Seasonal allergies are as common as they are annoying. According to the Asthma and Allergy Foundation of American, allergic rhinitis (aka hay fever) affects 20 million adults in the United States each year. And millions more experience various other types of allergies—everything from insect bites and pet dander to shellfish, peanuts, and mold spores (to name a few). If your allergy is severe enough, you might carry an EpiPen or receive allergy shots from your doctor. For most people, however, over-the-counter allergy medicine is the first line of defense.
But how does taking allergy medication impact your ability to enjoy those #weekendvibes? In other words, will you still have the option to enjoy a cold beer on a hot summer night if you are taking something to combat your itchy eyes, runny nose, hives, or scratchy throat?
First-generation allergy medicines, like Benadryl, and alcohol
If your allergy med of choice is diphenhydramine, also known as Benadryl, the answer is an emphatic NO. Benadryl and alcohol should never, EVER, be combined, says David Corry, MD, a pulmonologist and professor of medicine in the immunology, allergy, and rheumatology department at Baylor College of Medicine in Houston, Texas. The same rule goes for other first-generation allergy medications such as chlorpheniramine (Chlor-Trimeton), clemastine (Tavist) and hydroxyzine (Atarax).
“That is a big contraindication,” Dr. Corry says.
Why? Because the primary side effect of these medications is drowsiness (case in point: Benadryl is also used to treat insomnia), which is also one of the primary side effects of alcohol consumption.
“First-generation antihistamines will cause drowsiness in just about everybody, [and] alcohol does that, too,” Dr. Corry explains. “So if you are taking alcohol and antihistamines your chances of having a double dose of that drowsiness are very, very high.”
And in the worst-case scenario, he explains, this double-dose of drowsiness can not only impair your ability to function and increase the likelihood of some sort of accident, it can also lead to unconsciousness. Meaning, that cold beer is not worth the risk.
The only exception to this hard-and-fast rule is if someone has a severe allergic reaction to something, like food or an insect bite, in the midst of alcohol consumption.
“If you are allergic to shellfish and you had two martinis and then somebody passes you a shrimp and you are having a reaction … you would not withhold Benadryl,” says Maria Marzella Mantione, Pharm.D., director of the Doctor of Pharmacy program at St. John’s University in Queens, New York. She adds that in this scenario the patient needs professional medical care so call 911 or get them to a doctor immediately.
“These concerns [about antihistamines and drowsiness] are really outside of this particular context of severe, life-threatening situations,” Dr. Corry agrees.
Fortunately, Benadryl clears from your system in four to six hours, says Dr. Mantione. So, presuming the allergic reaction is kept at bay, you won’t be teetotaling indefinitely.
Second-generation allergy medicines, like Zyrtec, and alcohol
If you have chronic seasonal allergies it is unlikely your doctor will recommend a first-generation antihistamine, says Dr. Mantione, because these are normally used for acute reactions. Instead, she explains, you’ll likely be steered toward one of the second-generation allergy medications. Loratadine (Claritin), fexofenadine (Allegra), or cetirizine (Zyrtec) and alcohol are generally considered a slightly safer combination. These medications do not typically cause drowsiness or other side effects that are intensified by alcohol consumption.
“Most of these have a reduced, if not completely absent, side effect of sleepiness,” Dr. Corry says.
This is not to say, however, that it is okay to go on a bender while taking Claritin, Zyrtec, Xyzal, or Allegra—Dr. Corry recommends avoiding alcohol altogether while taking any medication.
But is doing so going to lead to a critical medical emergency? Probably not, explains Dr. Mantione. “It is one of those situations where, as a pharmacist, I say it is best to avoid because we don’t know how it is going to affect you, but it is not [considered] a life-threatening combination,” she says.
She also offers an alternative for those who don’t want to give up the opportunity to have a drink—nasal corticosteroids, such as Flonase or Nasonex. These are used as needed, and are safe to use regularly throughout the allergy season. They don’t have a contraindication with alcohol, and they don’t cause drowsiness or other systemic side effects, she says.
“If somebody came to me and said ‘I am on this allergy medication but I am going away on vacation and I am hoping to have Bahama Mamas every day’ I would recommend the nasal corticosteroid,” Dr. Mantione says.