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Antibiotics and Alcohol

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Can You Mix Antibiotics and Alcohol? 

Mixing antibiotics and alcohol can be unsafe and pose serious health hazards. Side effects of mixing the two substances can range from mild to severe health concerns. 

Side effects will vary depending on the type of antibiotic, amount of alcohol consumed, and other factors. Some antibiotics interact more negatively with alcohol than others. 

Talking to your doctor about the risks of consuming alcohol while taking your antibiotics is important. You should also talk to them about the risk of using alcohol-containing products.

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What are Antibiotics?

Antibiotics fight bacterial infections by killing bacteria or preventing bacteria growth. Doctors typically prescribe antibiotics to treat various bacterial infections. These infections can range from infected wounds to sexually transmitted diseases. 

Countless types of antibiotics can kill or prevent the growth of various bacteria. Since enzymes in the liver metabolize antibiotics, you shouldn’t mix any of them with alcohol. 

Mixing alcohol and antibiotics can cause enzyme changes in the liver. The enzyme changes can affect how drugs break down in your body. 

Does Alcohol Make Antibiotics Less Effective?

Moderate alcohol consumption doesn’t typically lessen most antibiotics’ effectiveness. However, alcohol can affect how your body absorbs the antibiotics if you consume them together.

Likewise, drinking alcohol can reduce your energy levels and weaken your overall immune system. This can prevent your body’s ability to heal. It can also prolong your recovery, even with antibiotics. 

You may be prescribed another course of antibiotics to overcome your illness or infection if you don’t get better during your first course. Taking too many antibiotics can also build up antibiotic resistance, causing complications if you need them again down the line.

Side Effects of Antibiotics and Alcohol

There are two types of alcohol-medication interactions:

  1. Pharmacokinetic interactions: This happens when alcohol interferes with the metabolism of the medication. Moderate alcohol consumption doesn’t typically impact an antibiotic’s effectiveness. 
  2. Pharmacodynamic interactions: This happens when the alcohol intensifies the medication’s side effects. This is the more likely interaction that can occur with most antibiotics.

Taking antibiotics and consuming alcoholic beverages can have similar side effects. These include:

  • Nausea with or without vomiting
  • Dizziness
  • Drowsiness
  • Confusion
  • Headaches
  • Stomach cramps
  • Flushed skin
  • Rapid heart rate
  • Chest pain

Combining antibiotics and alcohol can compound these side effects, making them even worse.

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Antibiotics That Interact Negatively With Alcohol

You should never mix alcohol with the following common antibiotics:

Metronidazole

Metronidazole (commonly known as Flagyl) treats:

  • Bacterial infections
  • Bacterial vaginosis
  • Infected bites
  • Ulcers
  • Sores
  • Wounds
  • Parasitic infections 

Mixing alcohol and Metronidazole can cause:

  • Stomach pain
  • Nausea
  • Cramping
  • Headaches
  • Sudden blood pressure drops 

Tinidazole

Tinidazole (commonly known as Tindamax) is used to treat: 

  • Trichomoniasis
  • Giardiasis (an intestinal infection that can cause gas, cramps, and diarrhea)
  • Amebiasis (an intestinal infection that can cause gas, cramps, and diarrhea, and can spread to other organs)
  • Bacterial vaginosi

Mixing alcohol and Tinidazole can cause:

  • Nausea
  • Vomiting
  • Headaches
  • Hot flashes
  • Dizziness
  • Cramping

Sulfamethoxazole and Trimethoprim

Sulfamethoxazole and Trimethoprim (commonly known by the brand name Bactrim) is a combination antibiotic used to treat:

  • UTIs
  • Skin infections 
  • Bronchitis
  • Middle ear infections
  • Traveler's diarrhea
  • Shigellosis
  • Serious kinds of pneumonia.

Mixing alcohol with Sulfamethoxazole and Trimethoprim can cause: 

  • Rapid heart rates
  • Abdominal cramping
  • Headaches
  • Nausea
  • Warmth or redness under your skin 

Cefoperazone

Cefoperazone (Cefobid) treats infections like

  • Bacterial septicemia (a bloodstream infection)
  • Respiratory tract infections
  • Peritonitis (inflammation of the peritoneum)
  • Skin infections
  • Endometritis (inflammation of the inner uterine lining)

Mixing alcohol with Cefoperazone can result in: 

  • Cramping
  • Headaches
  • Nausea
  • Flushing
  • Vomiting 

Linezolid

Linezolid (Zyvox) is used to treat skin infections and pneumonia. Mixing alcohol and Linezolid can cause a hypertensive crisis. This is when your blood pressure spikes to dangerous levels.  

