7 Medicines That You Shouldn’t Mix with Alcohol

If you like to have a glass of wine or a cocktail every now and then but also take certain medications, you may have wondered if you shouldn’t be mixing them. Well, we’ve got you covered. 

When it comes to drinking alcohol, there are plenty of warnings that come with it and how to do it responsibly. One of the most common we tend to see is not to mix alcohol with medications. But what exactly does this mean? Does this mean you shouldn’t take a pill and sip on an alcoholic beverage at the same time? Does this mean that you shouldn’t drink alcohol if you’re regularly taking medication? And what medications could actually be negatively affected? There are a lot of questions surrounding this particular warning, so we decided to ask medical doctors about what you really need to know about how alcohol can affect your medication.

“Alcohol and medication can interact in different ways based on the medication and the individual’s physiology,” says Thomas Pontinen, M.D., co-founder of MAPS, an interventional pain management clinic based in Chicago. “Many medications can become less effective with alcohol, which can be of concern for individuals who need their medication to stay healthy. This is because alcohol can affect the body’s ability to absorb medication.”

Here’s the science behind which medications don’t mix well with alcohol and what happens to your body—and the effectiveness of your medication—when you do.

How Alcohol Can Interact with Medication

“Alcohol should be avoided while taking medication because, in general, it can make side effects worse, diminish the intended benefit of the medication, and threaten the health and well-being of the individual taking it,” Pontinen explains. “It’s also important to mention that alcohol and many medications are metabolized by the liver, so combining them can put a lot of stress on the essential organ and worsen other conditions like liver disease.”

“There are a range of side effects and symptoms that may occur, including change in blood pressure, fainting, change in behavior, maybe even nausea and vomiting or dizziness and headaches,” says Laura Purdy, M.D., a board-certified family medicine physician and the medical director at SWELL Medical. “When it comes to operating heavy machinery and driving a car, there are additional concerns because of lack of coordination, change in mood, emotion and behavior can also be an issue. The effects might be stronger than you are used to, and you may feel more impaired after having one drink than you would typically plan for. Bottom line, your body can respond totally differently then, when both are consumed versus when just taking medications.”

7 Medications That Shouldn’t Be Mixed with Alcohol

Pain Relievers

“When alcohol is mixed with medications such as acetaminophen (Tylenol) and non-steroidal anti-inflammatory drugs (NSAIDs) like aspirin or ibuprofen, liver damage and gastrointestinal bleeding can be a result,” says Katy Dubinsky, PharmD, a pharmacist and the founder/CEO of Vitalize.

Antidepressants

According to Purdy, antidepressants won’t be as effective when mixed with alcohol, and in some cases, could even make symptoms worse. This includes selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors SNRIs. Dubinksy explains that mixing the two can also make you feel more sleep and less coordinated.

Antibiotics

“Taking certain antibiotics with alcohol might have serious side effects, such as headaches, flushing, and nausea,” says Dubinsky. “Examples of these include metronidazole and tinidazole.”

In particular, alcohol causes dehydration in the body by inhibiting the release of vasopressin. Because getting enough fluids is vital for fighting an infection, drinking alcohol isn’t advised because of the ways it can make symptoms worse—and prolong recovery.

Antipsychotics

“Alcohol may intensify the sedative effects of antipsychotic drugs, causing impairments in mental and physical abilities,” Dubinsky explains. Some of the more common symptoms of mixing the two include difficulty breathing, low blood pressure, fainting and, in severe cases, seizures or a coma.

Anxiety Medications and Sedatives

Alcohol coupled with drugs like benzodiazepines (Xanax and Valium) and sleep aids (Ambien) can result in extreme drowsiness, respiratory difficulties and potentially life-threatening sedation, according to Dubinsky.

“Anxiety medications and alcohol consumption can cause abnormal behaviors, loss of memory and motor function control and, as with sleeping medications, difficulties breathing normally,” says Purdy.

Diabetes Medication

Alcohol’s interference with certain medications can put someone with diabetes at risk for low or high blood sugar, depending on what drink is consumed and the medication. Additionally, certain alcoholic beverages like beer and sweetened mixed drinks are high in carbohydrates, which can negatively affect a person’s blood sugar levels.

Symptoms of low blood sugar include double or blurry vision, sweating, tingling and numbness, tiredness or trouble sleeping, fast or pounding heartbeat, shaking or trembling, unclear thinking and more. The symptoms of high blood sugar to watch out for are feeling thirsty, tired or weak, headaches, peeing frequently and blurred vision.

Dubinsky says this can occur for diabetes drugs such as insulin or sulfonylureas.

Blood thinners

Blood thinners, also known as anticoagulants or antiplatelet drugs, help prevent blood from clotting. People with certain heart conditions, congenital heart defects or before going into surgery take these medications. “Drinking alcohol may interfere with the way warfarin and other blood thinners function, increasing the risk of clotting or bleeding,” says Dubinsky. 

Additional Consequences of Mixing Alcohol with Medication

While these particular medications are important to keep in mind before consuming alcohol, in general, Purdy warns that there could be other underlying health conditions that could result in adverse (or even life-threatening) side effects when mixing the two.

“In some situations, the end result could be deadly, or overdosing can be a concern,” warns Purdy. “If you have any underlying health conditions that you take medications for, or maybe are not aware of, there could be additional side effects and new symptoms that you could experience that could be life-threatening.”

Plus, alcohol can make medicine less effective or even useless, and in some cases, it can react poorly with certain ingredients that are in your medications.

How to Stay Safe When Taking Medication and Alcohol

No matter the medication—whether it’s prescribed, over-the-counter, or otherwise—Pontinen says it’s important to speak with your doctor about the side effects before safely consuming alcohol.

“Combining medication and alcohol can be dangerous and even life-threatening, so do not willingly take risks and be sure to avoid alcohol while taking medication unless you’re sure it’s safe,” he says. “Individuals who are under heavy sedative effects need to be monitored to make sure they do not risk injury or choking.”

But what if you do consume alcohol while you’re on medication? Pontinen says it’s important to be in close contact with a loved one in case you fall out of consciousness. “If you begin to experience severe symptoms of headache, gastrointestinal pain, nausea, dizziness or drowsiness after combining medication with alcohol, seek medical attention immediately and remain with a loved one who is prepared to help if need be until medical help arrives.”

The Bottom Line

There’s a reason medical professionals recommend not consuming alcohol while on regular medication, especially medications such as pain relievers, antidepressants, antibiotics, antipsychotics, sedatives, diabetes medications and blood thinners. Not only could the medication not be as effective when mixed with alcohol, but your body could react poorly to the combination of the two. 

The side effects of consuming alcohol could range from mild to severe, some even life-threatening. This why it’s crucial to speak to a doctor before drinking alcohol while taking regular medication—whether it’s a prescription or over-the-counter. If you do consume alcohol, be sure to connect with a loved one in person to ensure that no adverse side effects occur if you need to seek medical attention.