective if you indulge in modest alcohol consumption. However, that doesn’t mean that you’ll get better just as fast as if you hadn’t gone out for drinks.

There is clinical evidence that alcohol can slow wound healing and recovery from illness. One study suggested that drinking may affect wound healing and lead to impaired tissue repair and another study showed that alcohol may impact immunity and the body’s ability to heal from infections. Further research has given evidence that ethanol intoxication, i.e. being drunk, can increase the risk of infection following abdominal trauma.

Essentially, alcohol can keep you sicker for longer. If you don’t want to draw out your illness, consider skipping the booze.

Certain antibiotics can cause a serious reaction if mixed with alcohol.

Though most antibiotics won’t cause any blatantly terribly effects if taken with alcohol, some definitely will.

Drinking alcohol while on certain antibiotics will cause you to have an almost immediate and horrible reaction.

Metronidazole is a common antibiotic used to treat some dental and vaginal infections like bacterial vaginosis and pelvic inflammatory disease. You might also be prescribed this drug if you have rosacea. Tinidazole treats many of the same infections and can eliminate certain kinds of parasites.

If you drink while taking either of these drugs, you’re putting yourself at risk of severe nausea, vomiting, and diarrhea. These effects can be serious enough to land you in the hospital for dehydration and heart palpitations.

Taking trimethoprim-sulfamethoxazole, also known as Bactrim or Septra, can also lead to rapid heart rate and severe nausea when mixed with alcohol.

Mixing erythromycin with drinks can lead to heightened intoxication, or getting much drunker than you expected in a much shorter time frame. This is due to erythromycin’s tendency to cause faster gastric emptying, which leads to more alcohol absorption. This can lead to lethal alcohol poisoning.

Interestingly, the antibiotic disulfiram causes such intolerable symptoms when taken with alcohol that the drug is actually used as a treatment for alcohol abuse.

Although taking most antibiotics alongside a beer isn’t going to kill you, it can lead to unpleasant side effects that go beyond a normal hangover. Ultimately, you should probably just rest up.

For more great stories, head to INSIDER’s homepage.

Is it Safe to Drink Alcohol While Taking Antibiotics?

It’s a question often put to GPs (and, we’d wager, to Google), particularly when the patient receiving treatment has a holiday or a social event coming up:

Can you drink alcohol if you’re taking antibiotics?

Alcohol should be strictly avoided when taking certain types, as we’ll discuss below.

However, it’s better not to drink alcohol at all if you’re unwell, or taking antibiotics of any kind.

Abstaining from alcohol consumption will give your body less work to do, enable you to get a decent night’s sleep, and facilitate the recovery process.

On the more specific question of:

Can alcohol and antibiotics interact?

Yes.

There are certain antibiotics which can be directly affected by alcohol.

Drinking alcohol while taking these may alter the way the drug is metabolised in the body, and this can mean the drug won’t work as well.

It may also increase the risk of an adverse reaction. Taking antibiotics on their own can cause side effects, but drinking alcohol while taking antibiotics can increase the likelihood of these, or make them worse.

On this page we’ll talk about which antibiotics in particular are known to interact with alcohol, how such interactions might occur in the body, and what to do if you’re taking antibiotics and aren’t sure.

Antibiotics known to cause interactions

Whether or not you can drink alcohol while taking antibiotics mostly depends on the antibiotic being used. NHS Choices advises that, with some common antibiotics, drinking alcohol in moderation is not likely to cause significant issues.

(‘Moderation’ means staying within the lower risk limits as specified by Public Health England. In short:

  • men and women should consume no more than 14 units of alcohol per week;

and:

  • if someone does drink 14 units in a week, they should spread this out over at least three days;
  • and have several alcohol free days each week)

However, as they point out, and as we’ll discuss here, there are certain antibiotics which are known to interact with alcohol, and mixing alcohol with these can pose a risk of serious side effects.

For example, if you’re taking:

  • Metronidazole, or
  • Tinidazole

you should avoid drinking any alcohol at all.

Metronidazole (also known as Flagyl) and Tinidazole (also known as Fasigyn) are used to treat some types of vaginal infections (such as trichomoniasis), dental infections, and some infected ulcers. Tinidazole is also sometimes used in the treatment of gut conditions caused by a type of bacteria called H. pylori.

When taking these antibiotics, you should also refrain from using any cough medicines or mouthwash products which also contain alcohol.

