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Is It Safe to Mix Antibiotics With Alcohol?

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Can You Mix Antibiotics With Alcohol?

It’s generally accepted wisdom that while taking antibiotics you should avoid alcohol because of potential side effects. While in many cases alcohol doesn’t actually make the antibiotics less effective, it can result in some unpleasant symptoms which, combined with the negative effect of alcohol on the immune system, can impede your recovery.

Read on to discover exactly why you shouldn’t drink alcohol while taking antibiotics, some of the common side effects of combining the two and the impact alcohol can have on your immune system…

It’s Important to Avoid Drinking Alcohol on Antibiotics

Most antibiotics will come with a warning to avoid consuming alcohol while taking this medication, but there still remains some level of confusion around the topic.

When you drink alcohol, your body doesn’t have anywhere to store it so it needs to immediately break it down. This process produces acetaldehyde, which can make you feel nauseous. Feeling sick, or experiencing digestive issues, is already a common side effect of taking certain kinds of antibiotics, and so adding alcohol to the mix can exacerbate this issue.

Both antibiotics and alcohol have been shown to have the potential to impact your cognitive ability too, such as experiencing brain fog or confusion. And on top of that, consuming alcohol negatively interferes with other vital processes in the body. For example, it can result in dehydration and lower quality of sleep, both of which are necessary for recovery.

Because of all of these issues, it is not advisable to consume alcohol while you take antibiotics.

Does Alcohol Reduce Antibiotic Effectiveness?

In most cases, it’s not believed that alcohol makes antibiotics ineffective, but the combination of the two can result in some nasty side effects which may make it harder for your body to recover properly. Specific side effects will depend on which antibiotic you’re taking, but some include:

  • Nausea     
  • Drowsiness
  • Dizziness
  • Digestive upset e.g., diarrhoea

Signs of a negative reaction from mixing alcohol and antibiotics can include:

  • Racing heartbeat
  • Severe headache
  • Red skin that is warm to touch

In some circumstances, if a large quantity of alcohol is consumed and present in your bloodstream, it could potentially impact the effectiveness of the antibiotics too. Alcohol is broken down by your liver using enzymes and some antibiotics are also broken down by these, or similar, enzymes. Because of this, changes in these enzymes may impact how antibiotics are broken down in your body.

If you consume a large amount of alcohol over a small period of time, these enzymes won’t be able to break down the antibiotics as well. This means that the levels of antibiotics in your body could increase because it hasn’t been properly broken down, which can result in more drug toxicity and side effects.

Likewise, if you use alcohol every day, enzyme levels can be induced. This means the antibiotic is broken down too quickly and the levels in your blood can reduce. This can result in either the infection remaining or antibiotic resistance.

The Effects of Alcohol on the Immune System

Regularly consuming alcohol can have a number of impacts on your immune system and render you more prone to infections. It can also make you more vulnerable to infections caused by bacteria and viruses, which could in turn make you more vulnerable to the risk of bacterial infection, such as urinary tract infections.

To understand the role alcohol plays, first of all, you have to understand the immune system. It consists of a network of cells and proteins that spot infections and then attack them. Usually, it takes the immune system a bit of time to build up to this full response and during that time you’ll often notice symptoms get worse as the infection develops. But you should then start to pick up once your immune system has mounted a strong enough response to fight the infection.

Alcohol suppresses the immune system, which means it can take the body more time to spot and mount a response to developing infections. Because of this, symptoms can last longer and can become more intense when alcohol is involved.  

Most people understand the capacity for immune system damage that comes from long-term alcohol abuse, but short-term alcohol use is not without its problems either. Even just one single episode of drinking can suppress the immune system for around 24 hours.

Alcohol use over the long term can create even bigger problems. The impact chronic alcohol use has on the immune system is complex, but research has found it can impact just about every area of the immune system and significantly increases the risk of developing infections. As well as suppressing every area of the immune system, these long-term adaptations to the immune system can cause chronic inflammation which comes with its own set of side effects and medical issues.

Research has found a connection between excess alcohol intake and a range of adverse health outcomes including a greater likelihood of acute respiratory stress syndromes, sepsis, liver toxicity resulting in alcoholic liver disease and certain cancer along with a higher rate of postoperative complications and slower and less complete recovery from infection and physical trauma, including poor wound healing.

