First, some general information about mixing alcohol and medications:
- Alcohol and medications can interact in different ways:
- Alcohol can make your medication less effective.
- Alcohol can make your medication toxic to your body.
- Alcohol can make side effects from your medication worse.
- Mixing alcohol and your medication can cause new symptoms and make you feel very ill.
- Some medications can make you drunker when you take them with alcohol.
So, which medications should you NOT mix with alcohol?
1) Painkillers
If you’re taking Motrin or Aleve, drinking alcohol can lead to an upset stomach, stomach bleeding, or ulcers. Drinking alcohol while taking Tylenol (acetaminophen) is also risky. Alcohol and acetaminophen are both broken down in the liver. When the liver is busy breaking down alcohol, it can’t deal with acetaminophen, and so the drug builds up in the body and can cause serious liver damage.
The greatest risk though is drinking alcohol with any opioid painkillers such as codeine or oxycodone: This can cause excessive drowsiness, slowed breathing, and even death.
2) Anti-anxiety medications and sleeping pills
Using alcohol while taking anti-anxiety medications—like Ativan (lorazepam), Xanax (alprazolam), Valium (diazepam), Klonopin (clonazepam)—or any sleeping pills can cause serious problems, too. These medications are sedatives and together with alcohol can make you drowsy or even unconscious.
3) Antidepressants and mood stabilizers
All antidepressants should be taken with care when drinking alcohol. The effect on your body will depend on the type of antidepressant, but the risks are real and include drowsiness, dizziness, overdosing, worsening feelings of depression, problems with movements, liver damage, and serious heart effects. Similar risks exist if you take alcohol with mood stabilizers such as Divalproex or lithium.
4) ADHD medications
ADHD treatments such as Adderall, Ritalin, and Vyvanse can interact with alcohol, causing dizziness, drowsiness, poor concentration, and possibly, heart problems and liver damage.
5) Antibiotics
Flagyl (metronidazole) is a common antibiotic—and drinking ANY alcohol with it will cause violent nausea and vomiting. Other antibiotics such as nitrofurantoin, isoniazid, and azithromycin can all cause unpleasant reactions when mixed with alcohol.
6) Nitrates and other blood pressure medications
Lots of blood pressure medications and anti-angina medications (nitrates) can interact dangerously with alcohol. Common effects include dizziness, fainting, drowsiness, and a faster heartbeat or arrhythmias.
7) Diabetes medications
If you take any medications for diabetes (insulin injections or pills like metformin, glyburide, or glipizide), drinking alcohol can lead to very low blood sugar levels, flushing, nausea, vomiting, headache, rapid heartbeat, and sudden changes in blood pressure—so, take great care.
8) Coumadin
Alcohol has an unpredictable effect on warfarin. If you drink alcohol while taking warfarin, you will need close monitoring to make sure your blood is not too thin.
9) OTC cold and flu treatments
Most over-the-counter cold and flu remedies contain a mix of different painkillers, antihistamines, and decongestants, and some (like NyQuil) even contain alcohol. Check the ingredients on the box before taking any of these with alcohol. Effects can include drowsiness, dizziness, and an increased risk of overdosing.
10) Erectile dysfunction medications
Taking alcohol with medications like Cialis, Viagra, and Levitra can significantly lower blood pressure and also cause dizziness, flushing, or a headache.
The bottom line
Mixing alcohol with medications—including many over-the-counter medications—is a risky and unpredictable business. If you’re unsure, avoid alcohol completely until you can check with your pharmacist or healthcare provider. A good resource for safe alcohol habits is the NIAA (National Institute on Alcohol Abuse and Alcoholism).
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