How Bad Is It Really to Drink While Taking Antibiotics and Other Meds?

Warning: Do Not Use With Alcohol

You’re about to order your first beer of the night when it hits you: You’ve been taking antibiotics for a few days to treat a no-longer-bothersome travel bug. Are you even “allowed” to drink? Maybe, maybe not. “Alcohol is a drug, so anytime you combine one drug with another, you’re at risk for drug interactions,” says Jocelyn Kerl, a pharmacist in Madison, Wisconsin, including those that enhance the medication’s side effects or slow or speed up how the body processes it. But the severity of potential interactions varies greatly. Here’s a look at some common medicines and what can happen — if anything — if you drink moderately while taking them:


Whether an antibiotic cooperates with cocktails depends on the drug itself. Metronidazole, which is sold as Flagyl and often used to treat the sexually transmitted infection trichomoniasis, for example, is dangerous to booze on since it can cause vomiting and other severe symptoms, Kerl says. Folks on ketoconazole (sold as Nizoral for skin infections) and isoniazid (sold as Nydrazid for tuberculosis) also need to stay away from alcohol to avoid potential liver damage, according to the National Institute on Alcohol Abuse and Alcoholism. While many other antibiotics are generally safe for moderate drinkers, check with a pharmacist first and, if cleared, space out when you take each, advises Mohamed Jalloh, a spokesperson for the American Pharmacists Association.

Cold, flu and allergy meds

Over-the-counter meds that fend off sneezing and other cold, flu and allergy symptoms are mostly likely to lead to drowsiness if you take them while alcohol is in your system. That can be especially dangerous if you get behind the wheel or overdose, since alcohol and many allergy meds both slow down how the brain and spinal cord function. If you are an allergy (or cold or flu) sufferer who drinks, opt for non-drowsy varieties of the meds, Jalloh suggests. As with all med-alcohol mixes, check with your doctor or a pharmacist first, and take characteristics like age and gender into account; women and older people tend to be at higher risk for negative consequences, the NIAAA says.

Over-the-counter pain meds

Just because pills like Advil and Tylenol are commonplace in Americans’ medicine cabinets, they’re not entirely harmless when consumed with what’s in those Americans’ liquor cabinets. While taking one or two ibuprofen (Advil, Motrin) occasionally is generally safe and recommended over mixing acetaminophen (Tylenol) with alcohol, if spirits and ibuprofen are staples in your diet, you may raise your risk for developing bleeding and stomach ulcers, Kerl says. Mixing booze with Tylenol, meanwhile, can put you at risk for liver damage, even if you don’t take more than the recommended dose, according to the U.S. Food and Drug Administration. Lesson: Moderate your drinking and you may not need so many, if any, pills for the hangover.


If you just ate a greasy meal and washed it down with a few big brews, you may be eager to reach for a drug to ease heartburn or indigestion. But it behooves you to choose that med wisely, since some antacids and proton pump inhibitors are more likely to interact negatively with alcohol than others, says Jalloh, also an assistant professor at Touro University California. “Go to a pharmacy and speak to a pharmacist,” he says. A drug like ranitidine (Zantac) probably won’t be recommended to drinkers, since it can lead to sudden blood pressure changes, the NIAAA reports, while famotidine (Pepcid AC) may be since it doesn’t have any known interactions with alcohol.

Prescription pain meds

Opioids like hydrocodone (Vicodin) and oxycodone (Percocet) aren’t only risky for their dangerously addictive nature; when mixed with alcohol, the NIAAA reports they can lead to slowed or difficulty breathing, memory problems, unusual behavior and — perhaps most troubling — an increased risk of overdosing due to the way the substances enhance each others’ effects. “The No. 1 thing I’m worried about is any opioid that’s extended release,” or a particular form of the drug that’s made to last longer in the body, Jalloh says. “Even if you separate when you take them, they can still have effect as if they were taken together,” he says.

Cholesterol-lowering drugs

If you have high cholesterol, booze isn’t exactly part of a highly-effective cholesterol-lowering prescription. But if you do imbibe moderately, keep in mind that nearly all drugs for high cholesterol — think brands like Lipitor, Crestor and Zocor — can lead to liver damage, while those that are also spiked with aspirin (like the brand Pravachol) raise the risk of stomach bleeding when taken with alcohol. Just another reason to be honest with your doctor about your habits; he or she may either adjust your prescription accordingly, or simply keep tabs on your liver enzymes to get ahead of any damage, Kerl says. “Most of this can be monitored,” she says.

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