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What are Antibiotics? 

Antibiotics are medicines that fight bacterial infections in people and animals. They work by killing the bacteria or by making it hard for the bacteria to grow and multiply [1]. Antibiotics only treat certain bacterial infections, such as strep throat, urinary tract infections, and E. coli. You may not need to take antibiotics for some bacterial infections. For example, you might not need them for many sinus infections or some ear infections. Taking antibiotics when they’re not needed won’t help you, and they can have side effects and can contribute to antibiotic resistance. Antibiotic resistance happens when the bacteria change and become able to resist the effects of an antibiotic [2]. This means that the bacteria continue to grow.

Antibiotics can be taken in different ways:

  • Orally (by mouth). This could be pills, capsules, or liquids.
  • Topically. This might be a cream, spray, or ointment that you put on your skin. It could also be eye ointment, eye drops, or ear drops.
  • Through an injection or intravenously (IV). This is usually for more serious infections.
Antibiotics and Alcohol
While the antibiotics and alcohol myth might generally hold true,  combining some specific antibiotics and alcohol can be dangerous.

Can You Take Antibiotics and Drink Alcohol?

Combining antibiotics and alcohol will not usually lower your antibiotic’s effectiveness, but it may cause side effects and hinder your body’s natural ability to heal itself. Drinking alcohol while you’re fighting an infection can lead to upset stomach dehydration, lower your immune response and interrupt normal sleep. Some antibiotics can also be dangerous for your liver, so it’s important to check with your doctor or pharmacist before mixing antibiotics and alcohol.

When the body breaks down alcohol, it produces acetaldehyde, which can cause nausea. Many people taking antibiotics already experience stomach or digestive side effects, and drinking alcohol while on these medications can increase feelings of nausea. In addition to gastrointestinal issues, both antibiotics and alcohol can hinder cognitive function, concentration, and coordination. Another thing to consider with antibiotics and alcohol is the fact that drinking interferes with the essential processes of the body like hydration, and sleep and these are critical components of recovering from a bacterial illness. Due to these factors, it’s best to stay away from alcohol for the duration of antibiotic treatment.

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Antibiotics and Alcohol Myth

Staying off alcohol when taking prescription antibiotics has always been advised by doctors, pharmacists, and well-meaning relatives for decades. This advice may have originated far back os the 1950s when penicillin came into use as the first really effective treatment for sexually transmitted infections (STIs) such as gonorrhea and syphilis.

Doctors were apparently worried that alcohol intoxication could undo their expensive treatment with the new miracle drugs. So patients were advised to abstain from alcohol until things cleared up. This may be well-founded because patients receiving penicillin for STD (sexually transmitted disease) at that time were more likely to engage in risky sexual activity while intoxicated.

The advice that you shouldn’t mix antibiotics and alcohol does hold true for a small group of anti-infective drugs including metronidazole (Flagyl, Metronide, or Metrogyl), tinidazole (Fasigyn or Simplotan), and sulfamethoxazole/trimethoprim (Bactrim, Co-trimoxazole).

These antibiotics block one of the major pathways that metabolize alcohol and cause a rapid build-up of acetaldehydes, which are responsible for many of the uncomfortable physical effects of hangovers. With these drugs, you can be red-faced, fainting and vomiting after as little as one glass of beer.

For nearly all other types of antibiotics, there is no clear evidence of harm from moderate alcohol intake. But this doesn’t mean it’s a good idea to drink to excess when you’re in the grip of an infection, as the nauseating and sedative effects of the alcohol are likely to increase if you are battling infections.

Can You Mix Antibiotics and Alcohol?

Both antibiotics and alcohol have individual sets of side effects that impact an individual’s mental and behavioral state. Because of this, the two should never be combined. A handful of antibiotics can cause violent physical reactions when combined with alcohol. These include Metronidazole and Linezolid, which are commonly prescribed to treat intestinal tract and skin infections, and the sulfonamide medications of Sulfamethoxazole and Trimethoprim (Bactrim), which are used to treat everything from urinary tract infections to pneumonia to ear infections.

Consuming alcohol while taking these drugs can result in severe fatigue, a throbbing headache, dizziness, anxiety, chest pain, and heart palpitations. Alcohol can also worsen digestive side effects and turn into blood or mucus in stool, severe diarrhea, intense stomach cramping or pain, fever, uncontrollable vomiting. Mixing alcohol with certain antibiotics can also damage vital organs, including the liver. The kidneys are responsible for removing toxins, including medications, from the blood and body through urine. Antibiotics can overburden and damage kidneys and alcohol exacerbates this.

In addition to all of the debilitating side effects detailed above, alcohol can also hinder certain immune system processes and have a negative impact on the body’s ability to recover from an infection. Alcohol then not only slows the healing process and recovery time but additionally puts an individual at increased risk of developing another infection.

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The Effects of Mixing Antibiotics and Alcohol

Combining antibiotics and alcohol can damage your organs. Both antibiotics and alcohol burden the liver and kidneys. Alcohol can also compromise the body’s immune system responses affecting the body’s recovery. Besides slowing down the healing process, alcohol can put a person at risk of getting new infections.

Many antibiotics are known to cause violent reactions when taken alongside alcohol. These reactions range from vomiting and nausea to dizziness, headaches, chest pains, anxiety, and heart palpitations.

These symptoms match those of alcohol intolerance caused by medication like disulfiram (Antabuse medication) prescribed to individuals with alcohol addiction problems.

