Can You Drink Alcohol While Taking Antibiotics?
Drinking alcohol while on antibiotics can harm your body’s ability to fight infection, and some antibiotics can make you even sicker.
Alcohol is one of the most commonly consumed substances worldwide. However, illnesses like infections are also common. This may make you wonder if it is safe to drink alcohol while treating an infection with antibiotic medications.
What Are Antibiotics?
Antibiotics are medications that kill bacteria. They can work in many ways, attacking different parts of the bacterial cell to kill it. They treat infections, including pneumonia, skin infections, urinary tract infections and serious diseases like tuberculosis. Antifungals are medications similar to antibiotics, except they target fungal infections instead of bacteria. Some antibiotics are also antifungal drugs.
What Happens if You Drink Alcohol While Taking Antibiotics?
If you drink while taking antibiotics, you can get even sicker. This is because drinking while treating an infection with antibiotics can lead to many problems. Not only does alcohol increase your risk for infections by weakening your immune system, but antibiotics can sometimes have drug interactions with alcohol.
Alcohol’s interactions with antibiotics and antifungals include:
- Antitubercular drugs: Alcohol should not be used with the tuberculosis antibiotic cycloserine, which can cause central nervous system side effects if taken with alcohol. It should also be avoided with the tuberculosis antibiotic isoniazid due to the risk of liver damage.
- Nitroimidazole: Combining alcohol with a nitroimidazole like metronidazole can lead to a disulfiram-like reaction. Besides sometimes being used as an antibiotic, metronidazole is prescribed to treat fungal infections.
- Imidazole: Although not an antibiotic, imidazole antifungal drugs like ketoconazole should not be used with alcohol due to the risk of a disulfiram-like reaction and liver damage.
- Azole Derivative: The antifungal drug posaconazole should not be taken with alcohol because it might cause the drug to release too quickly into your body.
- Sulfonamides: Rarely, mixing alcohol with a sulfonamide antibiotic like trimethoprim/sulfamethoxazole (Bactrim) can lead to a disulfiram-like reaction.
- Cephalosporins: Alcohol can interact with some cephalosporin antibiotics, including cefotetan, and can lead to side effects known as a disulfiram-like reaction.
- Tetracyclines: Alcohol has a mild drug interaction with the antibiotic doxycycline, making doxycycline last for a shorter time in your body than expected. This can make it harder for your infection to resolve.
- Macrolides: Alcohol has a minor drug interaction with the macrolide antibiotic erythromycin and can delay the antibiotic’s effects.
- Oxazolidinones: There is no known interaction between alcohol and oxazolidinones like linezolid; however, it is best to limit your consumption of alcohol while on linezolid, especially if you have a history of high blood pressure because excessive alcohol use can worsen your blood pressure in some cases while taking this antibiotic.
- Fluoroquinolones: There is no known drug interaction between alcohol and fluoroquinolones like ciprofloxacin, levofloxacin or moxifloxacin.
- Penicillins: No known interaction exists between alcohol and penicillins like amoxicillin or penicillin.
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Dangers of Mixing Alcohol and Antibiotics
The dangers of mixing alcohol and antibiotics are multifold. First, alcohol can suppress your immune system, making it harder for your body to fight off your infection. Second, alcohol can have drug interactions with some antibiotics, which can be hazardous.
A disulfiram-like reaction is one of the more uncomfortable drug interactions between alcohol and antibiotics. This type of reaction can start within minutes of drinking alcohol while an antibiotic is in your system and includes symptoms like:
- Facial flushing
- Nausea or vomiting
- Chest pain
- Blurred vision
- Breathing problems
Although not all antibiotics and antifungals can cause a disulfiram-like reaction when mixed with alcohol, the ones that can include:
Central Nervous System Damage
Cycloserine, a tuberculosis antibiotic, can damage the central nervous system if you drink alcohol while taking it. Symptoms can include:
- Low mood
- Memory problems
Other non-antibiotic medications can also cause issues with the central nervous system if you drink while taking them, including opioids, muscle relaxants, antidepressants, benzodiazepines, sedatives, antipsychotics and seizure medications. Mixing these drugs with alcohol can cause intensified side effects like drowsiness and slowed breathing and may increase your risk of an overdose.
Some antimicrobials, including the antibiotic isoniazid and the antifungal ketoconazole, can cause liver damage if you take them with alcohol. You should therefore avoid alcohol while on these medications, especially if you have a preexisting liver disease like cirrhosis. Symptoms of liver damage include:
- Skin rash or itching
- Low appetite
- Nausea or vomiting
- Abdominal pain
- Dark, cola-colored urine
- Abnormally light-colored stool
- Yellowed skin or eyes
Does Alcohol Make Antibiotics Less Effective?
Alcohol can make some antibiotics less effective, including doxycycline, due to a drug interaction. However, because alcohol can suppress your immune system, it can also indirectly make your antibiotic less effective by harming your body’s ability to fight infection.
How Long After Taking Antibiotics Can You Drink Alcohol?
How long you have to wait before drinking after antibiotics can differ widely. You should generally wait until your infection is entirely resolved to drink. This is because of alcohol’s immunosuppressive effects, which can harm your body’s ability to fight infection.
Additionally, some antibiotics have drug interactions with alcohol. Depending on your medical history and the antibiotic you take, the time you should wait before drinking can differ widely. For example, you should wait at least three days after completing therapy with metronidazole before drinking due to a drug interaction with alcohol. However, other antibiotics like ciprofloxacin have no interaction with alcohol, and you can drink as soon as your infection is resolved.
Talk With Your Doctor
Because everyone’s body is different, and every infection is unique, you should ask your doctor or pharmacist about drinking alcohol while taking an antibiotic. Although it is best to avoid alcohol while you have an infection due to alcohol’s immunosuppressive properties, your doctor can give you specific recommendations based on your medical history. In addition, your pharmacist can tell you if your antibiotic has any drug interactions with alcohol.
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U.S. National Library of Medicine. “Disulfiram: MedlinePlus Drug Information.” August 15, 2017. Accessed March 26, 2023.
Mergenhagen, Kari A.; Wattengel, Bethany A.; Skelly, Megan K.; et al. “Fact versus Fiction: a Review of the Evidence behind Alcohol and Antibiotic Interactions.” Antimicrobial Agents and Chemotherapy, March 2020. Accessed March 26, 2023.
Drugs.com. “Cycloserine and ethanol Interactions.” Accessed March 26, 2023.
Drugs.com. “Ethanol and ketoconazole Interactions.” Accessed March 26, 2023.