Furthermore:

  • In the case of Metronidazole, you should stay off alcohol until 48 hours after finishing the course.
  • If you’re taking Tinidazole, you should stay off alcohol until 72 hours after you finish taking it.

Mixing alcohol with these particular medications can cause severe and potentially harmful reactions, which may be characterised by:

  • pain in the chest
  • flushing
  • irregular or fast heartbeat
  • feeling or being sick
  • headaches
  • or loss of breath

There are other antibiotics which have been known to cause reactions when mixed with alcohol; so it is recommended that you avoid drinking alcohol if you are taking them.

These include:

  • Co-trimoxazole (which contains Trimethoprim and Sulfamethoxazole)
  • Doxycycline
  • Erythromycin
  • and Linezolid

Co-trimoxazole, used to treat a range of conditions including lung and bladder infections, may in some cases cause a reaction like the one described above when consumed with alcohol; and both Doxycycline and Erythromycin may not be as effective when mixed with alcohol.

How does alcohol interact with them?

There are several ways in which alcohol can disrupt the way antibiotics work.

Alcohol is processed in the body by liver enzymes, as are some antibiotic drugs. When both antibiotics and alcohol are consumed over the same period, alcohol takes up enzyme capacity, which means the antibiotic may not be broken down properly. This may mean that the drug doesn’t metabolise in the way it should, and therefore doesn’t work as well.

It may also mean that, because the antibiotic cannot be broken down and excreted sufficiently, higher levels of the drug remain in the body, which in turn increases drug toxicity, and the likelihood of side effects.

What if I’m not sure?

In some cases, your doctor will tell you to avoid alcohol when issuing a course of antibiotics. If they don’t specify, or if you want to know whether you can drink alcohol when taking a certain drug, ask them.

However, for reasons already explained above, the best thing to do when taking antibiotics of any kind is not to drink alcohol at all until you’ve finished the course, and you’re better. This will help to give your body the rest it needs and increase the likelihood of a speedy recovery.

Share Tweet

Can you drink alcohol with antibiotics (amoxicillin)?

E.g. beer or wine

Medically reviewed by Drugs.com Last updated on Aug 27, 2018.

Official Answer

by Drugs.com

Yes, you can drink alcohol while taking the antibiotic amoxicillin. The alcohol will not stop amoxicillin from working. Moderation is key.

However, many health professionals will recommend you avoid alcohol to give your body the best chance possible to fight the infection.

There are certain antibiotics where alcohol must be avoided such as Metronidazole, Tinidazole and Bactrim because the combination may result in a severe reaction. Drinking any amount of alcohol with these medications can result in side effects such as flushing, headache, nausea and vomiting, and rapid heart rate.

There are no such side effects issues when alcohol is taken with amoxicillin.

For a list of the most significant antibiotics that interact with alcohol see the table here:

Or look up your antibiotic in the interactions checker here:

Related Drug Information

  • Amoxicillin Drug Information

Other Medical Questions

  • Can penicillin treat chlamydia?
  • Can I drink alcohol while taking amoxicillin?
  • What is the normal daily dose of 500mg amoxicillin capsules for chest infections?
  • Can amoxicillin be used to treat a bacterial vaginitis infection?
  • What is the recommended dosage of amoxicillin for a 14 year old child?
  • How often should I take amoxicillin for a sinus infection?
  • How many times a day should a male adult take amoxicillin 500mg for an ear infection?
  • Side effects – can you safely consume alcohol while taking amoxicillin clavulanate?
  • If I am allergic to penicillin, is it safe to use amoxicillin?
  • If people are allergic to amoxicillin can they take cephalexin?
  • Amoxicillin – does it have sulfa or penicillin in it?
  • If I can not take penicillin, is amoxicillin the same or do I need to avoid it?
  • Are there any foods I should avoid while taking amoxicillin?
  • What is the best antibiotic to treat strep throat?
  • Can you take antibiotics while pregnant?
  • What antibiotics are used to treat pneumonia?
  • Does amoxicillin expire? Is it safe to take after expiration?
  • What’s the difference between amoxicillin and penicillin?

Although metronidazole is not used to fight alcohol abuse, it remains a critical drug for the treatment of various gastrointestinal infections, including diverticulitis, and in the treatment of gynecologic conditions and sexually transmitted diseases. It is safe and effective, with the caveat that one must avoid alcohol while taking it.

