If you’re one of the 85% of American adults who drink alcohol, whether occasionally or regularly, it’s important to know that it can interact with any medications you take. If you take several medications or drink excessively, your risk of adverse medication reactions may be higher.
Taking medications while drinking alcohol can be unpredictable. The combination may intensify either the drug’s effect or the drink’s effect. It can also make your medication less effective or change how you feel the effects of alcohol. Beware that some medications, like laxatives and cough syrups, may contain some alcohol themselves, too.
Read on to learn which types of medications not to mix with alcohol. And remember, always read the medication label thoroughly, and talk to your healthcare provider if you have any concerns.
1. Depression and Anxiety Medications
One in 10 teenagers and adults take antidepressant or anxiety medications every day, according to the Centers for Disease Control and Prevention (CDC). Many of these medications interact negatively with alcohol, particularly monoamine oxidase inhibitors (MAOIs), like Parnate (tranylcypromine) and Nardil (phenelzine). MAOIs can cause blood pressure to spike dangerously when combined with tyramine, an amino acid found in red wine and beer.
Combining alcohol with these medications increases the risk for an overdose and can make you feel more depressed. You can also experience drowsiness, dizziness, impaired motor control and coordination, difficulty breathing, strange behaviors, and heart or liver damage. Some of these medications can also make the effects of alcohol more extreme.
Additionally, if you take any kind of antidepressant medication, talk to your healthcare provider if you want to drink alcohol. St. John’s Wort and Kava. Kava are herbal supplements often used to treat depression or anxiety, but taking those supplements and drinking alcohol at the same time can result in serious consequences, such as liver damage.
Anxiety and antidepressant medications that should not be mixed with alcohol include:
- Zoloft (sertraline)
- Wellbutrin (bupropion)
- Symbyax (fluoxetine/olanzapine)
- Prozac (fluoxetine)
- Paxil (paroxetine)
- Pristiq (desvenlafaxine)
- Abilify (aripiprazole)
- Cymbalta (duloxetine)
- Valium (diazepam)
- Xanax (alprazolam)
- Eskalith/Lithobid (lithium)
- Many others
2. Diabetes Medications
Nearly half of the U.S. population has diabetes, prediabetes, or insulin resistance (a precursor to diabetes). This means that millions of people take diabetes medications each day. Adding alcohol can lead to dangerously low blood sugar levels. In addition, there is a risk of the following symptoms:
- Sudden changes in blood pressure
- Rapid heartbeat
- Weakness
- Headache
- Nausea and vomiting
Talk to your doctor before drinking alcohol if you take any of the following diabetes medications:
- Diabinese (chlorpropamide)
- Glucophage (metformin)
- Glucotrol (glipizide)
- Glynase and DiaBeta (glyburide)
- Micronase (glibenclamide)
- Orinase (tolbutamide)
- Tolinase (tolazamide)
3. Cold or Allergy Medications
Millions of people take medications for colds, allergies, and the flu each year, which are known to cause drowsiness and dizziness. Alcohol also does that, so taking them both together can amplify those side effects, causing impaired judgment and coordination and a slow reaction time. The combination of alcohol and cold or allergy medicine can put you at an increased risk for overdose.
It’s important to avoid alcohol if you’re taking any of the following:
- Benadryl (diphenhydramine)
- Claritin or Claritin-D (loratadine)
- Dimetapp (brompheniramine)
- Sudafed, Tylenol allergy or cold medicines, or Triaminic (chlorpheniramine)
- Zyrtec (cetirizine)
- Robitussin (guaifenesin + codeine)
- Any others
4. Blood Pressure Medications
Nearly half of all U.S. adults live with high blood pressure, also called hypertension. Medications used to treat hypertension can react badly with alcohol, causing dizziness and fainting, extreme sleepiness, and arrhythmias, or other heart problems.
Talk to your healthcare provider before drinking alcohol if you take any of the following medications:
- Prinivil, Zestril (lisinopril)
- Norvasc (amlodipine besylate)
- Lopressor (hydrochlorothiazide)
- Catapres (clonidine)
- Any others
5. Sleep Aids
Close to 10% of the U.S. population regularly uses medications or supplements to try to fall asleep or stay asleep. These types of medications should never be used when you have alcohol in your system. Sleep aids and alcohol both have sedating effects and can amplify each other. Side effects of mixing alcohol with sleep aids may include difficulty breathing, memory problems, strange behavior, dizziness, and impaired motor control.
Don’t mix alcohol with any sleep aid, including the following:
- Ambien (zolpidem)
- Lunesta (eszopiclone)
- Restoril (temazepam)
- Unisom (doxylamine)
- Prosom (estazolam)
- Sominex (diphenhydramine)
- Herbal supplements like chamomile, lavender, or valerian
6. Pain Medications
Whether the pain medication is OTC or a prescription drug, you should talk to your healthcare provider before drinking alcohol. Combining alcohol with any type of pain medication can cause dangerous side effects.
Mixing alcohol with medications for muscle pain, like Flexeril (cyclobenzaprine) and Soma (carisoprodol), can increase your risk for seizures, overdose, and cause difficulty breathing.
Medications for minor pain, like Tylenol (acetaminophen), Motrin and Advil (ibuprofen), Aleve (naproxen), and Excedrin (acetaminophen and aspirin) can result in stomach pain, bleeding, stomach ulcers, and possible heart or liver damage.
Combining alcohol with strong pain medications for severe pain, like opioids, can cause drowsiness and dizziness, difficulty breathing, memory problems, and puts you at an increased risk for an overdose.
