What is the Relationship Between Alcohol and Medications?
Author: Christine Roth
Last Updated: 10/02/2022
Mixing alcohol while taking medication poses several risks. These risks range in severity from amplification of side effects to death depending on the medication. If you’re taking any medication, regardless of whether or not it is OTC (over-the-counter) or prescription medication, always speak with your doctor. Mixing alcohol with most medications is dangerous.
While there are some medications, such as benzodiazepines, that have very serious and well-known risks, several other medications pose lesser known risks. Alcohol, like many of the medications on this list, also poses serious risks for addiction.
What Are the Medications You Should Never Mix with Alcohol?
There are several medications you should never mix with alcohol. These medications vary in side effects but when mixing them with alcohol the side effects increase. We list the medications you should never mix with alcohol below.
- Muscle relaxants
- Blood thinners (Aspirin)
- Diabetes medication
- Arthritis medications
- Hypertension medications
- Sleep aids
- Allergy medications (Sudafed)
- Heartburn medications
- Cholesterol medications
- Anti-seizure medication
- Cold and flu medication (Benadryl)
- Cough suppressants
- Anti-anxiety medications (Xanax)
Learn more about each type of medication below.
Antidepressants are one of the categories of medications that can be extremely dangerous to mix with alcohol. Some of the most common antidepressants are commonly referred to as SSRIs (selective serotonin reuptake inhibitors), SNRIs (serotonin-noradrenaline reuptake inhibitors), and MAOIs (monoamine oxidase inhibitors). While they work in different ways, the main purpose of these medications is to increase serotonin production and absorption in the brain or help the neurotransmitters to communicate between brain cells. Many of these medications work by maintaining a consistent level of the drug within your body and, as such, it is not advised that you stop taking your medication to drink alcohol.
If you plan on drinking alcohol while on antidepressants, contact your healthcare provider to find out what levels may be safe for you. Depending on the mediation, and with the guidance of a doctor, some patients can drink a moderate amount of alcohol with food regularly.
The main concern with the combination between many antidepressants and alcohol is that it may lessen the positive effects of the medication; some people report feeling more anxious or depressed when drinking while on antidepressants. While it may seem as though alcohol can increase your mood in the short term, it may have long-term effects on your mood, making your symptoms harder to manage.
Some antidepressants known as MAOIs, such as Marplan, can cause your blood pressure to spike and may worsen with alcohol consumption; this has the potential to cause a stroke.
There is also a risk that the combination of antidepressants and alcohol can increase the severity of alcohol-related symptoms such as lowered judgment, coordination, and reaction time. In more extreme cases it may increase symptoms such as sedation or extreme drowsiness which have the potential to lead to overdose or death.
Antibiotics are medications that fight bacterial infections throughout the body. These medications only work on bacteria, and will not be effective on viruses, such as the flu. There is a widespread myth that alcohol can render antibiotics less or ineffective. While this is not true, there is a chance that drinking alcohol while on antibiotics may result in your body taking a long time to recover, but this is primarily only present in the short term due to a decrease in energy in the body as alcohol is a depressant.
Antibiotics commonly have similar side effects to those of alcohol (upset stomach, dizziness, drowsiness). When antibiotics are mixed with alcohol, these side effects can significantly increase and it may be difficult to tell which drug (antibiotic or alcohol) is creating the effect. Some antibiotics, such as Bactrim, have the potential for more severe, and in some cases fatal, side effects. If you intend to drink any alcohol while on an antibiotic you should consult a health care professional first to learn of safe levels and potential side effects or dangers.
While there is no hard answer as to how long you should wait to drink alcohol after taking an antibiotic, many doctors encourage the best practice of refraining from consuming alcohol until you have finished your course of the medication. In some cases, antibiotics may remain in your system for up to 7 days after your last dose.