A few other antibiotics have also been reported to cause reactions with alcohol. Most of these are cephalosporins, a class of broad-spectrum antibiotics that are used to treat a variety of infections. Yet, while there are many cephalosporins, only a handful have been reported to cause this reaction.

The vast majority of antibiotics do not interact with alcohol. The Food and Drug Administration’s product information for the five most frequently prescribed antibiotics in the United States — amoxicillin (Amoxil), azithromycin (Zithromax), amoxicillin-clavulanate (Augmentin), cephalexin (Keflex) and ciprofloxacin (Cipro) — does not carry warnings about alcohol consumption. Similarly, over-the-counter cough and cold products that contain alcohol do not warn against use with antibiotics. While there are no studies proving that it is safe to consume alcohol while taking these antibiotics, the potential for serious interactions seems low.

Nevertheless, it may be a good idea to avoid alcohol while fighting an infection, since alcohol can interact with many drugs other than antibiotics and irritate an already inflamed stomach lining. The F.D.A. generally advises that patients “should talk to your doctor about any alcohol you use or plan to use.”

Do you have a health question? Ask Well

How Bad Is It to Have a Drink While on Antibiotics?

Getty Images

Q: Is it so terrible to have a glass of wine while on antibiotics?

With a few antibiotics in particular, it is a pretty big deal. Metronidazole, tinidazole, and trimethoprim-sulfamethoxazole should never be mixed with any amount of alcohol because the combo can cause an unpleasant reaction, which may include headache, flushing, a rapid heartbeat, nausea, and vomiting. (FYI: Some cold medicines have alcohol in them, so read labels carefully.)

As for other antibiotics, sipping a small amount of alcohol generally won’t hamper their effectiveness, though some folks may find that the drugs’ usual side effects (upset stomach, dizziness, drowsiness) are enhanced by alcohol.

But there are legitimate reasons why many doctors often warn against mixing the two. If that one drinks turns into several, the excess alcohol can depress your immune system and leave you tired and dehydrated. So if you’re sick enough to need antibiotics, you’re not helping your chances of getting better quickly by downing a glass of wine. Sorry to be a buzzkill!

Health’s medical editor, Roshini Rajapaksa, MD, is assistant professor of medicine at the NYU School of Medicine.

Can you drink alcohol with antibiotics?

Finally! The weekend is here and you are ready to kick back with a few libations. But wait—you’re still working through that course of antibiotics your doctor prescribed last week after your (insert name of pesky infection here) diagnosis. Is drinking alcohol safe? Or should you wait until you’ve completed the regimen and are officially infection free?

Effects of alcohol on infections

For the sake of your recovery it is probably better to just skip the vino and volunteer for designated driver duty instead, says Brian Werth, Pharm.D., an assistant professor at the University of Washington School of Pharmacy in Seattle.

“Alcohol has immunosuppressive effects, and it can prevent your ability to fight the infection you are taking the antibiotics for,” Dr. Werth says. “And it can make certain side effects of antibiotics worse.”

He’s talking side effects like upset stomach, nausea, vomiting, diarrhea, and dehydration, which are common side effects among most—if not all—antibiotics.

“If you are throwing alcohol into the mix … you can get sort of a compounding of these issues,” he says, adding that this could ultimately prolong your recovery.

Furthermore, according to the National Sleep Foundation, alcohol consumption can interfere with sleep quality. And since sleep is so important to the healing process, it is probably best to avoid anything that will keep you from getting enough ZZZs while your immune system is working on fighting that bacterial infection.

Is it safe to mix antibiotics and alcohol?

In terms of actual safety, the good news is that there is not a direct contraindication between alcohol use and most antibiotics. However, the keyword here is most. Common antibiotics like amoxicillin and azithromycin, for example, aren’t contraindicated (according to the Centers for Disease Control, out of 270.2 million antibiotic prescriptions written in 2016, 56.7 million were for amoxicillin and 44.9 million were for azithromycin). But some others are, and mixing them with alcohol could be risky, Dr. Werth says.

Which antibiotics can you not drink alcohol with?

“There are specific antibiotics that have a direct interaction with the alcohol metabolism pathway,” he says. “And those are the ones that pose the biggest risk of having a direct negative impact with co-administration with alcohol.”

