Can You Drink Alcohol When On Antibiotics?

Being prescribed antibiotics can disrupt your routine, and understandably, you might wonder about enjoying a social drink or a glass of wine with dinner.

Understanding the potential interactions between alcohol and your antibiotics or other medications you’re taking is crucial for a smooth recovery.

Jasmine Vayalil, DO, a family physician with Franciscan Physician Network Dyer, shares essential information about the risks associated with mixing alcohol and antibiotics.

How Does Alcohol Affect Your Body's Ability To Heal?

"An important point to consider is what effect alcohol has on the body in terms of fighting infection in general," Dr. Vayalil said. "Long-term use of alcohol can put you at risk for developing infections. Drinking alcohol while you are sick can affect blood sugar levels and slow recovery time. I encourage abstaining from alcohol while you’re sick just due to the negative impact it can have on the healing process and potential side effects in general."

What Happens If You Drink When On Antibiotics?

Many antibiotics can cause side effects like nausea and diarrhea. Combining alcohol and antibiotics can amplify the adverse side effects that you might experience with taking antibiotics or drinking alcohol alone, Dr. Vayalil said. 

What Are Some Common Side Effects Of Combining Alcohol With Antibiotics?

"The degree of adverse side effects experienced with combining alcohol and antibiotics depends on which antibiotic you are taking and how much you are drinking," Dr. Vayalil said. "Check with your doctor or pharmacist to make sure that alcohol use is not contraindicated with the specific antibiotic you are taking first."  

Adverse side effects that can be amplified when mixing alcohol and antibiotics include:

• Nausea
• Diarrhea
• Vomiting
• Drowsiness
• Dizziness.

For some people, the side effects or drug interactions can be more serious. Some examples of more severe side effects/interactions when drinking alcohol while using antibiotics or antifungal medications include: 

• Mixing alcohol and an antibiotic called Linezolid can cause dangerously high blood pressures
• Mixing alcohol with Ketoconazole, a medication used to treat fungal infections, can cause serious liver problems/damage. "Ketoconazole has the potential to cause liver damage on its own; adding alcohol enhances this effect," Dr. Vayalil said. "It is generally recommended to avoid alcohol while taking this medication. It is also recommended to avoid combining alcohol with Isoniazid (a medication used to treat tuberculosis infection) for the same reason."
• Mixing alcohol with certain antifungal medications like Ketoconazole and Metronidazole can also lead to a “disulfiram-like reaction” (potential symptoms including facial flushing, nausea, vomiting, headache, sweating, thirst, anxiety, irregular heartbeat, low blood pressure, weakness, confusion, etc.). This reaction is classically associated with Metronidazole, but actual data on the frequency and severity of this interaction varies. 

How Can Alcohol Reduce My Antibiotic’s Effectiveness?

"Alcohol may change how certain antibiotics work," Dr. Vayalil said. "On one end of the spectrum, this can cause them to be less effective. On the other, mixing alcohol and antibiotics can cause buildup of certain byproducts that can lead to toxicity. This is not the case for all antibiotics."

How Much Alcohol Is OK With Antibiotics?

"There is limited data on the concurrent use of alcohol and antibiotics, so the frequency or degree to which these interactions and adverse side effects occur varies," Dr. Vayalil cautioned. "Check with your doctor or pharmacist regarding potential effects of alcohol on the specific antibiotic you are prescribed."

Are Some People More At Risk For Antibiotic Interactions With Alcohol?

Gender, age and other health conditions can affect whether a person is at higher risk of having antibiotic interactions when consuming alcohol.

"Women tend to be at a higher risk for these complications than men," she said. "A woman’s body generally has less water than a man’s, leading to a higher concentration of alcohol. Even if a man and a woman drink the same amount, the alcohol generally reaches a higher level in the woman’s bloodstream." 

Older adults are also high risk for alcohol-medication interactions, as aging slows how quickly a person can break down the alcohol, leaving alcohol in their system for longer. 

"In general, alcohol can cause liver damage when there is too much for the liver to break down and toxins build up," Dr. Vayalil said. "This is exacerbated when the liver doesn’t work as well (i.e. in people with liver disease) or when the liver is trying to process other medications/toxins simultaneously (i.e. in the case of older people who often require multiple medications)."

How Long Should I Avoid Alcohol While On Antibiotics?

"I would recommend avoiding alcohol while recovering from an infection in general because it can delay the healing process," Dr. Vayalil said. "For how long it should be avoided after completing a course of antibiotics depends on the antibiotic. You should check with your doctor or pharmacist for specific recommendations. For example, to err on the side of caution and help avoid some of the potentially more serious interactions, it is recommended to avoid drinking alcohol for at least 72 hours after taking metronidazole and for two weeks after completing a course of Linezolid."

Should I Be Concerned About Alcohol In Medications?

"Certain medications like cough syrups, laxatives, and mouthwashes can contain a notable amount of alcohol—not just alcoholic beverages," Dr. Vayalil said. "If experiencing these adverse side effects mentioned while on antibiotics, check to make sure one of those is not the culprit."

Taking antibiotics is a temporary measure to address a specific illness or infection. Prioritizing your health during this period will contribute to a faster and more complete recovery. While the occasional drink might seem tempting, remember that your long-term well-being is the goal. By making responsible choices now, you're investing in your future health.