3. Muscle Relaxants
Muscle relaxants, much like alcohol, are Central Nervous System (CNS) Depressants. Muscle relaxants work in many different ways, but most target either the muscles directly or the brain and pain sensors. For those that target the brain, they work by slowing down brain activity which, in turn, can slow down standard bodily functions such as breathing in heart rate. In many cases, the most common side effects are feeling calm or drowsy. Because muscle relaxants and alcohol both have these potential side effects, it is dangerous to mix them as side effects could quickly lead to overdose or prove fatal. When mixed, the side effects may be more intense which makes it hard to determine the degree to which they are affecting you, or which drug may cause potentially adverse side effects. When alcohol is mixed with muscle relaxants there is also a chance that it may impair judgment and coordination further, which could result in injuries or the inability to seek help when needed. There is a significantly increased risk of seizures and memory problems.
Common muscle relaxants include more serious drugs like Benzodiazepines, such as Valium and Ativan, but often also include Cannabis. In the case of Benzodiazepines, there is an additional warning as both benzodiazepines and alcohol have the potential to be addictive.
4. Blood Thinners
Blood thinners are medications that lower your body’s ability to form blood clots. A common misconception is that blood thinners physically alter the consistency of the blood or can dissolve clots, but this is not true; instead, they directly work with the vitamins and enzymes found in your blood to lower the chance of new or growing blood clots. Alcohol also has some distinct effects on the blood; in moderate amounts, alcohol can make it harder for your blood to clot but extended, heavy alcohol consumption can increase your body’s likelihood of forming blood clots. Due to these very different possibilities, and the differences in individual drinking habits and assumptions, it can be extremely dangerous to mix alcohol and blood thinners. Mixing blood thinners and alcohol poses some very serious, and potentially fatal, risks such as serious bleeds (internal or external), and a possibility of nulling the effectiveness of the blood thinners, leading to a higher risk for heart attacks and strokes.
Some of the most common blood thinners are Aspirin and Apixaban, both of which are processed by the liver. Because many blood thinning medications and alcohol are processed by the liver, there is a further risk of damage to liver tissue. Also, when the liver is faced with medication and alcohol, there is increased stress placed on the organ which can delay the metabolization or clearance of the medication from the system or that of alcohol which could lead to higher levels of intoxication and risk for overdose.
5. Diabetes Medications
Diabetes is a chronic health condition that affects the way your body turns food into energy. The most common types of diabetes are Type 1, in which the pancreas produces little to no insulin, and Type 2, which affects the way the body processes blood sugar. For most types of diabetes, the most common treatment methods include insulin and metformin which help to regulate blood sugar.
The main concern in drinking alcohol for those with diabetes is hypoglycemia (low blood sugar) – this risk is increased for those who are taking insulin. When someone experiences hypoglycemia they may present symptoms such as slurred speech, drowsiness, confusion, or difficulty walking; these symptoms are very similar to side effects of alcohol which may make it hard to determine whether someone is simply intoxicated, or suffering from a medical emergency which requires immediate medical attention. Additionally, drinking alcohol while on diabetes medication can put an increased strain on your liver; the liver is responsible for metabolizing alcohol but also plays a large role in stabilizing glucose levels.
6). Arthritis Medications
Arthritis is a general term that refers to many types of joint pain and joint diseases; there are over 100 different types of arthritis ranging from mild to severe cases. The most common symptoms of arthritis are swelling, pain, stiffness, and reduced range of motion in the joints. One of the most common forms of arthritis is Gout, which most commonly presents as intense pain in the big toe, but can occur in any joint. There is evidence to suggest that regular alcohol consumption can increase the risk of recurrent gout attacks.
The most common medications prescribed are anti-inflammatory medications, such as NSAIDs (Nonsteroidal anti-inflammatory drugs) such as Advil (ibuprofen), or Aleve (Naproxen). NSAIDs should never be taken with alcohol as there is a significantly increased risk for stomach bleeds and ulcers when the two are mixed. While not an NSAID, acetaminophen is another common pain reliever that is used to treat arthritis pain; acetaminophen and aleve, specifically, pose the risk for toxic hepatitis – an inflammation of the liver – when combined with alcohol, especially if they have been used for an extended period. While toxic hepatitis usually goes away over time when the toxins have been removed from the body, there is a chance that increased exposure can cause severe liver damage including cirrhosis or liver failure.