The drugs in question? Flagyl (metronidazole; this includes prescriptions for vaginal forms as well as oral tablet form), Tindamax (tinidazole), Bactrim (sulfamethoxazole-trimethoprim) and Zyvox (linezolid) are the main offenders. You’ll need to avoid alcohol and products containing alcohol while you take these medications, plus for several days after when taking metronidazole or tinidazole.

Be sure to check labels for hidden sources of alcohol; mouthwashes or cough medicines may contain alcohol. Your pharmacist is a great resource if you need help!

Side effects of alcohol with antibiotics

However, in the event that you do wind up with a prescription for one of these, be aware that mixing these antibiotics and alcohol can cause some severe drug interactions, which could lead to: liver damage, high blood pressure, rapid heart rate, flushing of the skin, drowsiness, dizziness, and headaches. Some antibiotics, like Zyvox, may have a worse reaction to certain types of alcohol, like tap beer or red wine. For these reasons, drinking any amount of alcohol should be completely avoided while taking these medications, according to the Mayo Clinic.

Of course, these are just general guidelines. Speaking directly to your own doctor or pharmacist about your own specific prescription is always recommended. And most importantly, if you suspect you are experiencing a medication interaction it never hurts to call your doctor, Dr. Werth says.

“If someone is feeling really bad, it might be worth getting checked out,” he says.

Women who are in the early stages of pregnancy, and who are not ready to share the happy news, know that turning down an alcoholic drink at a social occasion can be a dead giveaway. Telling friends and colleagues they are on antibiotics is the perfect excuse because they are so commonly used. Even the nosiest of acquaintances is unlikely to ask what they are being taken for.

But is it really true that you need to abstain from alcohol when on a course of antibiotics?

Some people assume that alcohol will stop antibiotics from working properly, while others believe that it will cause side-effects. When staff in a London genitourinary clinic surveyed more than 300 patients they found that 81% believed the former assumption, with 71% believing the latter.

For most antibiotics neither of these assumptions is true. The fear for doctors is that these erroneous beliefs might make patients skip their medication over a glass of wine. Anything that encourages people to miss doses of antibiotics adds to the serious problem of antibiotic resistance.

In fact, the majority of the most commonly prescribed antibiotics are not affected by alcohol. There are some exceptions. The antibiotic cephalosporin cefotetan slows alcohol breakdown, leading to a rise in levels of a substance called acetaldehyde. This can cause a host of unpleasant symptoms including nausea, vomiting, facial flushing, headache, breathlessness and chest pain. Similar symptoms are caused by a drug called disulfiram, sometimes used in the treatment for alcohol dependency. The idea is that the moment a patient has a drink, they experience these unpleasant symptoms, and this dissuades them from drinking more. The symptoms are unpleasant, so it is important that people abstain from alcohol while they’re taking these particular antibiotics, and for a few days afterwards.

Another type of antibiotic that comes with a specific warning not to take alongside alcohol is metronidazole. Used to treat dental infections, infected leg ulcers and pressure sores, it’s thought to cause the same list of symptoms as the previously mentioned cephalosporins. This link has been disputed since a 2003 review of studies found a lack of evidence to support it, and a very small controlled study in which Finnish men given metronidazole for five days suffered no side effects when they consumed alcohol. The authors concede that this doesn’t rule out the possibility that a few individuals are affected, and the current advice is still to avoid alcohol when taking it.

There are a few other antibiotics for which there are good reasons to avoid drinking alcohol while taking them, including tinidazole, linezolid and erythromycin, but these interactions are so well-known that doctors give patients specific warnings.

Recycled tale

This leaves a long list of other antibiotics that can be mixed with alcohol. Of course getting drunk is not going to help your recovery when you’re ill. It can make you tired and dehydrated, but it’s not because of any interaction with your medication.

It’s possible that the isolated cases led to the myth that all antibiotics don’t mix with alcoholic drinks, but there are two more intriguing theories. One is that because antibiotics are used to treat some of the most common sexually transmitted diseases, doctors in the past were somehow punishing the patients for becoming infected by depriving them of their favourite tipple.

Or there’s the explanation given to one of the authors of the London genitourinary clinic survey. James Bingham met the late Brigadier Sir Ian Fraser, who introduced the use of penicillin for injured soldiers in North Africa during World War II. At the time penicillin was in such short supply that after a patient had taken it, the drug was retrieved from his urine and recycled. Recuperating soldiers were allowed to drink beer, but unfortunately this increased the volume of their urine, making it harder obtain the penicillin and, according to the Brigadier, led commanding officers to ban beer.

