Interactions Between Medications and Alcohol

Regular consumption of alcohol can have several damaging health impacts. It can, however, have an even more devastating effect when combined with medications. Many drug interactions can occur with alcohol. 

Some interactions can change the way people metabolize the medication or can increase symptoms of intoxication. Unfortunately, that can mean significant challenges for anyone who consumes alcohol while taking non-prescription or prescription drugs.

Table of Contents

The Dangers of Alcohol Use with Medications

Mixing medications, including prescription and non-prescription medications, with alcohol can have adverse side effects. Older adults, in particular, may face a higher overall degree of vulnerability when they mix drugs and alcohol, as may medically vulnerable youth5, who tend to consume alcohol at the same rate, in general, as their healthy peers.

Patients may mix alcohol and medications for several reasons. Some patients do not think about the potential impact of mixing alcohol with their drugs, especially if they have just started taking a new medication or have picked up an over-the-counter medicine to treat acute symptoms like allergies or minor pain. Not knowing the risks can also decrease the odds that a patient will recognize the potentially devastating consequences of mixing drugs and alcohol in time to avoid further impact. 

Other patients may deliberately consume drugs and alcohol together to help increase the effect of the alcohol. That behavior can lead to additional risks, including long-term health challenges. 

Finally, some patients may not want to stop drinking despite knowing that a new medication could lead to increased side effects. These patients may suffer from a devastating addiction that can make it challenging to control alcohol consumption.

Increasing Effects

Sometimes, alcohol consumption can increase the effect of the medication, mainly when someone takes a drug with similar side effects to alcohol. For example, alcohol has a sedative effect, which means that, when combined with medications that cause patients to feel sleepy or sedated, it may increase the overall impact of those medications and make it more difficult for patients to deal with symptoms. 

Alcohol may also cause a person to metabolize some of the medications they regularly take more quickly, which means that they may hit the system hard but that the impact of the drug may go away more rapidly than intended. 

A person’s medications may also increase their reaction to alcohol consumed. Any time someone takes a new medicine or drug, they may notice a change in how alcohol hits them. They may become inebriated more easily or more quickly. As a result, a person may engage in more dangerous behavior or continue to drink well past the potentially dangerous point due to an overall lack of awareness of those drug/alcohol interactions.

Decreased Impact of Medication

In many cases, alcohol consumption can interfere with a person’s medications. Some medications break down when exposed to alcohol, which can cause them not to work properly. In other cases, a person may find that drinking alcohol causes medication to metabolize more slowly, making it more difficult to predict how the medicine will enter the system and manage symptoms. 

Excess alcohol consumption can substantially raise the risk of this damaging side effect since it may take longer for the body to metabolize the alcohol a person has consumed. In some cases, medication can also interfere with a person’s overall metabolism, which means it may prove more challenging to predict how long it will take for the system to go back to normal after drinking.

Long-Term Health Impacts

In some cases, consuming alcohol with other substances can substantially increase the long-term health impacts4. Not only can alcohol consumption lead to several potential diseases and symptoms, but you may also worsen the effects by adding drugs or medications that can interact with those symptoms. 

The longer those interactions continue, the worse the health effects a person may face. While discontinuing alcohol or drug use can allow the body to heal from some of those effects, many symptoms may linger long after the initial period of use.

Decreased Physical Abilities and Motor Control

In many cases, adding drugs to alcohol can further impair overall motor function. Unfortunately, many people fail to realize total motor impairment when high or drunk. As a result, they may engage in potentially dangerous activities, including getting behind the wheel or trying tricks and stunts, while under the influence of drugs and alcohol. Even drinking while taking prescription medication can interfere heavily with motor control and increase the risk of severe injury.

Common Medications and Their Interactions with Alcohol

The interactions between alcohol and medication can vary depending on the type of medication you consume. Take a look at these common medications and how consuming alcohol can interact with those medications1.

Antibiotics

Many people take antibiotics for infections without considering how they may interact with alcohol. However, some antibiotics, including erythromycin, may not interact well when taken with alcohol. Erythromycin may cause your intestines to empty faster. When combined with alcohol consumption, this may lead to faster alcohol absorption, which may, in turn, increase the risk that you will show enhanced symptoms of drunkenness faster.

