Wine may go well with a nice meal at dinner, but the one thing it shouldn’t be paired with is antibiotics. In fact, drinking alcohol while taking a course of antibiotics can be a dangerous combination.
While good bacteria, known as probiotics, help your body function properly by supporting the immune system and restore balance throughout, an overgrowth of bad bacteria can make you ill. Thankfully, antibiotics are medications that can treat and prevent bacterial infections — such as strep throat — by killing bacteria or inhibiting their growth and proliferation.
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“Without antibiotics, it would be incredibly difficult to fight harmful infections,” says Dr. Tochi Iroku-Malize, president of the American Academy of Family Physicians and chair of family medicine at Northwell Health in Long Island, New York.
Since Dr. Alexander Fleming’s accidental discovery of penicillin — the world’s first true antibiotic — in 1928, antibiotics have saved millions of lives and are still widely used today. According to the Centers for Disease Control and Prevention, health care providers prescribed more than 201 million antibiotic prescriptions in 2020.
While antibiotics are a mainstay of treatment, certain foods, beverages and other medicines can interfere with the effectiveness and absorption of antibiotics. One of the top things to avoid is alcohol. Having an alcoholic drink will not usually impact the effectiveness of antibiotics, depending on the amount consumed and type of antibiotic taken. But any consumption of alcohol while taking an antibiotic can lead to unpleasant side effects and lower your body’s ability to fight infection.
“Mixing alcohol and antibiotics can exacerbate side effects of some antibiotics like drowsiness, nausea and dizziness,” Iroku-Malize explains. “The mixture can also lead to more dangerous side effects such as elevated blood pressure or cause liver damage.”
[SEE: Alcoholic Hepatitis Symptoms: Here’s What You Need to Know.]
Serious Consequences of Mixing Alcohol and Antibiotics
Although antibiotics are generally safe when used as prescribed by a health care professional, some medications within certain classes of drugs can cause liver damage. This risk significantly increases when antibiotics are mixed with alcohol. Some antibiotics carry a risk of injuring the liver, a risk greatly amplified when alcohol is also being consumed as alcohol is a type of liver toxin. This combination can also reduce the effectiveness of certain antibiotics.
“Alcohol can change both the absorption and breakdown of antibiotics by the liver, making them less available in the body to treat the underlying infection for which they are being used,” says Dr. Scott Friedman, dean for therapeutic discovery and chief of the division of liver diseases at the Icahn School of Medicine at Mount Sinai Hospital in New York City.
Drinking alcohol while taking antibiotics can worsen symptoms, and in rare cases, can lead to severe illness, particularly in older people.
Because our bodies’ natural ability to metabolize alcohol slows down as we age, seniors are at increased risk for harmful interactions since more medications are used as people age. For women, there is also a heightened threat of mixing alcohol with antibiotics because women have less water in their bodies than men even when they weigh the same. As a result, a higher concentration of alcohol remains circulating in the blood.
[Read: Antibiotics Screwed Up My Gut. Now What?]
Alcohol and Medication Interactions
In a 2020 study published in the journal Antimicrobial Agents and Chemotherapy, pharmacists at the department of Veteran Affairs Western New York in Buffalo evaluated the available research to determine which antibiotics are safe to consume and which ones should not be mixed with alcohol. Several of the most common antibiotics — such as azithromycin, ciprofloxacin and penicillin — are safe when alcohol is consumed. But the researchers noted that concomitant use of alcohol with certain antibiotics should be avoided in many cases.
Below is a list of how antibiotics can be used with alcohol.
Antibiotics that may be used with alcohol consumption:
— Azithromycin.
— Ciprofloxacin.
— Doxycycline.
— Fluconazole.
— Levofloxacin.
— Minocycline.
— Moxifloxacin.
— Nitrofurantoin.
— Penicillin.
— Secnidazole.
— Tetracycline.
— Tinidazole.
— Trimethoprim-sulfamethoxazole.
Antibiotics that may be used with moderate alcohol consumption:
— Linezolid.
— Tedizolid.
[Read: Getting Your Probiotic Fix When Taking Antibiotics.]
Antibiotics that are unsafe or with unclear risk with alcohol consumption:
— Cephalosporins (cefamandole, cefdinir, cefmetazole, cefoperazone, cefotetan, cefpodoxime, ceftriaxone).
— Cycloserine.
— Erythromycin.
— Ethambutol.
— Ethionamide.
— Griseofulvin.
— Isoniazid.
— Ketoconazole.
— Metronidazole.
— Pyrazinamide.
Alcohol warnings on antibiotic packages may vary depending on the pharmacy chain that dispenses the prescription. Sometimes just reading the label is not enough. To be safe, speak with your doctor or pharmacist to make sure you are using the prescribed medication correctly.
Here are some questions to ask your doctor or pharmacist:
— Will drinking alcohol affect the efficacy of this antibiotic to fight my infection?
— What side effects may occur if combining the two and are any dangerous? What should I look out for?
— Will drinking alcohol on this medication affect my liver?
— How long after finishing this antibiotic should I wait to have a drink?
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Can You Drink on Antibiotics? The Truth About Mixing Antibiotics and Alcohol originally appeared on usnews.com