It’s a good story, irrespective of whether or not it is the true source of the popular misconception. Dispelling the myth is something of a double-edged sword. Encouraging those on the antibiotics who cannot resist a glass or two to complete their courses of treatment could help counter the spread of antibiotic resistance. However greater public understanding of the true picture may mean that women wanting to keep their early pregnancies to themselves in social situations may have to be a little more inventive in future.

If you would like to comment on this article or anything else you have seen on Future, head over to our Facebook page or message us on Twitter.

You can hear more Medical Myths on Health Check on the BBC World Service.

Disclaimer
All content within this column is provided for general information only, and should not be treated as a substitute for the medical advice of your own doctor or any other health care professional. The BBC is not responsible or liable for any diagnosis made by a user based on the content of this site. The BBC is not liable for the contents of any external internet sites listed, nor does it endorse any commercial product or service mentioned or advised on any of the sites. Always consult your own GP if you’re in any way concerned about your health.

What happens when you mix alcohol and antibiotics?

Different antibiotics react differently with alcohol. Some are very dangerous, while others have no effect.

Written by SpunOut | View this authors Twitter page and posted in health

Share this article –

People often assume that when they are on antibiotics that they can’t drink alcohol. Some antibiotics are dangerous when mixed with alcohol, while some have less severe side effects. If you are put on antibiotics speak to your doctor about the side-effects and whether or not you are allowed to drink alcohol while taking them. They will know what is best for you to do.

However, drinking alcohol when you are sick is usually not a good idea because alcohol affects your body negatively by impacting your immune system, sleep and health.

Can you mix alcohol and antibiotics?

Whether you can mix alcohol and antibiotics really depends on what kind of antibiotic you are taking. Each antibiotic is a different drug with different effects on your body.

Does the kind of antibiotic matter?

Mixing some kinds of antibiotics with alcohol can be very dangerous, others aren’t affected by alcohol at all. It is important to talk to your doctor or pharmacist about it and to find out if it is possible to drink alcohol on the antibiotics that you are on.

What happens when you drink alcohol on antibiotics?

Mixing alcohol and antibiotics can potentially have a variety of side effects. Some antibiotics can have dangerous side effects such as rapid heart rate, increased blood pressure and liver damage. Others side effects include a red and hot face and neck or flushing, excessive sweating, dizziness, headache, nausea and stomach issues.

Similarly common side effects of alcohol such as stomach problems, tiredness or headaches may be made worse by taking antibiotics at the same time.

You should never drink alcohol while you are taking any of the following antibiotics:

  • Isoniazid
  • Linezolid
  • Metronidazole
  • Tinidazole
  • Cefoperazone
  • Cefotetan
  • Ketoconazole
  • Doxycycline
  • Erythromycin
  • Griseofulvin (antifungal medication)

Isoniazid and linezolid

Drinking alcohol while taking these antibiotics can cause dangerous side effects such as:

  • liver damage
  • high blood pressure

These antibiotics are available as generic drugs. The branding and packaging may vary.

Metronidazole, tinidazole, cefoperazone, cefotetan, and ketoconazole (antifungal)

Mixing alcohol and these antibiotics can cause:

  • fast heartbeat
  • nausea
  • vomiting
  • flushing
  • headache
  • stomach cramps

Avoid drinking alcohol before, during, and up to three days after taking these.

Possible brand names of these antibiotics might include: Flagyl, Tindamax, Fasigyn, Simplotan, Cefobid, Apatef and Nizoral. They may be marketed as different brand names too.

Griseofulvin (antifungal)

Drinking alcohol while taking this medication can cause:

  • fast heartbeat
  • flushing
  • excessive sweating

Possible brand names of this include Gris-peg and Grifulvin but there may be others as well.

Doxycycline and erythromycin

Drinking alcohol while taking these antibiotics may make them less effective.

Both of these drugs are available as generic drugs. The branding and packaging may vary.

Alcohol and recovering from illness

Drinking alcohol while you are sick, regardless of what antibiotics you are on, might slow down your recovery.

Alcohol and sleep

Sleep is essential for recovering from an illness and alcohol can have a negative impact on the quality of sleep that you have.

Alcohol and nutrition

Eating healthily is also an important part of getting better. Alcohol is a sugar and has no nutritional value. Sugar puts your body, including your immune system, under pressure. Alcohol also prevents your body from absorbing some vital nutrients and slows down the process of converting fat into energy.

