General Warnings

Is it Dangerous to Drink Alcohol on Medication?

Alcohol is formed when yeast ferments (breaks down without oxygen) the sugars in different food. For example, wine is made from the sugar in grapes, beer from the sugar in malted barley (a type of grain), cider from the sugar in apples, vodka from the sugar in potatoes, beets, or other plants.

Alcohol is classed as a ‘sedative hypnotic’ drug, which means it acts to depress the central nervous system at high doses. At lower doses, alcohol can act as a stimulant, inducing feelings of euphoria and talkativeness, but drinking too much alcohol at one session can lead to drowsiness, respiratory depression (where breathing becomes slow, shallow, or stops entirely), coma, or even death.

Mixing medication and alcohol

Mixing medication and alcohol comes with serious risks – and it’s extremely important to understand the dangers. Findings from studies suggest a significant percentage of people do know about the risks of mixing medication with alcohol, but their perceptions of danger are somewhat different from what doctors and pharmacists say.

Results from research also indicate that alcohol is a significant part of many people’s social lives, and the perceived dangers of drinking with medication are perhaps not enough to stop this behavior. Understanding how best to address American health and safety, especially in a nation where over half the population consumes prescription drugs is important. We can help ourselves, our friends, and our community by understanding the dangers and taking steps to prevent harm.

Drug Interactions With Alcohol

According to a study conducted by the NIH looking at drugs and alcohol, the most common medications that interact with alcohol involve these drug classes:

•          High blood pressure medication

•          Sleeping pills (sedatives and hypnotics)

•          Anxiety Medications

•          Pain medications (analgesics)

•          Skeletal muscle relaxants

•          Diabetes medicine

•          Cholesterol medications

•          Antidepressants

•          Antipsychotics

List of Top Ten Medications you Should Never Mix with Alcohol

According to GoodRx, the following top 10 medications should never be taken or mixed with alcohol:

Painkillers: If you’re taking ibuprofen (Motrin) or naproxen (Naprosyn, Aleve), drinking alcohol can lead to an upset stomach, stomach bleeding, or ulcers. Drinking alcohol while taking acetaminophen (Tylenol) is also risky. Alcohol and acetaminophen are both broken down in the liver. When the liver is busy breaking down alcohol, it can’t deal with acetaminophen, and so the drug builds up in the body and can cause serious liver damage.

The greatest risk, though, is drinking alcohol with any opioid painkillers, such as codeine, hydrocodone, or oxycodone. Unlike ibuprofen and acetaminophen, these are prescription medications for people dealing with severe pain from injuries, postsurgical care, oral surgery, and migraines. Combining them with alcohol can cause excessive drowsiness, slowed breathing, and even death. Avoid alcohol completely if you’re taking any of these painkillers.

Anti-anxiety medications and sleeping pills: Using alcohol while taking anti-anxiety medications or sleeping pills can cause serious problems, too. Examples of anti-anxiety medications include:

These medications are sedatives, and taken together with alcohol, can make you drowsy or even unconscious.

Antidepressants and mood stabilizers: All antidepressants should be taken with care when drinking alcohol. The effect on your body will depend on the type of antidepressant, but the risks are real and can include:

  • Drowsiness
  • Dizziness
  • Overdosing
  • Worsening feelings of depression
  • Problems with movements
  • Liver damage
  • Serious heart effects

Similar risks exist if you take alcohol with mood stabilizers and antipsychotics such as aripiprazole (Abilify), divalproex (Depakote), or lithium.

ADHD medications: ADHD treatments such as amphetamine (Adderall), methylphenidate (Ritalin), and lisdexamfetamine (Vyvanse) can interact with alcohol, causing any of the following symptoms:

  • Dizziness
  • Drowsiness
  • Poor concentration
  • Heart problems
  • Liver damage

Antibiotics: Metronidazole (Metrogel, Flagyl) is a common antibiotic, and drinking any amount of alcohol with it will cause violent nausea and vomiting. Other antibiotics such as nitrofurantoin (Macrodantin), isoniazid (Laniazid), and azithromycin (Zithromax) can all cause unpleasant reactions when mixed with alcohol.

Nitrates and other blood pressure medications: Lots of blood pressure medications and anti-angina medications (nitrates) can interact dangerously with alcohol. Common effects include:

  • Dizziness
  • Fainting
  • Drowsiness
  • A faster heartbeat or arrhythmias

Diabetes medications: If you take any medications for diabetes, drinking alcohol can lead to:

  • Very low blood sugar levels
  • Flushing
  • Nausea and vomiting
  • Headache
  • Rapid heartbeat
  • Sudden changes in blood pressure

These medications include insulin or pills like metformin (Glucophage), glyburide (Micronase), and glipizide (Glucotrol). Take great care with these.

Coumadin: Alcohol has an unpredictable effect on warfarin (Coumadin). If you drink alcohol while taking warfarin, you will need close monitoring to make sure your blood is not too thin.

Over-the-counter cold and flu treatments: Most over-the-counter cold and flu remedies such as pseudoephedrine (Sudafed), guaifenesin (Mucinex), and oseltamivir (Tamiflu) contain a mix of different painkillers, antihistamines, and decongestants, and some (like NyQuil) even contain alcohol. On their own, these medications can make you drowsy and dizzy. If you combine them with alcohol, it can make the drowsiness and dizziness worse, and increase your risk of overdosing. Check the ingredients on the box before taking any of these with alcohol.

Erectile dysfunction medications: Taking alcohol with medications like tadalafil (Cialis), sildenafil (Viagra), and vardenafil (Levitra) can significantly lower blood pressure and cause dizziness, flushing, or a headache. Alcohol can also cause erectile dysfunction, so if you’re struggling with ED, it might be best to avoid alcohol altogether anyway.


Dr. Oche Otorkpa PG Cert, MPH, PhD

Dr. Oche is a seasoned Public Health specialist who holds a post graduate certificate in Pharmacology and Therapeutics, an MPH, and a PhD both from Texila American University. He is a member of the International Society of Substance Use Professionals and a Fellow of the Royal Society for Public Health in the UK. He authored two books: "The Unseen Terrorist," published by AuthorHouse UK, and "The Night Before I Killed Addiction."
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