Health Education

Is it safe to drink alcohol with cold and flu medication?

Dawn Weinberger headshot By | January 10, 2020
Medically reviewed by Karen Berger, Pharm.D.

If you have the flu—or even just a severe cold—the last thing you probably feel like doing is going out for a night on the town. And while abstaining from alcohol is a good thing (and what your body needs when it is in virus-fighting mode), you may be tempted to try a hot toddy to soothe your sickness. Is that a good idea? Well, it all boils down to hydration (or lack thereof), experts say. 

“One major reason people get hospitalized with severe viral infections is [because] they get severely dehydrated and weak,” explains Robert McLean, MD, president of the American College of Physicians

Alcohol only exacerbates this, he says, because it triggers a diuretic effect. Next thing you know, your body is expelling fluid (through urination) at a rapid rate. The hydration you need to get better? Gone (so much for all the tea, water and chicken soup you’ve been downing). Not only that, but alcohol can actually make some of your symptoms, like nausea, vomiting, and headaches, worse. Why? Because alcohol produces some of the same side effects, says Kevin Davis, Pharm.D., pharmacy supervisor at the University of Florida Health, Jacksonville, and that adds insult to injury. 

Flu and cold medicine and alcohol interactions

And then there’s the matter of the over-the-counter meds you are taking to manage your symptoms. Alcohol actually has some very significant drug-drug interactions with many of them, says Dr. Davis.

Some of these medications include:

Tylenol and alcohol

Tylenol (acetaminophen) is a commonly-used pain reliever and fever reducer that is metabolized by the liver, just like alcohol. Mixing the two under any circumstances is considered risky because, according to the Food and Drug Administration (and essentially all medical professionals), it has the potential to cause severe liver damage, or even death.

Benadryl and alcohol

Benadryl (diphenhydramine) is an antihistamine that can relieve some of the upper respiratory symptoms that sometimes come with colds and flu. However, it also makes you drowsy. Alcohol, too, causes drowsiness. Take the two together, and you could wind up experiencing the worst-case scenario—extreme drowsiness, slowed breathing, and possibly even unconsciousness. 

Unisom and alcohol

Unisom (doxylamine succinate), also an antihistamine/sleep-aid, functions much like diphenhydramine, says Dr. Davis, so taking it with alcohol is a recipe for disaster. 

Robitussin and alcohol

Robitussin CoughGels (dextromethorphan) is an OTC drug used to treat coughs and other flu-related complications (like coughs from bronchitis). Taking dextromethorphan alone has the potential to make you dizzy, drowsy, and impair your mental function. Alcohol increases these effects. 

NyQuil and alcohol

To make matters worse, many cold and flu remedies are a combination of these medications. NyQuil, for example, contains acetaminophen, doxylamine, and dextromethorphan. Tylenol Severe Cold and Flu contains, in addition to acetaminophen, a cough suppressant (and several other medications). So when you combine these OTC remedies with alcohol, your risk of side effects increases a lot, says Dr. Davis. In addition to staying away from alcohol altogether while you are recovering from a cold or the flu, he urges patients to speak to the pharmacist about the best medications to actually use. The multiple ingredient OTC meds are often unneeded with your specific symptoms—it is best to use single-ingredient products targeted to your exact symptoms

Tamiflu and alcohol

Somewhat ironically, antiviral medications used to treat the flu do not have direct drug-drug interactions with alcohol, says Dr. Davis. Tamiflu (which hit the market in 1999 and generated more than $200 million in sales in 2018) and Xofluza (which is a single-dose antiviral medication approved in October 2018) both have some drug-drug interactions, but they both do not interact with alcohol. 

RELATED: Tamiflu vs. Xofluza—which works better? 

So does this mean it is okay to have a little whiskey while you fight the fever and severe aches and pains brought on by this punishing virus? No, for all the reasons listed above. 

“It is definitely not a good idea when you are sick at all to drink alcohol,” Dr. Davis says. 

Plus, Tamiflu and Xofluza need to be taken within 24-48 hours of symptoms onset—when you likely feel extremely miserable. Chances are you won’t be getting up off the couch, let alone heading to the fridge to grab a beer (and of course we recommend avoiding getting the flu altogether by getting a flu shot—it is not too late!).