For more on looking after yourself when taking antibiotics have a look at our article about probiotics.

Combining Antibiotics and Alcohol: Is It Safe?

Interactions

Alcohol doesn’t make antibiotics less effective, but consuming alcohol — especially if you drink too much — might increase your chance of experiencing certain side effects.

You should never consume alcohol while taking any of the following antibiotics:

  • cefoperazone
  • cefotetan
  • doxycycline
  • erythromycin
  • metronidazole
  • tinidazole
  • ketoconazole
  • isoniazid
  • linezolid
  • griseofulvin

Combining these antibiotics and alcohol can cause a potentially dangerous reaction.

Metronidazole, tinidazole, cefoperazone, cefotetan, and ketoconazole

Drinking alcohol while taking these drugs can cause:

  • nausea
  • vomiting
  • flushing
  • headache
  • fast heartbeat
  • stomach cramps

Don’t drink alcohol before, during, or up to three days after taking these drugs.

Griseofulvin

Drinking alcohol while taking this medication can cause:

  • flushing
  • excessive sweating
  • fast heartbeat

Drinking alcohol with these medications can cause side effects such as:

  • liver damage
  • high blood pressure

Drinking alcohol while taking these antibiotics may make them less effective.

General side effects

The specific side effects that an antibiotic can cause depends on the drug. However, some common side effects of antibiotics include:

  • nausea
  • sleepiness
  • dizziness
  • lightheadedness
  • diarrhea

Alcohol can also cause side effects. These include:

  • an upset stomach
  • digestive problems, such as stomach pain, diarrhea, and ulcers
  • tiredness

Signs of a negative alcohol-antibiotic reaction include:

  • flushing (reddening and warming of your skin)
  • severe headache
  • racing heart rate

In most cases, these side effects go away on their own. If you think you’re having a medical emergency, call 911 or your local emergency services number immediately.

What to do

The warning label on your antibiotic should include information about alcohol use.

Talk to your doctor or pharmacist if you’re unsure about the details of your medications. They may tell you that an occasional drink is OK. But that likely depends on your age, overall health, and the type of drug you’re taking.

If your doctor tells you that you shouldn’t drink alcohol, ask how long you should wait before drinking again. You may need to wait at least 72 hours after finishing your course of antibiotics before having any alcohol.

Listening to your doctor or pharmacist’s advice can help you avoid the effects of an alcohol-drug interaction.

Other Qs & As

Antibiotics and vaccines

Can adults get mumps

Can an inner ear infection damage my brain?

Can collidial silver cure molluscum?

Can I drink while taking antibiotics?

Could I have psitticosis?

Czech tick – what is this insect buried in my leg?

Do I have to take antibiotics against cystitis?

Does doxycycline affect hearing?

Enlargements around the neck

Erythema mulitforme – cause and prevention

Have I got bedbugs?

Homeopathic treatments for verrucas

How long does a BCG last?

I want to live in India, but I’ve had a spleenectomy.

Long term antibiotics after spleen operation

Laporoscopy stitches not healing properly

Painful reaction with travel jabs

Post-polio syndrome

Receding gums

Recurrent infections under my fingertips

Should I get a hepatitis vaccination?

Should my father have his wrists fused?

Stubborn verrucas

Throat infections for four months – what can I do?

Treating persistent giardia

What are the early signs of BSE?

What are the long-term consequences of a splenectomy?

What is a pilonidal sinus?

What is ESR?

What is giardia infection?

What is giardia lamblia?

What is phlebitis?

What is slapped cheek disease?

What issues surround rubella in the middle aged?

What would raised blood urea nitrogen be like?

What’s the difference between pneumonia and pleurisy?

Which vaccinations should I have?

Who’s got the worm?

Why is my stepson passing blood in his urine?

Why haven’t I responded to the hepatitis B vaccine?

Will L-lysine ease my cold sores?

Yellow fever

Can You Drink Alcohol While Taking Antibiotics?

Photo: Fahroni /

It’s common sense to be careful about the interactions of prescription medication, and most people are at least vaguely aware of the advice to not drink alcohol while taking antibiotics. To be fair, when you’re feeling miserable with the cold or flu, it’s likely that the *last* question on your mind is where’s the tequila? But people take antibiotics for plenty of other issues-acne, UTIs, skin infections, and more. What most people ~can’t~ tell you, though, is exactly why you’re not supposed to consume alcohol while taking antibiotics. (BTW, it looks like you may not need to complete a full course of antibiotics after all.)

