Health Education

Can you drink alcohol with antibiotics?

By | May 24, 2019

Finally! The weekend is here and you are ready to kick back with a few libations. But wait—you’re still working through that course of antibiotics your doctor prescribed last week after your (insert name of pesky infection here) diagnosis. Is it even safe to drink alcohol? Or should you wait until you’ve completed the regimen and are officially infection free?

For the sake of your recovery it is probably better to just skip the vino and volunteer for designated driver duty instead, says Brian Werth, PharmD, an assistant professor at the University of Washington School of Pharmacy in Seattle.

“Alcohol has immunosuppressive effects, and it can prevent your ability to fight the infection you are taking the antibiotics for,” Dr. Werth says. “And it can make certain side effects of antibiotics worse.”

He’s talking side effects like nausea, vomiting, diarrhea, and dehydration, which are common among most—if not all—antibiotics.

“If you are throwing alcohol into the mix … you can get sort of a compounding of these issues,” he says, adding that this could ultimately prolong your recovery.

Furthermore, according to the National Sleep Foundation, consuming alcohol can interfere with sleep quality. And since sleep is so important to the healing process, it is probably best to avoid anything that will keep you from getting enough ZZZs while your body is working on fighting that infection.

In terms of actual safety, the good news is that there is not a direct contraindication between alcohol and most antibiotics. However, the keyword here is most. Commonly-prescribed antibiotics like amoxicillin and azithromycin, for example, aren’t contraindicated (according to the Centers for Disease Control, out of 270.2 million antibiotic prescriptions written in 2016, 56.7 million were for amoxicillin and 44.9 million were for azithromycin). But some others are, and mixing them with alcohol could be risky, Dr. Werth says.

“There are specific antibiotics that have a direct interaction with the alcohol metabolism pathway,” he says. “And those are the ones that pose the biggest risk of having a direct negative impact with co-administration with alcohol.”

The drugs in question? Basically, anything that ends in -zole, like metraonidazole (Flagyl), tinidazole (Tindamax) or sulphamethoxazole (Bactrim) or -lid, like linezolid (Zyvox). If you haven’t heard of them, you’re not alone—these medications are rarely prescribed in outpatient settings (meaning patients typically receive them while hospitalized), says Dr. Werth. However, in the event that you do wind up with a prescription for one of these, be aware that mixing them with alcohol can cause some severe adverse reactions, such as flushing of the skin, drowsiness, dizziness, and headaches. For these reasons, alcohol should be completely avoided while taking these medications, according to the Mayo Clinic.

Also, be aware that alcohol can impair your liver function and some antibiotics are metabolized by the liver, explains Emily Mui, an infectious disease clinical pharmacist with Stanford Health Care.

“This may result in increased or decreased drug metabolism, which can either increase the risk of side effects or decrease the effectiveness of the antibiotic,” she says.

Of course, these are just general guidelines. Speaking directly to your own doctor or pharmacist about your own specific prescription is always recommended. And most importantly, if you suspect you are experiencing a reaction to an antibiotic it never hurts to call your doctor, Dr. Werth says.

“If someone is feeling really bad, it might be worth getting checked out,” he says.