Alcohol interrupts immune pathways in all sorts of confusing, but ultimately unhelpful, ways. This disruption makes it harder for your body to protect itself against infection and even recover from tissue injury.

If you are currently drinking excessively, the best way to protect your immune system is to get help and avoid alcohol.  

What Happens if You Drink Alcohol With Antibiotics?

In most cases, as we discussed above, drinking alcohol won’t stop your antibiotic from working to fight against the infection. But it can hamper your recovery in a number of ways, which is why it is usually advised you avoid alcohol if you are taking a course of antibiotics.

Recovering from infection requires rest, high-quality sleep and good nutrition. Drinking alcohol can make it harder to achieve these basic principles for recovery. For example, alcohol reduces the quality of sleep you can get. So even if you fall asleep, you’ll often find yourself waking up throughout the night which won’t give your body the rest it needs.

Consuming alcohol also stops your body from getting the vital nutrients it needs from food, and in addition, it can push your blood sugar levels up and leave you feeling lethargic. Again, all of this is incredibly unhelpful in the context of recovery from infection.

Remember that alcohol is in more than just drinks like wine, beer and spirits, it can also be found in products like mouthwashes and cold medications too. If you have experienced a bad reaction to mixing alcohol with antibiotics in the past, this is something to be mindful of.

If you have drunk alcohol while taking antibiotics and are suffering from a side effect, it should usually resolve itself in a few hours. However, if it goes on for longer than this, or is severe in nature, it’s really important to seek urgent medical care.

Are There Any Antibiotics You Can Drink With?

While it’s a good idea to avoid drinking alcohol when you’re already feeling unwell with an infection, it is unlikely that moderate drinking will cause you to have a reaction to your antibiotics. Some of the more commonly prescribed medicines won’t become less effective with moderate alcohol intake. These include flucloxacillin and amoxicillin.

Though drinking moderately shouldn’t reduce the effectiveness of these common antibiotics, it could still impede healing, put stress on the liver, cause dehydration, and increase the risk of, or worsen, side effects.

However, you need to exert extra care and avoid all alcohol with certain antibiotics:

Metronidazole: This is an antibiotic sometimes used for dental or vaginal infections, skin infections, infected leg ulcers and pressure sores.

Tinidazole: This is an antibiotic which is often used to treat many of the same infections as metronidazole, but it can also assist in clearing a bacteria called Helicobacter pylori from the gut.

Both of these antibiotics do not mix well with alcohol and can result in a series of deeply unpleasant side effects including:

  •         Feeling nauseous
  •         Being sick
  •         Stomach issues
  •         Heartbeat irregularities
  •         Headaches
  •         Dizziness and drowsiness

You will also want to totally avoid alcohol if you are taking any of the following antibiotics:

Linezolid: Used to treat infections, including pneumonia, and infections of the skin, this antibiotic can be affected by fermented alcoholic drinks like wine, beer and sherry.

Doxycycline: Used to treat infections including chest infections and dental infections, alcohol does not mix well with this antibiotic. In addition, it may also be less effective in people with a history of excessive drinking.

What to Do Next

Mixing alcohol and antibiotics is best avoided altogether. While antibiotics come with side effects that may be exacerbated by alcohol use, it’s worth avoiding alcohol when you’re ill anyway. When your body is busy fighting off an infection, it is best to support it with high-quality sleep, rest and nutrition.

If in doubt, speak with your healthcare provider. When you are prescribed antibiotics, your healthcare provider should talk you through how best to take them effectively. Your medication should also come with a warning label which will include information about alcohol use while taking them.

If you have any concerns about the details of your antibiotics, speak with your doctor or pharmacist as they will be able to give you an answer specific to you that takes into account your history, age, health and the type of antibiotic you have been prescribed.

Your doctor is likely to advise you to avoid drinking alcohol for the time that you’re taking your medication and they can advise how long you should avoid it after you have finished your course of antibiotics too. It could be up to 72 hours in some cases, so it is always worth checking.

It’s worth heeding the advice of your doctor or pharmacist and avoiding the unpleasant effect of any alcohol-drug interaction.  

Last updated & clinically assessed 22 June, 2022