Below we have listed the names of antibiotics that you should strictly avoid alcohol while continuing the course of medication. These include:

  • Tetracyclines: Alcohol should be avoided when taking antibiotics like tetracyclines like doxycycline and minocycline because doxycycline reduces the effectiveness of antibiotics and minocycline can increase liver disease risks
Antibiotics and Alcohol
Does alcohol affect antibiotics? Not normally, at least not in the sense that it typically inhibits how antibiotics work. However, there are other reasons it’s not a good idea to combine antibiotics and alcohol.
  • Oxazolidinones: Oxazolidinones like Linezolid shouldn’t be mixed with alcohol because it can cause fever, agitation, rapid heartbeat, unusual sweating, rapid breathing, vomiting, elevated blood pressure, seizures, abnormal heart rhythm, coma, cardiorespiratory depression, muscle spasms, muscle rigidity, and altered mental status
  • Sulfonamides: Sulfonamides like trimethoprim and sulfamethoxazole shouldn’t be mixed with alcohol to avoid side effects like a folic acid deficiency
  • Fluoroquinolones: Fluoroquinolones like levofloxacin and ciprofloxacin can cause confusion, nervousness, agitation, memory loss, disorientation, and attention disturbances when mixed with alcohol. The effects are, however, pronounced with high alcohol consumption
  • Nitroimidazoles: Nitroimidazoles like metronidazole can cause headaches, facial flushing, nausea, vomiting, and abdominal cramping when mixed with alcohol. In fact, you shouldn’t take alcohol for 3 days after your last dose of Nitroimidazoles

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Side Effects of Antibiotics and Alcohol 

Alcohol is also considered a central nervous system (CNS) depressant. Some antibiotics, like metronidazole (Flagyl), may also lead to CNS side effects such as:

  • Drowsiness
  • Sedation
  • Dizziness
  • Confusion

When alcohol is combined with antibiotics that also have a CNS depressant effect, additive effects may occur. These effects can be serious when driving or operating machinery, in the elderly, and in patients who may take other CNS depressant medications, such as opioid pain relievers, muscle relaxants, antidepressants, anxiety or seizure medications, among others.

Stomach side effects

Stomach problems, such as nausea, vomiting, diarrhea, and stomach pain can be common with antibiotics, too. Consuming alcohol can worsen these stomach side effects.

Liver damage

Excessive alcohol use is well-known to cause liver damage like cirrhosis. Taking antibiotics that can also damage the liver may worsen these types of problems.

Does Alcohol Affect How Well an Antibiotic Will Work? 

Usually, alcohol does not affect how well an antibiotic works to fight infection. However, the combination may produce unpleasant side effects. Also, in some circumstances levels of a drug in your bloodstream might be changed which may affect its effectiveness.

Alcohol is broken down (metabolized) in the liver extensively by enzymes. Some drugs are also metabolized by the same or similar enzymes. Depending upon how much and how often alcohol is consumed, changes in these enzymes may alter how drugs are metabolized in your body. For example:

  • When an intoxicating, acute amount of alcohol (large amount over a short period of time) is consumed, certain enzymes do not work as well to break down the drug for metabolism. The levels of the antibiotic in the body may increase because it is not fully metabolized and excreted, which could lead to greater drug toxicity and side effects.
  • Alternatively, when alcohol is used on a daily basis (chronically) enzyme levels can be “induced”. This means the drug is being broken down more quickly in the body and the levels of antibiotic in the blood may decrease. Your infection may not be cured and antibiotic resistance may occur, too.

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When You Can’t Stop Abusing Alcohol

Most individuals can avoid alcohol for a few days or weeks while on antibiotics or other medications that may interact poorly with alcoholic drinks. However, some cannot stop abusing alcohol. According to the Substance Abuse and Mental Health Service Administration (SAMHSA), substance use disorder is marked by a person who uses drugs or alcohol in a way that clinically impairs some aspect of their life. 

This might include behavior that damages their home life, social life, education, work, or physical or emotional health. This behavior is a sign that you need help. At its most severe, it can represent serious alcohol addiction, which comes with a host of dangers. If you can’t stop drinking for the period that you are on antibiotics, it’s a clear red flag that you need treatment.

First, make your doctor aware of this fact. It can be dangerous if a doctor prescribes antibiotics or other medication without knowing you have a problem with alcohol abuse. They can potentially give you a medication that interacts less strongly with alcohol. They can also advise you on the best path forward to deal with your alcohol abuse issue. Generally, some form of alcohol addiction treatment will be recommended.

Mixing antibiotics and alcohol can be risky. Not only can alcohol interact badly with some medications and cause severe side effects, but it can also potentially interrupt the natural healing process. Alcohol should be avoided until the regimen of antibiotics is completed and your body receives adequate rest and nutrition. However, if you’re someone who suffers from alcoholism, this may be easier said than done. If you think that you may be addicted to alcohol, contact We Level Up NJ to get started on the road to recovery today.

Antibiotics and Alcohol
As a good rule of thumb, you should never mix drugs. This applies to antibiotics and alcohol. Always ask your doctor whether it’s OK to drink alcohol while taking any prescribed medication.

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Sources:

[1] NIH – https://medlineplus.gov/antibiotics.html

[2] CDC – https://www.cdc.gov/antibiotic-use/q-a.html

[3] SAMHSA – https://www.samhsa.gov/find-help/disorders