Other medications used to treat more severe forms of Arthritis include steroids, analgesics, narcotics, and immunosuppressive drugs. Steroids, such as prednisone, are offered in a variety of different forms such as creams and oral tablets; because of this, there is a very low chance that someone may experience the risks and dangers associated with mixing steroids and alcohol when prescribed a cream – those taking an oral medication, however, may notice that their medication is less effective when they are consuming alcohol. Additionally, some steroids act as immunosuppressants, as does alcohol, which can decrease your body’s ability to fight off infection leading to more frequent or severe illnesses.
7. Hypertension/ Blood Pressure Medications
Hypertension, also known as high blood pressure, is a chronic condition in which the blood pressure is higher than normal for some time, usually over 130/80. Hypertension can cause a wide array of additional health problems or complications such as chest pain, heart attack, heart failure, or arrhythmia (irregular heartbeat).
There are several myths surrounding the relationship between blood pressure and alcohol consumption with the most prevalent being that drinking 1-2 drinks of red wine per day is good for your heart. While not wholly untrue, this conception is skewed; in the clinical trials surrounding this theory, those involved in the tests often do additional heart-healthy activities alongside the trial such as exercising regularly and eating a healthy diet. The truth is that regularly consuming alcohol can raise your blood pressure, and in some cases make it more difficult for blood pressure medications to work. With this, it is highly advised that you avoid drinking alcohol while on blood pressure and hypertension medications.
Many of the less-severe side effects of blood pressure medications, such as dizziness or lightheadedness, are also symptoms of intoxication, which may make it difficult to determine which drug is causing the effects. The more serious risks of combining alcohol and blood pressure medications include dangerously low blood pressure, especially for those on antihypertensive medications, and arrhythmias (heart rhythm problems/irregular heartbeat).
There are two main types of medication used to treat hypertension. The first, ACE (angiotensin-converting enzyme) inhibitors, such as lisinopril, work by helping to prevent the narrowing of blood vessels, lowering the stress put on the heart. When mixed with alcohol, lisinopril is known to become mostly ineffective; the most common reaction to this is extreme dizziness and fainting, which pose the risk for additional injury.
8. Sleep Aids
Sleep aids are commonly available via prescription, but there is also a wide variety available over-the-counter, making them easily accessible to many people. Sleep aids are used and prescribed for several reasons ranging from frequent waking to severe insomnia. There is evidence that shows that alcohol, especially in larger amounts or over long periods, hurts your sleep cycle and can influence insomnia.
Some of the most common non-prescription sleep aids include Benadryl and melatonin. Melatonin poses a very little risk when mixed with alcohol however, alcohol has the potential to disrupt the sleep-wake cycle, which melatonin promotes which could counteract the benefits of taking melatonin. Benadryl, on the other hand, poses many more serious risks when mixed with alcohol. It is important to note that despite its common usage as a sleep aid, Benadryl is intended to be used to treat allergy symptoms, not to be used as a sleep aid. Benadryl is an antihistamine, meaning that it also works as an allergy medication by interfering with the histamines in your body, and it is also a CNS depressant. When mixed with alcohol, there is a serious risk that your CNS can be slowed down too much resulting in complications such as trouble breathing and extreme drowsiness; in turn, this can lead to a risk for overdose or death. The most common prescription sleep aids are generally benzodiazepines such as Restoril; benzodiazepines are one of the most dangerous medications to mix with alcohol and pose severe risks for addiction and overdose.
The most common symptoms of prescription and non-prescription sleeping aids are drowsiness, dizziness, memory problems, confusion or disorientation, impaired motor control, slowed heart rate, low blood pressure, and slow or difficulty breathing; almost all of which are side effects of alcohol intoxication. When mixing alcohol with sleep aids there is an increased risk for these side effects to become amplified, and potentially fatal.
9. Allergy Medications
Allergy symptoms are any set of symptoms that occur when your immune system reacts to a foreign substance or food that doesn’t commonly cause reactions in most people. In the case of an allergy attack, your immune system will produce antibodies to fight off the allergen under the assumption that it is harmful. The most common symptoms of mild allergies are sneezing, itchy nose or eyes, runny or stuffy nose, hives, rash, or itching. However severe allergies can present as anaphylaxis which is a life-threatening condition. While the symptoms of mild allergies should go away on their overtime, they can still be bothersome which leads many people to look for relief. It is important to note that for some people drinking alcohol while experiencing mild allergy symptoms can make those symptoms worse, especially in cases of nasal symptoms or asthma.