Here’s why you shouldn’t mix antibiotics and alcohol.

First, there’s the whole common sense factor. “Even when you’re healthy, drinking alcohol can affect your sleep cycle, dehydrate you, lower your energy, and in some cases give you a hangover,” says Sonia Patel, Pharm.D., chief pharmacist at Capsule, a digital pharmacy in New York City. “It stands to reason that when you’re sick and already not feeling well, extra symptoms like those are the last things you want to deal with.”

There’s also research showing that alcohol can get in the way of infection recovery by impairing your natural immune response, meaning that you’d potentially have to take antibiotics for longer, she says. So even if you’re not really feeling that bad, there’s a chance it will take you longer to get over whatever you have going on if you’re drinking on the reg. (FYI, alcohol can also mess with your fitness performance and training.)

But how bad is it, really?

“The truth of the matter is that only a few antibiotics actually interact with alcohol,” says Laura Hagopian, M.D., an emergency medicine physician at Lowell General Hospital. And while it’s not super dangerous to have a drink or two while you’re on antibiotics in general, there are a few medications that have serious interactions with alcohol that will make whatever you’re going through feel a lot worse. “These include metronidazole, Tindamax, and sulfamethoxazole/trimethoprim,” Patel says. Combining these medications with alcohol can lead to nausea and vomiting, abdominal pain, cramps, and more. “Alcohol should be completely avoided when taking any of these,” Patel says.

The good news is that alcohol isn’t likely to reduce the effectiveness of your meds (although as mentioned earlier, it could affect your body’s immune response). “Mild to moderate alcohol intake generally doesn’t reduce the efficacy of most antibiotics,” Dr. Hagopian says.

While rare, some antibiotics can intensify the effects of alcohol. “For instance, erythromycin can increase the amount of alcohol that gets absorbed from your stomach,” Dr. Hagopian says. That means you’ll become intoxicated faster than you normally would. (Related: What Young Women Need to Know About Alcoholism)

There’s also the fact that “alcohol is metabolized in the liver, as well as some antibiotics,” according to Margarita Rohr, M.D., clinical instructor of medicine at NYU Langone Health. “Depending on how much alcohol is consumed, it may affect the way the liver processes the antibiotic,” she says. This is one of the rare cases when an antibiotic could be less effective due to drinking. For all of these reasons, it’s very common for doctors to recommend you skip out on alcohol if you’re taking any type of antibiotic, even though many antibiotics are pretty okay to drink on.

Patel’s bottom line: “Will drinking on antibiotics kill you? Nope. Will it make you feel like it did? Quite possibly.” If you’re already feeling pretty crappy, know that alcohol isn’t likely to make you feel much better, but if you’re feeling all right, there’s one simple, safe way to find out the deal: “If you’re not sure whether or not your antibiotic is safe, talk to your doctor or pharmacist,” Patel says. “She can give you the lowdown.” Better safe than sorry, right?!

Can You Drink on Antibiotics?

If you’re taking antibiotics, your body is struggling to fight off something. No doctor is going to tell you to go out drinking—your immune system already has enough going on without you washing down your course of pills with a few pints. But can you really not drink at all?

Let’s just say alcohol isn’t great when you’re feeling sick or have some sort of infection. “Alcohol is a toxin, and it can decrease the immune system’s response and ability to fight off an infection maximally,” says Ted Epperly, an Idaho-based physician and former president of the American Academy of Family Physicians.

And while avoiding alcohol is a prudent, common-sense approach if you’re on antibiotics, there’s not much hard science showing that booze can interfere with the way these medications work.

“This is one of those scenarios where we all just assume you’re not supposed to drink,” says Aaron White, a senior scientific advisor with the National Institute on Alcohol Abuse and Alcoholism. “But when you stop and look at the evidence, it’s really not cut and dry.” No pun intended.

White says there’s no question that drinking alcohol can worsen some of the possible side effects of taking antibiotics—stuff like upset stomach, diarrhea, and fatigue. The reverse is also true; if you drink so much that you experience negative consequences—nausea, headaches, and everything else you associate with a hangover—antibiotics could potentially worsen those symptoms. “The body only has so many ways that it can say it’s not happy,” White says. “So alcohol and antibiotics can have a lot of overlapping negative effects.”

