With some exceptions, it is usually safe to drink alcohol while on antibiotics, but it is not recommended. Doing so can make you tired, and alcohol can inhibit the immune response, prolonging the infection or illness.

Always ask your doctor whether it’s OK to drink alcohol while taking any prescribed medication.

The Centers for Disease Control and Prevention reported there were 201.9 million antibiotic prescriptions filled in 2020. This equates to 613 prescriptions per 1,000 people. Of those, almost 169 million were prescribed for individuals over age 20, and 125 were female. Nearly 88.5 million antibiotics were prescribed in the South region of the country. It is the highest number of prescriptions in the United States.

This begs the question many people taking these drugs want to know: can you drink alcohol while taking antibiotics?

Antibiotics & Alcohol

Antibiotics are a broad class of medicines that stop bacteria from reproducing or destroy bacteria altogether. They are prescribed for many issues, both extremely serious and fairly mild. Most people will take some form of antibiotic at least a few times in their lives.

As a good rule of thumb, you should never mix drugs. This is true both of prescription medications, over-the-counter medicines, and recreational or illicit drugs. If you ever have any need to mix drugs, ask your doctor before doing so.

This applies to antibiotics and alcohol. Generally, doctors will recommend that you do not drink while taking antibiotics. You may not experience dangerous effects, but drinking can impede the healing process and cause discomfort while on antibiotics.

Why You Should Not Mix Antibiotics and Alcohol

There are many valid reasons why you should not be drinking on antibiotics. First, let’s look at what alcohol does when you are ill. Alcohol weakens your immune system. When you have a weakened immune system, you are more susceptible to infection and contracting a virus. Alcohol can change your blood sugar levels, and that can slow your healing and recovery time, as GoodRx says. Secondly, some antibiotic medication carries known side effects of nausea, vomiting, and diarrhea. When you drink alcohol on antibiotics, you are increasing the risk of those symptoms and adding drowsiness, headaches, and dizziness. Those can make you feel really terrible.

Dangerous Combinations

How else does alcohol affect antibiotics? Some antibiotics, when consumed with alcohol, can cause severe heart and abdominal issues.  It is best to avoid alcohol when taking these antibiotics:

  • Metronidazole (Flagyl), which is commonly prescribed to treat skin and vaginal infections. Avoid drinking alcohol for 48 hours after you stop taking metronidazole so that it can flush out of your system.
  • Sulfamethoxazole (Bactrim), which is commonly prescribed to treat urinary tract infections and ear infections.
  • Trimethoprim (Primsol), which is also prescribed to treat urinary tract infections and ear infections, among other infections.
  • Tinidazole (Tindamax), which treats both bacterial and parasitic infections. For similar reasons as metronidazole, you should not drink alcohol until about 72 hours after finishing a course of tinidazole.
  • Isoniazid, (brand name Nydrazid)
  • Cephalosporins (brand names Ancef, Kefazol, Ceclor, Cefaclor, and others)

As discussed by the Mayo Clinic and the United Kingdom’s NHS, taking these drugs along with alcohol can cause some pretty severe reactions. Symptoms of these reactions include:

  • Nausea
  • Hot flushes
  • Fast or irregular heartbeat
  • Headache
  • Dizziness
  • Drowsiness
  • Low blood pressure
  • Anxiety
  • Sweating
  • Vertigo
  • Vomiting
  • Extreme thirst

Linezolid is a commonly prescribed antibiotic. Its brand name is Zyvox. It is usually prescribed to treat pneumonia and skin infections and works by stopping bacteria growth. Linezolid can interfere with the breakdown of tyramine in your body. Tyramine is a substance in many alcoholic beverages and fermented foods, such as:

  • Sherry
  • Lager beer
  • Sausage
  • Salami
  • Aged cheeses, including blue cheese, brie, cheddar, parmesan, romano, and swiss
  • Sour cream
  • Sauerkraut
  • Raisins
  • Bananas
  • Avocado (more so when very ripe)
  • Tofu
  • Soy sauce
  • Soybeans
  • Fava beans

When you drink alcohol when taking this medicine, it can cause alarmingly high blood pressure. Drugs.com strongly advises not to consume any foods or beverages that contain tyramine during and two weeks after taking linezolid due to the very real possibility of dangerously high blood pressure. They even state that this condition could possibly be fatal for some people.

Remember Hidden Sources of Alcohol

Not all alcohol use is intentional. Some cold medicines, mouthwashes, and food items can have small amounts of alcohol in them. While normally a person will not get drunk taking these things as intended, you still should avoid them if on a medication that can interact dangerously with alcohol. It is always better to avoid unnecessary risk, especially when on any drugs and recovering from an illness. Generally, a product will be labeled accordingly if it contains alcohol. Food items can be a bit more difficult, especially if you are eating out. Familiarize yourself with food items that may contain alcohol, including but not limited to the following:

  • Pure and artificial flavor extracts
  • Foods that use rum, cooking wine, or similar ingredients
  • Some desserts, such as liqueur-filled chocolates and mousse
  • Cooking sprays

Discomfort

Modest alcohol use generally will not be a major health risk when taking antibiotics. Dr. James M. Steckelberg of the Mayo Clinic points out that alcohol can make you tired and slow your recovery process. He personally recommends that you, therefore, avoid alcohol until you feel better, simply for comfort and the sake of a speedier recovery rather than because of any major risks.

Many antibiotics can cause nausea and dizziness. If you are drinking on top of that, it can lead to serious discomfort or even vomiting. Even if it is not explicitly dangerous, it can be very unpleasant.

Be careful not to push your body too hard with recreational drinking, especially if you are already sick and feeling side effects from your antibiotics.

When You Can’t Stop Abusing Alcohol

Most people can avoid alcohol for a few days or weeks while on a medication that interacts poorly with it.

Some people cannot stop abusing alcohol. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), substance use disorder is marked by a person who uses drugs or alcohol in a way that clinically impairs some aspect of their life. This might include behavior that damages their home life, social life, education, work, or physical or emotional health.

This behavior is a sign that you need help. At its most severe, it can represent serious alcohol addiction, which comes with a host of dangers.

If you can’t stop drinking for the period that you are on antibiotics, it’s a clear red flag that you need treatment.

First, make your doctor aware of this fact. It can be dangerous if a doctor prescribes antibiotics or other medication without knowing you have a problem with alcohol abuse. They can potentially give you a medication that interacts less strongly with alcohol. They can also advise you on the best path forward to deal with your alcohol abuse issue.

Generally, some form of addiction treatment will be recommended.

Conclusion

Can you drink alcohol while taking antibiotics? In short, you can, but you shouldn’t. Alcohol and antibiotics are not a good combination as the effects you could potentially experience can result in dangerous conditions for your heart and gastrointestinal system. Antibiotics are usually prescribed for a short time, so it is best to wait for at least a few days after you finish the prescription antibiotic before consuming alcohol. 

If you can’t moderate your drinking, reach out for help. Arete Recovery is an accredited and licensed mental health and substance use disorder center in South Florida. We’ve helped many people overcome alcohol use disorder by exceeding our industry’s standards on care, and providing proven, evidence-based therapies, which focus on the whole person and not just their alcohol addiction. Arete provides a safe and comfortable environment for you and accepts most of the major insurance carrier plans.

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