Benadryl, as discussed above, is an extremely dangerous medication to mix with alcohol, but is one of the most commonly available medications used to treat occasional allergies, but should not be used for extended periods. Benadryl and alcohol are both CNS depressants and pose serious risks for overdose when mixed. The most common side effects of interactions between allergy medications and alcohol are confusion, impaired decision making, and drowsiness, all of which are general symptoms of alcohol intoxication and therefore may be amplified. In cases of more severe interaction, however, there are risks of disorientation, hallucinations, seizures, and trouble breathing. It is worth noting that most of these symptoms are most commonly seen when taking oral allergy medications; while there is less of a risk for severe interactions when taking nasal sprays or ointments to treat your allergy symptoms, it is still possible.
For those who are taking prescription or year rough allergy medication, it is important to speak to your doctor about appropriate and safe drinking in moderation. In cases where you are self-medicating allergies regularly, it is suggested that you wait between 1 and 4 days after stopping daily use of the medication before you start drinking alcohol as trace amounts of the medication can linger in your body.
10. Heartburn Medications
Recent research estimates that more than 44% of Americans experience heartburn every month, making it an extremely common health condition. Heartburn, rather than being a condition itself, is a symptom of acid reflux. With the prevalence of this condition, especially in its more mild forms, there is a variety of over-the-counter medications available to help soothe the symptoms that come along with it. Some of the most common heartburn medications include antacids, such as Pepto Bismol but there are also stronger medications such as Pepcid and Prilosec that may be prescribed for more persistent or severe cases.
While Pepto Bismol and Pepcid are unlikely to have any serious interactions when mixed with alcohol, it is still not recommended to mix them. When drinking alcohol, the stomach produces more stomach acid than normal which increases your risk for acid reflux but can make symptoms that may already be occurring worse. In some cases, it can negate the positive benefits of the medications.
For stronger medications such as Prilosec, there is a strong recommendation to avoid drinking alcohol due to a significant increase in or amplification of your negative symptoms.
For many people with chronic acid reflux or heartburn, alcohol should be fine in moderation, but large amounts may progressively worsen symptoms or increase the frequency of your symptoms.
11. Cholesterol Medications
High cholesterol is a condition in which the levels of cholesterol in your body are too high, putting you at risk for heart disease. High cholesterol also puts you at risk of developing fatty deposits in your blood vessels, which can make it difficult for blood to flow. Cholesterol medications are known as statins, with two of the most common being Lipitor and Lipostat, and they work by reducing how much cholesterol the liver produces, while also increasing its clearance from the blood. In general, there are very few risks for drinking alcohol moderately while taking cholesterol medication, however, with heavy alcohol consumption you can be at risk for impaired liver function and liver damage as there is higher stress placed on the liver from both drugs. Heavy alcohol usage mixed with statins is also known to increase the risks for muscle problems and kidney problems. If you would like to continue consuming alcohol in moderation while taking statins, your doctor may suggest regular blood tests to monitor your liver function.
12. Anti-Seizure Medications
Anti-Seizure medications, more commonly known as anticonvulsants, are medications that either alter the electrical activity of neurons in the brain or alter the chemical transmission between neurons to stop or lessen the chance of seizures. It is important to note that most anticonvulsants act as CNS depressants and can pose side effects such as drowsiness, dizziness, mood changes, and trouble concentrating – many of which are shared side effects of alcohol, which may make it difficult to tell which medication is causing these side effects, or the exact extent to which these side effects are impacting you. In general, patients with epilepsy are advised to avoid drinking alcohol regardless of whether or not they are on medications; for some people with epilepsy it is possible that drinking too much alcohol on a single occasion may result in seizures for up to three days after the alcohol consumption has stopped. Additionally, heavy drinking, such as binge drinking, can be a trigger for seizures or increase your risk for them.