Cefotetan

Cefotetan (Cefotan) treats infections of the:

  • Skin
  • Bone
  • Blood
  • Lungs
  • Joints
  • Stomach
  • Vagina
  • Urinary tract

Mixing Cefotetan and alcohol can cause:

  • Nausea
  • Vomiting
  • Headaches
  • Cramping
  • Flushing 

Doxycycline

Doxycycline is in the tetracycline class of antibiotics that can treat pneumonia. It can also treat the following infections:

  • Respiratory tract
  • Skin
  • Eye
  • Lymphatic system
  • Intestine
  • Genital
  • Urinary tract

Mixing Doxycycline and alcohol is ill-advised because it can cause:

  • Headaches
  • Dizziness
  • Nausea
  • Increased skin sensitivity to the sun 

Erythromycin

Erythromycin is used to treat bacterial infections of the respiratory tract such as: 

  • Bronchitis
  • Pneumonia
  • Legionnaires' Disease (a severe form of pneumonia)
  • Pertussis (a respiratory disease)
  • Diphtheria (a serious throat infection)

It can also treat:

  • Some skin infections
  • Intestinal infections
  • Urinary tract infections
  • Syphilis, a sexually transmitted disease

Mixing alcohol and Erythromycin can delay the drug’s absorption into the bloodstream. As such, Erythromycin won’t work as effectively. 

Disulfiram

Disulfiram (Antabuse) creates such an adverse reaction with alcohol that it’s used as an alcohol addiction treatment.

Taking disulfiram with alcohol can induce unpleasant side effects. These include nausea and vomiting, headaches, stomach pain, heart palpitations, and liver damage.

Other common antibiotics that should not be mixed with alcohol include: 

  • Amoxicillin (Amoxil)
  • Other penicillins
  • Ciprofloxacin (Cipro)
  • Levofloxacin (Levaquin)

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Are Any Antibiotics Safe to Take While Drinking Alcohol?

You should generally stay away from alcohol while taking antibiotics. Drinking alcohol while taking antibiotics can intensify both substances' side effects. 

Some antibiotics have less dangerous interactions with alcohol. Nonetheless, it’s best to avoid alcohol consumption during the treatment course.

Can I Have One Alcoholic Drink With Antibiotics? 

Factors such as your sleep adequacy, food intake, hydration levels, and more may all influence alcohol’s impact. This impact can affect how alcohol and antibiotics mix. Even one alcoholic drink, like a glass of red wine, could be one too many. 

Summary

Mixing alcohol and antibiotics can increase the risk of adverse reactions. Common side effects of mixing the two substances include:

  • Nausea
  • Dizziness
  • Headaches
  • Cramps
  • Rapid heartbeats

It’s best to avoid alcohol and stick to non-alcoholic drinks.

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Updated on September 19, 2022
15 sources cited
  1. Centers for Disease Control and Prevention. “Antibiotic Use Questions and Answers,” 2019. 
  2. Centers for Disease Control and Prevention. “Be Antibiotics Aware: Smart Use, Best Care,” 2020. 
  3. National Center for Biotechnology Information, PubChem Compound Database. “Cefoperazone,” MedlinePlus.
  4. U.S. National Library of Medicine. “Cefotetan Injection: MedlinePlus Drug Information.” 
  5. MedlinePlus, U.S. National Library of Medicine. “Doxycycline: MedlinePlus Drug Information.” 
  6. Weathermon, R., & Crabb, D. W. "Alcohol and medication interactions." Alcohol research & health: the journal of the National Institute on Alcohol Abuse and Alcoholism, 1999.
  7. MedlinePlus, U.S. National Library of Medicine. “Erythromycin: MedlinePlus Drug Information.” 
  8. Harmful Interactions.” National Institute on Alcohol Abuse and Alcoholism, U.S. Department of Health and Human Services. “Harmful Interactions,” 2019. 
  9. James M. Steckelberg, M.D. “Can I Drink Alcohol While Taking Antibiotics? Mayo Clinic, Mayo Foundation for Medical Education and Research, 2020. 
  10. Linezolid: MedlinePlus Drug Information.” MedlinePlus, U.S. National Library of Medicine.
  11. Metronidazole (Oral Route) Description and Brand Names.” Mayo Clinic, Mayo Foundation for Medical Education and Research. “Metronidazole (Oral Route) Description and Brand Names,” 2020. 
  12. NHS Choices, NHS. “Metronidazole.” 
  13.  Mayo Clinic, Mayo Foundation for Medical Education and Research. “Sulfamethoxazole/Trimethoprim (Oral Route) Description and Brand Names,” 2020. 
  14. MedlinePlus, U.S. National Library of Medicine. “Tinidazole: MedlinePlus Drug Information.”  
  15. InformedHealth.org [Internet]., U.S. National Library of Medicine. “Using Medication: Using Antibiotics Correctly and Avoiding Resistance,” 2013. 

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