Anticonvulsants

People taking anticonvulsants intended to decrease or eliminate seizures may need to avoid alcohol regularly. Alcohol consumption can cause those anticonvulsants to break down, leading to increased seizure risk. Patients who routinely consume alcohol may notice that they do not get the same impact from their medications and that they may no longer have their seizures under control.

Anticoagulants

Alcohol intake can have an interesting interaction with anticoagulants intended to prevent blood clots. While a high degree of immediate alcohol intake may cause the patient to see the decreased anticoagulant impact by reducing the metabolism of those medications, chronic alcohol consumption may increase the metabolism of those substances. As a result, drinking while taking anticoagulants can result in unpredictable medication reactions. These reactions could make those medications ineffective or even dangerous.

Blood Sugar Regulation

Many people with diabetes take medications daily to help control blood sugar. Unfortunately, consuming those medications while drinking alcohol can lead to extremely low blood sugar. This is because alcohol increases the impact of those medications. 

Alcohol use by diabetics can also leave blood sugar uncontrolled, leading to substantial long-term side effects2. People with diabetes who drink regularly or heavily may have a much higher risk of diabetes side effects.

Antidepressants

Many people take antidepressants to help combat the impact of depression. However, alcohol acts as a depressant, which can combat the effects of those antidepressants. Furthermore, consuming alcohol while taking antidepressants may increase the influence of alcohol’s side effects, including the sedative effects. That means you may have a greater overall risk of suffering impaired motor skills, focus, and concentration. 

Furthermore, combining antidepressants and alcohol may increase symptoms of drowsiness and sedation, increasing the chance of a person’s overdose. In some patients, taking antidepressants can decrease the rate of alcohol consumption, leading to a positive overall decrease in symptoms3. However, failure to pay attention to alcohol consumption while taking antidepressants can have catastrophic consequences. Because depression can also increase the risk of substance abuse and addiction, family members may need to pay close attention to depressed individuals at risk for consuming high levels of alcohol.

Muscle Relaxants

Patients may take muscle relaxants to help reduce overall muscle pain and tension. Muscle relaxants can be beneficial in the aftermath of an injury. However, some of those muscle relaxants can interact dangerously with alcohol. 

Alcohol consumption while taking muscle relaxants can cause the patient to lose control of motor functions more quickly and may lead to a higher overall level of impairment than either alcohol consumption or muscle relaxant use alone. Furthermore, depending on the muscle relaxant someone takes, they may experience an opiate-like high that may cause severe symptoms. Avoiding alcohol while taking muscle relaxants can help patients avoid those responses.

Opioids

Many opioids can substantially impact the body on their own, even without the addition of alcohol. Add in alcohol, on the other hand, and you may have significantly increased effects. Consuming alcohol while taking any opiate can lead to increased drowsiness and symptoms of sedation. 

Furthermore, mixing alcohol and pain medications can substantially impact motor control. Patients taking pain medications should not mix them with alcohol. Mixing alcohol with drugs should be avoided because of the intense sedating effect and increased risk of heavy intoxication. If alcohol and opioid drugs are combined, the patient should avoid driving or engaging in dangerous activity until the effects wear off.

Sedatives

While alcohol may also have a sedative effect, combining alcohol and sedatives may not have an enhanced effect. Instead, it may prevent sedatives from metabolizing correctly, leading to extreme disorientation and confusion without creating the sedating effect the patient may have been looking for. The sedative impact may also take longer to wear off after consuming alcohol due to the metabolic slowing.

The Impact of Alcohol and Over-the-Counter Medications

While you might know that you may need to avoid consuming alcohol when taking prescription medication for any reason, many patients may not realize the impact alcohol can have when consumed with common over-the-counter medications. In many cases, alcohol consumption can have a heavy impact on the body of the patient who has taken those medications, leading to extreme side effects.

Herbal Sleep Aids

Many herbal sleep aids, including chamomile and echinacea, can help ease patients off to sleep with relatively few side effects. If you add alcohol to even common herbal sleep aids, however, it may increase the sedative impact of those medications. It may ultimately lead to excess sleepiness, drowsiness, or difficulty waking.

NSAID Pain Relievers

NSAIDs act as anti-inflammatory agents to help relieve pain. Many common over-the-counter pain medications, including options like naproxen, are NSAIDs. Consuming these pain relievers with alcohol, especially in high quantities, can substantially increase the risk of gastrointestinal bleeding. Alcohol consumption and pain relievers may increase the likelihood that patients will not notice those symptoms immediately after consumption.

