Both of these antibiotics should never be paired with alcohol, as severe and potentially fatal liver damage can occur. Nitroimidazole antimicrobials are a class of antibiotics that stop bacterial growth. Like other medications, patients can be allergic to certain classes of antibiotics. Antibiotics are prescription drugs that work to either kill infection-causing bacteria, or prevent those bacteria from reproducing. Most of the time you visit the doctor, it’s because you’re sick or not feeling well. Maybe you’re scheduling a visit, hoping your doctor will have some medicine—like an antibiotic—to improve your symptoms or make you feel better sooner.
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This review may also be helpful in assessing a patient who presents with an adverse drug effect which may or may not have been due to an alcohol and antibiotic interaction. If a reaction does occur, this review provides mechanisms and symptom complexes potentially allowing for a more efficient diagnosis. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment.
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One of the most common concerns when taking antibiotics is whether alcohol can still be consumed during treatment. While not all antibiotics interact with alcohol, some do, and the potential side effects can range from mild to severe. The package labeling recommends against the use of metronidazole and alcohol within 48 h due to the risk of a disulfiram-like reaction (46). Although it is commonly believed that metronidazole mediates disulfiram reactions, data are contradictory. In 1964, a study stated that metronidazole may be effective for alcoholism based on 53 patients who had reduced desires to drink and lower tolerances and reported disulfiram-like reactions (47).
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However, some other antifungals, such as Diflucan (fluconazole), might be able to be used more safely with alcohol. Linezolid (Zyvox) is an oxazolidinone antibiotic used for different types of infections, such as pneumonia and certain skin infections that are resistant to other medications. Griseofulvin (Gris-PEG) is antifungal medication used to treat infections such as ringworm, athlete’s foot, jock itch, and fungal infections of the scalp or nails (the medical term is onychomycosis). Alcohol and cycloserine should not be used together, especially during a regimen calling for large doses of cycloserine. The risk of seizures is increased in chronic alcoholics, as well.
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Ketoconazole is an antifungal that may be used to treat topical infections like athlete’s foot, ringworm, and others. Cefotetan may commonly be given by IV before or after surgical procedures. Antibiotics are grouped by their class type, which is determined by the chemical structure of how they target or destroy bacteria. Antibiotics often kill both the “good” and “bad” bacteria in the human body, which is why they can often cause gastrointestinal side effects. There are no such side effects issues when alcohol is taken with amoxicillin.
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Symptoms may include facial flushing, nausea, headache, vomiting, chest pain, vertigo, sweating, thirst, blurred vision, weakness, confusion, and hypotension (8). Many antibiotics carry caution stickers that warn against alcohol consumption. An awareness of data that address this common clinical scenario is important so health care professionals can make informed clinical decisions and address questions in an evidence-based manner. The purpose of this systematic review was to determine the evidence behind alcohol warnings issued for many common antimicrobials. Check with your healthcare provider each time you start a new prescription or over-the-counter medicine to determine if there are important drug interactions with alcohol. Moderate alcohol consumption doesn’t usually reduce antibiotic effectiveness or cause serious interactions (although, there are a few exceptions).
Ethanol, when combined with erythromycin, may delay the absorption of the antibiotic into the bloodstream and lower the effect. Alcohol appears to lead to this slowed “gastric emptying” when combined with erythromycin facts about moderate drinking ethylsuccinate. It is not known if other erythromycin salts are affected in this way. A person should always consult a doctor before mixing alcohol and antibiotics, as some potential side effects can be dangerous.
The recommendations are open to interpretation (often based on personal experience, observation and general knowledge of how alcohol and antibiotics act in the body). It’s possible that the isolated cases led to the myth that all antibiotics don’t mix with alcoholic drinks, but there are two more intriguing theories. Women who are in the early stages of pregnancy, and who are not ready to share the happy news, know that turning down an alcoholic drink at a social occasion can be a dead giveaway. Telling friends and colleagues they are on antibiotics is the perfect excuse because they are so commonly used. Even the nosiest of acquaintances is unlikely to ask what they are being taken for. Keep in mind that some cold medicines and mouthwashes also have alcohol.
