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Updated on August 11, 2023
5 min read

Macrobid and Alcohol Interactions

Kelly Brown
Dr P. E. Pancoast, MD
Written by 
6 Sources Cited
Kelly Brown
Written by 
6 Sources Cited

Can You Drink Alcohol While Taking Macrobid?

Healthcare providers do not recommend consuming alcohol while on Macrobid. However, if you do, it is not cause for immediate medical attention.

One of the greatest risks of drinking alcohol while taking Macrobid is dehydration. Staying hydrated is essential when dealing with a urinary tract infection (UTI)

Alcohol is a diuretic (a substance that promotes urination) and can irritate the bladder. It can increase your risk of dehydration, worsen UTI symptoms, and increase the risk of Macrobid’s side effects.


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What is Macrobid (nitrofurantoin)?

Macrobid (nitrofurantoin) is an antibacterial agent part of a class of drugs known as nitrofuran antibacterials. Healthcare providers prescribe it to treat urinary tract infections (UTIs) or other bladder issues.

Macrobid contains a large crystal structure that restricts bacteria’s absorption through the gastrointestinal tract. It inhibits several of the bacteria’s vital biochemical processes.

What Is a UTI?

Urinary tract infections (UTIs) occur due to bacteria entering the urinary tract. Most infections only involve the bladder and urethra, but they can also affect ureters and kidneys.

Ideally, the urinary system keeps bacteria from the body by expelling them through urine. However, the body’s natural defenses sometimes fail due to dehydration. The less you urinate, the more likely bacteria can enter your body’s different systems.

Risk factors that increase the chances of developing a UTI include:

  • Female anatomy (shorter urethra)
  • Sexual activity
  • Some types of birth control
  • Menopause and a decline in estrogen
  • Genetic urinary tract problems
  • Blockages in the urinary tract
  • Suppressed immune system
  • Use of a catheter
  • Undergoing urinary surgery or urinary tract exams

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What to Do After Drinking Alcohol and Macrobid

If you drank alcohol while on Macrobid without realizing the risk, there’s no need to panic. Stop drinking immediately and increase your water intake to offset dehydration symptoms.

One of the primary concerns of drinking alcohol while using Macrobid is an increased risk of the medication’s side effects. These side effects include:

  • Interstitial pneumonitis
  • Headache disorder
  • Nausea
  • Vomiting
  • Urine discoloration
  • Anorexia
  • Megaloblastic anemia
  • Leukopenia
  • Granulocytopenic disorder
  • Polyneuropathy
  • Flatulence
  • Diarrhea
  • Acute abdominal pain

Excessive alcohol consumption worsens UTI symptoms, making it harder for medication to work. Although some people can handle moderate alcohol consumption with Macrobid, you can’t know how your body will react. For this reason, it’s recommended to avoid alcohol altogether while taking this medication.


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Alcohol and Macrobid Interactions

Alcohol irritates the bladder, dehydrating you and allowing bacteria from the UTI to spread. Besides causing dehydration, it increases the acidity of your urine which can worsen your current symptoms. Mixing alcohol with antibiotic medication for UTIs also triggers unpleasant side effects.

Not only does alcohol worsen a UTI, but it might also cause UTI development. This is because alcohol:

Harms the Kidneys

Your kidneys are responsible for regulating hydration and waste management. Drinking too much alcohol forces your kidneys to work hard to filter the toxins you’re introducing to your body. Some alcoholics even develop kidney diseases from long-term overuse of their kidneys.

Suppresses Vasopressin

Vasopressin is a hormone that triggers the body’s reabsorption of water. However, having alcohol in your system interferes with the production of vasopressin. When your body doesn’t have enough vasopressin, you forget to replenish your body’s fluids even as you reach dehydration.

Contains High Amounts of Sugar

Most alcoholic beverages are high in sugar. The more sugar in your urine, the more food there is for bacteria to grow. It allows them to flourish and move into other parts of the urinary tract.

What Other Drinks Should You Avoid If You’re Taking Macrobid

You should avoid all alcoholic drinks when taking Macrobid for your UTI. Drinks high in acidity and sugar content can also aggravate the bladder.

