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What Can Go Wrong When You Mix Alcohol and Medications

Suppose you’re taking an antibiotic for an infection, treating pain with Tylenol or Advil, or using medication to control heartburn. You might not think twice about having a glass of wine with dinner or a beer when you’re out with friends.

But, depending on the medication you take and the amount of alcohol you drink, the combination could lead to dangerous interactions. “A drink every now and then is okay with some medications,” said Georgina Rubal-Peace, director of the medication use policy for Banner Population Health Pharmacy Solutions. But when you’re taking certain medications —including over-the-counter drugs and supplements — you’ll want to abstain from alcoholic beverages to avoid dangerous side effects

There are several different types of medications that can interact with alcohol.

The medication: Prescription medications like tranquilizers, hypnotics and sedatives that depress your central nervous system, such as benzodiazepines, opioids and medicines that can help you sleep, like Ambien or Lunesta.
What could happen: Because alcohol and these drugs both affect your central nervous system, combining alcohol with them could slow your breathing and potentially lead to death. “You may need medical attention if you drink three or more drinks per day and were to take these medications,” said Dr. Rubal-Peace.

The medication: Antibiotics such as metronidazole (Flagyl), tinidazole (Tindamax) and sulfamethoxazole and trimethoprim (Bactrim). 
What could happen: Drinking alcohol while taking antibiotics can lead to headache, nausea, profuse vomiting, flushing and a dangerously increased heart rate. 

The medication: Acetaminophen (Tylenol).
What could happen: Using both alcohol and Tylenol regularly could lead to liver damage over time.

The medication: Nonsteroidal anti-inflammatory drugs (NSAIDs) including Advil and Aleve, aspirin, and certain medications for arthritis pain.
What could happen: Using these drugs and alcohol over the long term could lead to bleeding in the stomach or liver disease.

The medication: Over-the-counter allergy, cold and flu or cough medications.
What could happen: You could feel drowsy or dizzy, have difficulty concentrating or experience slowed breathing. 

The medication: Blood thinners.
What could happen: Alcohol combined with blood thinners could increase your risk of bleeding excessively. Alcohol can also affect how your liver and kidneys process your blood thinner.  

The medication: Chest pain (angina) medications.
What could happen: You could develop a fast heartbeat, blood pressure changes, dizziness or fainting.

The medication: Statins to treat cholesterol.
What could happen: Alcohol consumption could worsen the side effects of cholesterol medications.

The medication: Diabetes medications.
What could happen: Alcohol affects your blood sugar levels, making it harder for your diabetes medications to work properly. You could also have nausea, vomiting, headache, blood pressure changes or a rapid heart rate.

The medication: Antidepressants.
What could happen: You could become drowsy or over-sedated. Regular alcohol use can worsen your symptoms of depression, making it more challenging to treat. And alcohol, in combination with antidepressants called monoamine oxidase inhibitors (MAOIs), could raise your blood pressure to dangerous levels. 

The medication: Heartburn medications.
What could happen: Some heartburn drugs can increase the effects of alcohol. You could also have a rapid heartbeat or changes in your blood pressure.

The medication: Prescriptions that treat anxiety, seizures or epilepsy.
What could happen: Your breathing could slow or you could have impaired motor control or memory loss.

The medication: Medications to treat prostate conditions.
What could happen: You could become dizzy or lightheaded or you could faint.

The medication: Caffeine.
What could happen: When you combine caffeine and alcohol— for example, if you mix alcohol with an energy drink — you’re less likely to feel the effects of alcohol, and that can make you prone to alcohol-related injuries.

The medication: Herbal supplements.
What could happen: You might assume herbal supplements are always safe. But, like other medications, they can interact with alcohol. Depending on the supplement, you could experience excessive drowsiness, liver damage, low blood pressure, slowed breathing or other side effects.

This is not a definitive list of medications that can interact with alcohol. You may also experience interactions with:

  • Drugs that treat mental health conditions such as attention deficit hyperactivity disorder (ADHD), psychosis and bipolar disorder
  • Acne medications
  • Birth control
  • Erectile dysfunction medications
  • Heart medications
  • Motion sickness drugs
  • Muscle relaxants

Dr. Rubal-Peace said it’s especially important for older people to be cautious about alcohol-drug interactions. That’s because as you get older, you’re more likely to take multiple medications, increasing your odds of interactions. Also, your body metabolizes alcohol more slowly as you age, so you’re more likely to feel its effects.

Whenever you get a new prescription or start taking a new medication or supplement, talk to your doctor or pharmacist to learn how it might interact with alcohol.

The bottom line

It’s essential to be aware of possible interactions between alcoholic beverages and prescription medications, over-the-counter medications and supplements. Connect with a health care provider to learn more about what can happen when you drink alcohol and take certain medications.

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