Is -it -Safe -to -Drink -Alcohol -While -Taking -Antibiotics

It’s a question often put to GPs (and, we’d wager, to Google), particularly when the patient receiving treatment has a holiday or a social event coming up:

Can you drink alcohol if you’re taking antibiotics?

Alcohol should be strictly avoided when taking certain types, as we’ll discuss below.

However, it’s better not to drink alcohol at all if you're unwell, or taking antibiotics of any kind.

Abstaining from alcohol consumption will give your body less work to do, enable you to get a decent night’s sleep, and facilitate the recovery process.

On the more specific question of:

Can alcohol and antibiotics interact?

Yes.

There are certain antibiotics which can be directly affected by alcohol.

Drinking alcohol while taking these may alter the way the drug is metabolised in the body, and this can mean the drug won’t work as well.

It may also increase the risk of an adverse reaction. Taking antibiotics on their own can cause side effects, but drinking alcohol while taking antibiotics can increase the likelihood of these, or make them worse.

On this page we’ll talk about which antibiotics in particular are known to interact with alcohol, how such interactions might occur in the body, and what to do if you’re taking antibiotics and aren’t sure.

Antibiotics known to cause interactions

Whether or not you can drink alcohol while taking antibiotics mostly depends on the antibiotic being used. NHS Choices advises that, with some common antibiotics, drinking alcohol in moderation is not likely to cause significant issues.

(‘Moderation’ means staying within the lower risk limits as specified by Public Health England. In short:

  • men and women should consume no more than 14 units of alcohol per week;

and:

  • if someone does drink 14 units in a week, they should spread this out over at least three days;
  • and have several alcohol free days each week)

However, as they point out, and as we’ll discuss here, there are certain antibiotics which are known to interact with alcohol, and mixing alcohol with these can pose a risk of serious side effects.

For example, if you’re taking:

  • Metronidazole, or
  • Tinidazole

you should avoid drinking any alcohol at all.

Metronidazole (also known as Flagyl) and Tinidazole (also known as Fasigyn) are used to treat some types of vaginal infections (such as trichomoniasis), dental infections, and some infected ulcers. Tinidazole is also sometimes used in the treatment of gut conditions caused by a type of bacteria called H. pylori.

When taking these antibiotics, you should also refrain from using any cough medicines or mouthwash products which also contain alcohol.

Furthermore:

  • In the case of Metronidazole, you should stay off alcohol until 48 hours after finishing the course.
  • If you’re taking Tinidazole, you should stay off alcohol until 72 hours after you finish taking it.

Mixing alcohol with these particular medications can cause severe and potentially harmful reactions, which may be characterised by:

  • pain in the chest
  • flushing
  • irregular or fast heartbeat
  • feeling or being sick
  • headaches
  • or loss of breath

There are other antibiotics which have been known to cause reactions when mixed with alcohol; so it is recommended that you avoid drinking alcohol if you are taking them.

These include:

  • Co-trimoxazole (which contains Trimethoprim and Sulfamethoxazole)
  • Doxycycline
  • Erythromycin
  • and Linezolid 

Co-trimoxazole, used to treat a range of conditions including lung and bladder infections, may in some cases cause a reaction like the one described above when consumed with alcohol; and both Doxycycline and Erythromycin may not be as effective when mixed with alcohol.

How does alcohol interact with them?

There are several ways in which alcohol can disrupt the way antibiotics work.

Alcohol is processed in the body by liver enzymes, as are some antibiotic drugs. When both antibiotics and alcohol are consumed over the same period, alcohol takes up enzyme capacity, which means the antibiotic may not be broken down properly. This may mean that the drug doesn’t metabolise in the way it should, and therefore doesn’t work as well.

It may also mean that, because the antibiotic cannot be broken down and excreted sufficiently, higher levels of the drug remain in the body, which in turn increases drug toxicity, and the likelihood of side effects.

What if I’m not sure?

In some cases, your doctor will tell you to avoid alcohol when issuing a course of antibiotics. If they don’t specify, or if you want to know whether you can drink alcohol when taking a certain drug, ask them.

However, for reasons already explained above, the best thing to do when taking antibiotics of any kind is not to drink alcohol at all until you've finished the course, and you’re better. This will help to give your body the rest it needs and increase the likelihood of a speedy recovery.