There are a variety of medications that can be used to treat seizures but many people find success with benzodiazepines such as Klonopin or Valium. Benzodiazepines can be extremely dangerous to mix with alcohol as they are also CNS depressants and pose a significant risk for slowing down brain activity, and in turn breathing and heart rate, to dangerously low levels, which can result in death. Other medications, such as Trokendi XR, which is an extended release medication, may not work as effectively when mixed with alcohol as it is intended to work throughout your system over a longer period. Medications such as Trokendi are also broken down by the liver; when mixed with alcohol the combination can put increased stress on the liver, or result in a delay of the drugs being cleared from your system which puts you at a higher risk for toxicity and overdose.
It is important to acknowledge that some anticonvulsants, namely Gabapentin, are also approved for helping those suffering from alcohol use disorders. If you are being prescribed something such as gabapentin for seizures or an alcohol use disorder you must be transparent with your healthcare provider about your drinking habits so that they can monitor your health and recovery.
13. Cold and Flu Medications
Colds and flus are illnesses that are caused by viruses and, as such, cannot be treated with antibiotics. The most common symptoms are often congestion, runny nose, cough, body aches, fever, and fatigue. While these illnesses generally resolve themselves in a relatively short period as the body fights them off, several medications can be used to alleviate symptoms. It is important to remember that cold and flu medications will not cure the illness.
Two of the most common cold and flu medications are Dayquil and Nyquil. Nyquil poses some additional risks as it contains doxylamine, an antihistamine that is often prescribed as a sleep aid. When mixed with alcohol cold and flu medications have an increased risk for extreme drowsiness, dizziness or vertigo, gastrointestinal upset, tachycardia (rapid heartbeat), and increased risk of serious bleeds or stomach ulcers. Additionally, if there is acetaminophen in the medication, there is an additional risk for liver damage or failure when mixed with alcohol.
As discussed with antibiotics, alcohol is an immunosuppressant which means that it can lower your immune system, making it harder for your to fight off infection or illness. With that, drinking alcohol while you have a cold or flu, or mixing alcohol with cold and flu medication, may negate the positive benefits of the medication and make it harder for your body to fight off the virus at hand, further delaying recovery time.
14. Cough Suppressants
Many, but not all, medications intended to help alleviate cold and flu symptoms also include or act as cough suppressants. However, some cough suppressants do not target other symptoms such as runny nose or congestion and thus may pose different risks when mixed with alcohol. One of the most common and easily available cough suppressants is Robitussin in which the active ingredient is dextromethorphan which has been classified as a CNS depressant but is not considered to be a dissociative anesthetic. Many cough suppressants are CNS depressants, just as alcohol is, and thus may pose similar risks to those of benzodiazepines when mixed with alcohol including, but not limited to: slowed breathing, slowed heart rate, out-of-body feelings, memory loss, behavioral problems, increased risk for epilepsy and psychosis. Additionally, there is a significantly increased risk for overdose when alcohol is mixed with a cough suppressant.
For more serious illnesses or coughs, cough suppressants such as Codeine may be prescribed by a doctor. Codeine is a narcotic that carries a black box warning – the strongest warning label required by the FDA. This medication poses a very serious risk for abuse and addiction and has severe risks for overdose and death when taken on its own. When mixed with alcohol, there is an extremely high risk of overdose and death. As narcotics and alcohol both pose significant chances for addiction and overdose, you must consume them separately, in moderation, and only as directed by your doctor. If you suspect you or a loved one is abusing one or both of these medications, seek medical assistance immediately.
15. Anti-Anxiety Medications
Anti-Anxiety medications can take several forms including but not limited to SSRIs, SNRIs, other common medications used to treat depression, and benzodiazepines. When being prescribed an anti-anxiety medication, your doctor needs to determine whether the condition is psychiatric or caused by a non-psychiatric medical condition. As many medications intended to alleviate the symptoms of anxiety can be addictive or habit-forming, they are usually prescribed for short-term or as-needed use.
Xanax, a benzodiazepine, is a relatively popular medication used to treat anxiety, but one that is both extremely dangerous to mix with alcohol, and has a high risk of addiction. Xanax and alcohol are both CNS depressants that can critically slow down breathing, heart rate, and brain activity when mixed, posing an extremely high risk for overdose or death as it takes longer for them to be cleared from the body. Additionally, Xanax and alcohol are both broken down by the same liver enzymes which put an increased strain on the liver and could lead to liver damage or failure. With Xanax, there isn’t necessarily a “safe amount” of alcohol that can be consumed, even when done in moderation, as small amounts may affect different people in extremely different ways. The best practice when taking anxiety medications such as Xanax is to avoid alcohol entirely.