Analgesics

Many popular over-the-counter pain relievers may not interact well with alcohol, mainly when consumed at high levels. For example, when someone consumes aspirin along with alcohol, it can cause the digestive system to empty faster. This means that the person may absorb alcohol more quickly and face faster side effects. Excess acetaminophen consumption while drinking, on the other hand, may cause your body to metabolize that acetaminophen product into a toxic substance which can, especially when used over time, lead to a high risk of liver damage.

Antihistamines

Unfortunately, antihistamines combined with alcohol can lead to various severe effects. This includes an increase in the side effects of many antihistamines. For example, many patients may suffer a higher rate of drowsiness or sedation.

In addition, consuming alcohol while taking antihistamines may result in an overall reduction in motor control, making it more difficult for patients to deal with everyday tasks like driving.

Medications for Heartburn

Many commonly-used products for heartburn can harm the body when alcohol is added. When you take heartburn medications, including commonly-used Zantac, you may end up suffering increased alcoholic metabolism, which can mean higher blood alcohol levels than anticipated, given your usual rate of alcohol consumption. In many cases, drinkers may have difficulty judging how quickly that alcohol will impact them or how much, leading to an increased risk of dangerous behaviors.

Increased Risk of Overdose

Combining alcohol with many medications can substantially increase the risk of overdose. Alcohol consumption can increase the risk of overdose in several vital ways.

Faster Metabolism of Drugs and/or Alcohol

In many cases, consuming alcohol can increase the rate at which the person metabolizes drugs or alcohol. For some people, this can cause an overdose much faster than anticipated. People may sometimes consume alcohol and drugs to increase overall inebriation. Unfortunately, that may make it more difficult to judge how much alcohol they should consume, leading to severe side effects and much faster inebriation than anticipated. 

The faster metabolism of drugs or alcohol can make it more difficult for patients to judge their drinking correctly. They may assume that they “can’t be that drunk yet,” which may cause them to keep drinking. They may keep drinking despite starting to notice symptoms of heavy intoxication. As a result, they may have difficulty determining when they need to stop or engage in more dangerous behaviors than they would typically due to the increased risk of considerable inebriation.

Concealed Symptoms of Inebriation

In many cases, taking specific medication types can conceal inebriation symptoms. Some stimulants, for example, may make it difficult to note the signs of alcohol consumption. Many people, as a result, will continue to consume more alcohol, looking for a specific effect, and may not realize just how much they have already consumed.  They may consume additional alcohol, ultimately increasing the risk of severe overdose.

Do You or a Loved One Struggle with Alcohol Abuse?

A patient struggling with alcohol abuse may find it difficult to avoid alcohol consumption when changing or taking new medications. Unfortunately, that can increase the risks of widespread abuse, including overdose. If you find yourself or a loved one struggling with excessive alcohol consumption, a rehabilitation facility can help. 

Contact Southern California Sunrise Recovery Center to learn more about how we can help.

References & Resources

  1. Weathermon, R., & Crabb, D. W. (1999). Alcohol and medication interactions. Alcohol research & health : the journal of the National Institute on Alcohol Abuse and Alcoholism, 23(1), 40–54. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6761694/
  2. Emanuele, N. V., Swade, T. F., & Emanuele, M. A. (1998). Consequences of alcohol use in diabetics. Alcohol health and research world, 22(3), 211–219. https://pubmed.ncbi.nlm.nih.gov/15706798/#:~:text=Alcohol%20consumption%20by%20diabetics%20can,in%20excessive%20blood%20sugar%20levels.
  3. Agabio, R., Trogu, E., & Pani, P. P. (2018). Antidepressants for the treatment of people with co-occurring depression and alcohol dependence. The Cochrane database of systematic reviews, 4(4), CD008581. https://doi.org/10.1002/14651858.CD008581.pub2
  4. Shield, K. D., Parry, C., & Rehm, J. (2013). Chronic diseases and conditions related to alcohol use. Alcohol research : current reviews, 35(2), 155–173. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3908707/
  5. Weitzman, E. R., Magane, K. M., Wisk, L. E., Allario, J., Harstad, E., & Levy, S. (2018). Alcohol Use and Alcohol-Interactive Medications Among Medically Vulnerable Youth. Pediatrics, 142(4), e20174026. https://doi.org/10.1542/peds.2017-4026