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Medically Reviewed by Cheryl Mearig, PharmD.
Metronidazole, also known by its brand name Flagyl, is an FDA-approved antibiotic and antiprotozoal drug.
It’s used to treat various bacterial infections, especially those that affect the:
Metronidazole is typically prescribed for approximately 10 days.
Although a person might feel better within a few days of starting metronidazole, it’s important to finish the entire course of medication or the infection could return.
The most serious adverse effects reported for metronidazole are encephalopathy, seizures, and tingling of the hands and feet. Other side effects are usually mild and include:
People taking metronidazole should not consume alcohol during treatment.
Mixing Flagyl and alcohol can cause unpleasant side effects such as:
Summary
Metronidazole is an antibiotic and antiprotozoal medication used to treat bacterial infections. Drinking alcohol while taking metronidazole results in unpleasant side effects that may range from mild to severe. It is highly recommended not to mix alcohol and metronidazole together.
After you consume alcohol, your body begins breaking it down by turning the alcohol into acetaldehyde.
Acetaldehyde is a toxic compound that causes the undesirable effects of alcohol. The body uses an enzyme called aldehyde dehydrogenase to reduce acetaldehyde to acetate. Metronidazole stops this enzyme from working.
This means that someone taking Flagyl cannot metabolize alcohol properly. Acetaldehyde stays in their bloodstream, causing a toxic buildup.
This may be a cause of the disulfiram-like reaction that some scientists have observed. Disulfiram is a medication used to treat alcohol use disorder.
Unwanted effects occur when alcohol is combined with disulfiram, which discourages drinking.
There have been reports of people experiencing disulfiram-like reactions when mixing alcohol and metronidazole. These effects include:
It should be mentioned that this disulfiram-like reaction has not been proven to be a scientific fact. Severe reactions may be a result of alcohol use, metronidazole use, the combination, or other unknown factors.
The effects of mixing Flagyl and alcohol seem to vary greatly from person to person.
Since there is no way to predict how a person will respond, it’s recommended to avoid alcohol for the duration of treatment and for 3 days following the last dose of oral medication.
For topical metronidazole, alcohol should be avoided for 24 hours after the last application.
Summary
Metronidazole prevents the body from properly metabolizing alcohol. This results in the buildup of a toxic compound called acetaldehyde which may cause a disulfiram-like reaction. To prevent this from happening, do not mix alcohol and metronidazole.
While alcohol may not impact the therapeutic effectiveness of metronidazole, the combination may lead to significant unwanted effects.
Make sure you speak to your healthcare provider about your concerns if you are prescribed metronidazole and do not believe you can abstain from alcohol use during the entire length of the antibiotic course. They can provide medical advice or alternatives for treatment.
No, not without putting yourself at risk for potential side effects.
Metronidazole remains in a person’s system for a period of time after taking the last dose of medication. This means you should wait at least 3 days before consuming alcohol after your course of treatment is complete.
Doctors recommend waiting at least 3 days after your last dose of metronidazole before drinking alcohol.
For topical metronidazole, alcohol should be avoided for 24 hours after the last application.
Yes, it is possible to take too much metronidazole and overdose. Symptoms of overdose include:
If you or someone you know thinks they may have taken too much metronidazole, call your doctor or the American Association of Poison Control Centers (1-800-222-1222).
If your symptoms are severe, call 911 or head to your nearest emergency room for immediate care.
Summary
Do not take metronidazole with alcohol. If you want to drink, do so at least 3 days after your last dose. Get medical help if side effects become severe.
In addition to alcohol, metronidazole may interact with other prescription and over-the-counter medications, as well as nutrition supplements.
It is important to tell your doctor about your health and medication history before taking metronidazole. Medications that may interact with metronidazole include:
Metronidazole boosts the efficiency of blood-thinning medications, which can increase someone’s risk for abnormal bleeding.
In many cases, doctors will reduce the dose of a patient’s usual blood-thinning medication, such as warfarin, when used in combination with metronidazole.
Metronidazole can increase sensitivity to the sun. It is important to limit sun exposure by using sunscreen, wearing hats, and protective clothing.
Summary
Take note of medications that may interact with metronidazole. Tell your doctor about your health and medication history beforehand.
Having difficulty giving up alcohol for the duration of metronidazole treatment, or experiencing alcohol withdrawal symptoms during this time, might be a sign of alcohol use disorder.
Other symptoms of an alcohol use disorder include:
If you or a loved one is struggling with alcohol addiction, help is nearby.
Reach out to an addiction specialist to talk about your options. Your information will remain confidential. They’ll review your options and decide on the best course of action toward recovery.
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