People who regularly drink alcohol may have lower levels of folic acid and should use trimethoprim-sulfamethoxazole with caution. Doctors use oxazolidinones to treat abdominal, skin, lung, and urinary tract infections. It is not safe to mix some types of antibiotics, such as tetracyclines and nitroimidazoles, with alcohol. This can cause dangerous side effects or make them less effective at removing bacteria. Depending on the type of antibiotic someone is taking, doctors may recommend limiting or avoiding alcohol intake. Antibiotics are drugs that target bacteria to treat and prevent infections.
A person may be able to drink alcohol in moderation and with caution while they are taking some types of antibiotics. However, a person should always consult hallucinogens effects, addiction potential and treatment options a doctor before doing this. The table below summarizes the recommendations and effects of drinking alcohol while taking different antibiotics.
But if you are taking one of these medications, you probably should avoid drinking anyway as you recover from your infection. People should avoid drinking alcohol during treatment and up to 3 days after the last dose. The risks of drinking alcohol are lower with some types of antibiotics.
But what if you are on the third day of your prescription and already feel much better? Before you toss them aside, consider the do’s and don’ts of antibiotic usage. Antibiotics are common medications prescribed for many bacterial infections and diseases—strep throat, acne, urinary tract infections, and more.
Since having alcohol in your system can also cause these symptoms on its own, using both antibiotics and alcohol together increases your risk of these side effects. You can resume drinking alcohol once the antibiotic has cleared from your system, which is usually three days after the last dose. A few antibiotics should not be mixed with any amount of alcohol.
- However, for most antibiotics, we don’t have clear evidence that drinking impairs the antibiotic’s direct effectiveness.
- People with an impaired immune system have a higher risk of infection.
- An observational study of 55 alcoholics with TB found that mild liver impairment in alcoholics is not a contraindication for treatment with ethionamide (114).
- First-line antibiotics that might be selected include the macrolide antibiotics azithromycin (Zithromax) or clarithromycin (Biaxin XL); or the tetracycline known as doxycycline.
Concurrent use of alcohol precipitated disulfiram reactions in two patients treated with ketoconazole. Concurrent ketoconazole and alcohol consumption warrants caution. In vitro testing found that tedizolid reversibly inhibited MAO enzymes similarly to linezolid (80). A randomized, double-blind crossover trial of 30 healthy subjects assessed the pressor response to an oral tyramine challenge in patients treated with 200 mg of tedizolid. Seven subjects had a positive response of a 30 mm Hg increase in SBP during both placebo and treatment phases, suggesting that the result may have been related to other factors. The median tyramine dose required to produce a 30 mm Hg increase in SBP was 325 mg in the tedizolid group.
Tyramine is a naturally occurring trace compound from the amino acid tyrosine. High-tyramine alcohols include home-brewed beer, beer on tap, Korean beer, and vermouth. Most bottled beers are lower in tyramine, but it’s always best to ask a healthcare provider if it’s safe to consume alcohol on these antibiotics. Linezolid is a weak, nonspecific inhibitor of monoamine oxidase (MAO) enzymes (81). Studies have shown positive pressor responses in comparison with placebo with tyramine administration (81, 82).
The following lists are adapted from a 2020 review article from the American Society for Microbiology, which analyzed current data on safety on alcohol and antibiotics. Another antibiotic, Zyvox (linezolid) can cause very elevated blood pressure in some people when combined with some kinds of alcohol. Risks are greater for people with underlying blood pressure problems who consume a lot of alcohol.
In this day and age, with antibiotics being widely prescribed and alcohol use as prevalent as ever, it is unsurprising that mixing antibiotics and alcohol is not a rare occurrence. Read on to learn more about antibiotics, their side effects, and how they can barbiturates interact with alcohol. If you’d like to still drink while taking an antibiotic, talk with the healthcare provider treating you. For some infections, we have multiple antibiotic options open. Ask about what we know about using alcohol with that antibiotic.