Drinks to avoid include:

  • Wine
  • Beer
  • Spirits
  • Coffee
  • Soda
  • Fruit juices

What Can You Drink While on UTI Medication

If you can’t avoid drinking alcoholic drinks, picking less aggravating options is best. Choose beverages that are low in sugar and alcohol content. 

Even if you say no to alcohol, you can still have these beverages to drink as your alternative:

  • Water  ⁠— It hydrates your body and flushes bacteria through the urinary tract as urine.
  • Cranberry juice  ⁠— Cranberry juice’s antioxidants ease some symptoms of UTIs. However, make sure you use only full flavor no-sugar-added cranberry juice.
  • Herbal tea  ⁠— Herbal teas, such as jasmine and chamomile, are soothing to drink and contain no caffeine to irritate the digestive system or urinary tract.
  • Apple cider vinegar  ⁠— ACV contains probiotics and several vitamins and minerals that support bladder and urinary tract health.

What Other Antibiotics Don’t Mix Well with Alcohol?

Besides Macrobid, there are several antibiotic medications you’ll want to avoid combining alcohol with. These include:

  • Cefoperazone
  • Cefotetan
  • Metronidazole
  • Tinidazole
  • Ketoconazole
  • Isoniazid
  • Linezolid
  • Griseofulvin

Drinking alcohol shortly before, during, or for up to three days after using these medications increases your risk of:

  • Nausea
  • Vomiting
  • Flushing
  • Headache
  • Rapid heartbeat
  • Stomach cramps

What Should I Avoid While Taking Macrobid?

Macrobid doesn’t have many interactions with other substances, but there are a few, including:

  • Magnesium-containing antacids ⁠— Treats heartburn, including Gaviscon, Mylanta, and Milk of Magnesia; combined with Macrobid, these medications might cause your body to absorb less nitrofurantoin
  • Probenecid for gout ⁠— Can make certain antibiotics more effective but doesn’t include Macrobid
  • Certain live vaccines ⁠— Avoid travel vaccines for cholera and typhoid; this doesn’t apply to flu or covid-19 vaccines
  • Methotrexate ⁠— This medication with Macrobid can increase the risk of Methotrexate’s most severe symptoms

Macrobid can also affect the results of certain lab tests, especially lab tests to detect glucose in the urine.

Your doctor might recommend avoiding sexual intercourse while on Macrobid. This is more due to the UTI than the use of the medications. In most cases, it’s not recommended that you have sex until your UTI has completely cleared up. 


Having an alcoholic drink when you have a UTI probably isn’t going to send you to the hospital. However, it’s not doing your body any favors. Drinking alcohol damages your body’s healing response and aggravates the already-unpleasant symptoms you’re experiencing.

If you’re having trouble avoiding alcohol while getting treatment for UTI, consult your healthcare provider on how you should proceed.

Updated on August 11, 2023
6 sources cited
Updated on August 11, 2023
All Alcoholrehabhelp content is medically reviewed or fact checked to ensure as much factual accuracy as possible.

We have strict sourcing guidelines and only link to reputable media sites, academic research institutions and, whenever possible, medically peer reviewed studies.
  1. Mergenhagen et al. “Fact versus Fiction: A Review of the Evidence behind Alcohol and Antibiotic Interactions.” Antimicrobial Agents and Chemotherapy, 2020.

  2. Mayo Clinic. “Can I Drink Alcohol While Taking Antibiotics?”, 2022. 

  3. Mayo Clinic. “Nitrofurantoin (Oral Route) Precautions.”, 2023.

  4. National Institute on Aging. “15 Tips to Keep Your Bladder Healthy.”, 2022. 

  5. National Institute of Diabetes and Digestive and Kidney Diseases. “The Urinary Tract & How It Works.”, 2020. 

  6. Bradley, Catherine S., et al. “Evidence of the Impact of Diet, Fluid Intake, Caffeine, Alcohol and Tobacco on Lower Urinary Tract Symptoms: A Systematic Review.” Journal of Urology, 2017.

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All content created by Alcohol Rehab Help is sourced from current scientific research and fact-checked by an addiction counseling expert. However, the information provided by Alcohol Rehab Help is not a substitute for professional treatment advice.
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