Which Medicine is More Dangerous than Alcohol?
It is important to acknowledge that any medication can pose several risks and additional side effects when mixed with alcohol – especially when done in excess. In general, however, the most dangerous, and common, medication to mix with alcohol is benzodiazepines.
Many people who choose to mix benzodiazepines with alcohol are under the assumption that it is safe to do so because it should be safer than mixing illicit drugs with alcohol; this is not the case. Benzodiazepines on their own pose a high risk for addiction in addition to several dangerous side effects including, but not limited to drowsiness, light-headedness, confusion, decrease in motor control, slurred speech, muscle weakness, memory problems, nausea, and blurred vision. Nearly, if not all, of these side effects, are side effects that someone may experience with alcohol intoxication. Being that both alcohol and benzodiazepines are central nervous system depressants when these two drugs are mixed many of these symptoms, such as drowsiness, slowed heart rate, and slowed breathing, may be amplified, which can pose a serious risk for death.
What are the Risks of Mixing Alcohol and Medication Drugs?
There are several risks for mixing alcohol and medication drugs with some being mild or temporary, to more severe conditions including addiction or risk of death. Any drug must have the potential to be dangerous when mixed with alcohol, especially when done in excess.
Additionally, some people may be affected differently or to a different extent than others. We list the most common risks below.
- Slurred speech
- Impaired motor function
- Poor judgment
- CNS Depression (slowed heart rate and breathing)
- Trouble breathing
- Nausea, vomiting
- Severe dehydration
- Toxicity or overdose
- Memory loss
- Liver damage
- Total liver failures
- Cirrhosis of the liver
- Higher risk for internal bleeds
- Stroke or heart attack
- Higher risk for blood clots
- Suicidal thoughts
These are only some of the risks of mixing alcohol and medication.
How Long Should I Wait After Drinking Alcohol Before Taking Medicine?
The amount of time you should wait to drink alcohol after taking medication or wait to take medication after drinking alcohol varies drastically from medication to medication. In some cases, such as with antacids, there is little to no risk of taking them near when you are drinking alcohol. Other medications, such as seizure medications or antidepressants can remain in your system for a significant period after you stop taking the medication (usually 1-7 days). With things such as antibiotics, you should wait until you have finished your course of the medication.
The time you should wait to best minimize potential drug interactions is heavily dependent on the type of medication, potential side effects and dangers, which bodily organs clear the medication from the body, and the amount of time the medication continues to linger in your body; your drinking habits also play a crucial role. Those who drink in moderation are often at significantly lower risks for serious complications than those who drink heavily, or regularly. If you are unsure how long to wait with a specific medication that you are on, you should speak to your healthcare provider about best practices.
Is There a Drug that Can Stop Alcoholism?
There is not necessarily one specific drug that can stop alcoholism entirely, however, there are several medications that can help treat the symptoms of alcohol withdrawal, reduce cravings and help promote sobriety. Many of these medications, however, work best when used as part of a treatment plan alongside medical supervision, detox programs, group therapy, and individual therapy.
Some medications useful for alcohol recovery are below.
These are only some of the medications useful for recovery.
Can I Drink Alcohol While on Medication?
The short answer to the question is no, you should not drink alcohol while on medication unless specifically instructed otherwise by a licensed healthcare professional. While there is a plethora of information available as to the side effects of certain medications, medication can affect individuals in many different ways, and often only the most common side effects are listed. When mixed with alcohol, many medications pose the risk of amplification of side effects or have entirely new sets of side effects that may occur.
As many medications are cleared from the body via the liver, which is the same organ that metabolizes alcohol, medications that do not pose a risk for liver damage on their own may pose an increased risk when mixed with alcohol due to the increased strain put on the liver to clear both toxins from the body.
If you intend to drink alcohol while taking any medication, regardless of how mild you may perceive it to be, you must consult a health care professional about the potential risks associated with drinking alcohol in moderation, and potentially safe levels of alcohol consumption in regards to your medical history.