Watch More from VICE:

But those caveats aside, booze won’t disrupt the way your antibiotics work, says Andrew McLachlan, a professor of pharmacy at the University of Sydney in Australia. “The reality is that alcohol and antibiotics don’t interact,” he says.

McLachlan says it’s always smart to be cautious when mixing medications with alcohol. But if you’re worried that one or two drinks will blunt or counteract the benefits of your antibiotics, he says that’s “a myth.”

White isn’t willing to go quite as far as McLachlan, but he emphasizes the lack of research in this area. “From a scientific standpoint, there’s just not a lot of evidence that alcohol at moderate levels acts in any way on antibiotics,” he says.

Note the word “moderate” in his statement. White says alcoholism could influence the absorption, distribution, and metabolism of prescription drugs, which could make them less effective. He also says there are many different types of antibiotics, and so it’s hard to make blanket statements about them.

White uses an antibiotic called metronidazole (brand name Flagyl) as an example. When combined with booze, metronidazole could theoretically cause an overabundance of an alcohol byproduct called acetaldehyde. “If acetaldehyde builds up, you can get a flushing response, nausea, redness, and discomfort,” he says. “But whether metronidazole really causes this to happen in the real world—or how common it is—is unknown.” (He mentions one metronidazole study that failed to find an increase in acetaldehyde among young drinkers.)

Still, mixing ANY medication with alcohol could have side effects. And there are some antibiotics, including metronidazole and tinidazole, that may be more likely to have side effects when combined with booze. Those side-effects could include vomiting, which, if you’ve recently swallowed your antibiotic, could mess with its effectiveness. But puking aside, if you’re worried that having a drink or two will make your antibiotic stop working, you can rest easy.

What are you supposed to do with all this contradictory or incomplete information? White recommends airing on the side of caution. If you can abstain from alcohol while you’re on antibiotics, do that. But if you feel good—maybe your symptoms are improving or you have an infection like a UTI that didn’t affect your normal routine—you can probably have a drink or two without worrying. “We’re really lacking evidence that alcohol and antibiotic interactions are a significant concern,” he says.

Epperly agrees, and says you’d probably have to knock back four or more drinks for there to be a “clinical effect”—like a worsening of symptoms.

Whatever you do, don’t skip your antibiotic just because you’ve had some alcohol. Antibiotics only work if you take them exactly as prescribed—if you miss doses, your infection could come roaring back stronger than ever, White says. That scenario may also require a more potent, symptom-inducing antibiotic the second time around, and then you might have zero desire to hit happy hour.

Sign up for our newsletter to get the best of Tonic delivered to your inbox weekly.

For nearly all other types of antibiotics there is no clear evidence of harm from modest alcohol intake. A comprehensive but readable summary of alcohol and medication interference can be found here.

But this doesn’t mean it’s a good idea to drink to excess when you’re in the grip of an infection, as the sedative and nauseating effects of the alcohol are likely to increase if you are unwell.

Alcohol-induced dilation of blood vessels in the limbs interferes with your body’s attempts to raise a fever to slow the spread of infection. Your kidneys will be forced by the alcohol to lose more fluid, thus increasing the risk of dehydration. And the deep, aching muscle pain produced by viral infections may be more likely to lead to serious muscle damage when combined with binge drinking.

Alcohol can exacerbate mild or moderate infections, even if you’re not on antibiotics. schipulites

Some antibiotics such as isoniazid and flucloxacillin (Flopen, Staphylex) may inflame the liver (causing mild hepatitis) in a small percentage of those treated. A boozy night out could further irritate the liver, which is already working hard to get rid of the extra alcohol. A similar mild hepatitis may occur with some infections such as glandular fever, which would have the same outcome.

So if you’re unwell and thinking of having a big one at the office end-of-year party, it’s better to go easy on the alcohol whether you are on antibiotics or not. You’ll recover quicker and you’ll reduce your risk of secondary complications.

If you’re on one of the problematic drugs, it’s important to take the “no alcohol” warning seriously or you’ll quickly and deeply regret even a few mouthfuls of alcohol.

For most antibiotic users, though, a glass of bubbly or a cold beer at your office Christmas party should be fine.

Drinking alcohol with antibiotics

Leave a Reply

Your email address will not be published. Required fields are marked *