Do not drink alcohol if you are taking any strong pain medications such as the following:
- Percocet (oxycodone)
- Vicodin (hydrocodone)
- Demerol (meperidine)
- Darvocet (propoxyphene)
- Fiorinal (butalbital with codeine)
7. Heartburn and Nausea Medications
Any medication that can help calm your stomach from heartburn and nausea, including motion sickness, can interact negatively with alcohol. Mixing these with alcohol can cause a rapid heartbeat and a sudden change in blood pressure. It also puts you at an increased risk for overdose and can make the alcohol effects stronger.
Avoid drinking if you take any of the following stomach-related medication:
- Dramamine (dimenhydrinate)
- Antivert (meclizine)
- Tagamet (cimetidine)
- Reglan (metoclopramide)
- Axid (nizatidine)
8. Cholesterol Medications
Nearly a third of all American adults take medications to lower their cholesterol. In adults over age 75, that statistic increases to nearly 50%. Combining alcohol with cholesterol medications can cause liver damage, flushing and itching, and stomach bleeding.
Talk to your healthcare provider before combining alcohol with any cholesterol-lowering medication, including the following:
- Crestor (rosuvastatin)
- Lipitor (atorvastatin)
- Zocor (simvastatin)
- Altoprev, Mevacor, and Altocor (lovastatin)
- Vytorin (ezetimibe and simvastatin)
- Niaspan (niacin)
- Pravachol and Pravigard (pravastatin)
9. Prostate Medications
There are many medications available to treated enlarged prostates. Combining them with alcohol can cause dizziness and fainting.
Don’t drink alcohol if you’re taking the following medications, unless you speak with your healthcare provider first:
- Flomax (tamsulosin)
- Cardura (doxazosin)
- Hytrin (terazosin)
- Minipress (prazosin)
10. ADHD Medications
Medications to treat ADHD are stimulants, a broad class of drugs that increase the activity of the central nervous system. Alcohol, on the other hand, has the opposite effect—it’s a sedative. Mixing the two together can make it more likely that you’ll experience an overdose. Other side effects of mixing alcohol and ADHD medications together include dizziness, impaired concentration, liver damage, and heart problems.
Talk to your healthcare provider before mixing these medications with alcohol:
- Adderall (amphetamine/dextroamphetamine)
- Dexedrine (dextroamphetamine)
- Focalin (dexmethylphenidate)
- Concerta/Ritalin (methylphenidate)
- Strattera (atomoxetine)
- Vyvanse (lisdexamfetamine)
11. Arthritis Medications
Combining arthritis medications with alcohol can cause ulcers, liver damage, and stomach bleeding. Don’t drink alcohol while taking these medications, unless you speak with your healthcare provider first:
- Celebrex (celecoxib)
- Naprosyn (naproxen)
- Voltaren (diclofenac)
12. Seizure Medications
Combining alcohol with medication for seizures, including epilepsy medication, can cause serious side effects. These include dizziness, sleepiness, unusual behavior, changes in mental health status (including suicidal thoughts), and the increased risk of more seizures.
Don’t combine alcohol with any of the following medications:
- Horizant/Neurontin (gabapentin)
- Dilantin (phenytoin)
- Keppra (levetiracetam)
- Phenobarbital
- Klonopin (clonazepam)
- Lyrica (pregabalin)
- Lamictal (lamotrigine)
- Tegretol (carbamazepine)
- Topamax (topiramate)
- Barbiturates
- Trileptal (oxcarbazepine)
13. Infection Medications (Antibiotics, Antifungals, and Antiparasitics)
Many different medications exist to treat a multitude of infections. Combining any of them with alcohol can cause dangerous side effects, like liver damage, stomach pain and vomiting, redness of the face, a racing heartbeat, and a sudden drop in blood pressure.
These medications include the following, but are not limited to:
- Zithromax (azithromycin)
- Seromycin (cycloserine)
- Nizoral (ketoconazole)
- Flagyl (metronidazole)
- Macrodantin (nitrofurantoin)
- Grisactin (griseofulvin)
- Nydrazid (isoniazid)
- Tindamax (tinidazole)
Other Medications to Note
Coumadin (warfarin) is a medication that people take for blood clots. Even occasional drinking with Coumadin can cause internal bleeding. Heavy drinking can cause problems on both ends of the spectrum: either internal bleeding or excessive blood clots, which may lead to a stroke or heart attack.
Isordil (isosorbide nitroglycerin), often taken for angina (chest pain) or coronary heart disease, can also be dangerous when mixed with alcohol. Side effects can include dizziness and fainting, rapid heartbeat, and a sudden drop in blood pressure.
When To See A Healthcare Provider
If you take any of these medications, it’s important to talk to your healthcare provider before drinking any kind of alcohol in any amount. If you still want to fit alcohol into your lifestyle, talk to your healthcare provider about how to balance out your pills and any alcoholic drinks you may want. Some medication and alcohol interactions can be dangerous, so always check with your healthcare provider first.
If you do drink while taking these medications, there are some symptoms to look out for:
- Nausea and vomiting
- Drowsiness
- Headache
- Fainting
- Loss of coordination
- Internal bleeding
- Difficulty breathing
- Heart problems
- Liver damage
A Quick Review
Alcohol can change how your body breaks down and absorbs medications. There are hundreds of medications on the market today. The list in this article isn’t exhaustive, and there are other medications not listed that can be dangerous when taken with alcohol, so always talk to your healthcare provider before you consider taking any medication while also maintaining a lifestyle where you drink alcohol.
Content by: Courtney Southwick
