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Bactrim And Alcohol, A Dangerous Combination & Side Effects

It is not safe to mix Bactrim and alcohol. Each substance will have its effects of usage, but when combined, there will be a third set of potential side effects that can be dangerous. Continue to read more about Bactrim and alcohol interactions and adverse effects.

By We Level Up NJ Treatment Center | Editor Yamilla Francese | Clinically Reviewed By Lauren Barry, LMFT, MCAP, QS, Director of Quality Assurance | Editorial Policy | Research Policy | Last Updated: December 16, 2022

Bactrim And Alcohol Interaction

It is not entirely safe to mix Bactrim and alcohol. Alcohol can interact with many medications, including antibiotics such as Bactrim. A standard guideline is that if you are unwell enough to need antibiotics, you should not consume alcohol. However, alcohol is a frequent social element. You may want to drink while on an antibiotic if you attend a wedding, date, or birthday celebration.

Bactrim is a commonly prescribed antibiotic used to treat bacterial infections, including those in the ear, urinary tract, and respiratory system. You may know it by its generic name, sulfamethoxazole-trimethoprim, or SMZ-TMP.

While some antibiotics may be taken with moderate alcohol consumption, Bactrim is not one of them. Potentially harmful side effects can occur with Bactrim and alcohol disulfiram reaction.

What Is Bactrim?

Bactrim (sulfamethoxazole and trimethoprim) is a synthetic antibacterial combination product available in DS (double strength) tablets, each containing 800 mg sulfamethoxazole and 160 mg trimethoprim; in tablets, each containing 400 mg sulfamethoxazole and 80 mg trimethoprim for oral administration. [1]

It treats urinary tract infections, middle ear infections (otitis media), bronchitis, traveler’s diarrhea, and shigellosis (bacillary dysentery). This medicine is also used to prevent or treat “Pneumocystis jiroveci pneumonia” or “Pneumocystis carinii pneumonia (PCP),” a severe kind of pneumonia. This type of pneumonia occurs more commonly in patients whose immune systems are not usually working, including cancer patients, transplant patients, and patients with acquired immune deficiency syndrome (AIDS).

What Is Bactrim Used For?

  • Bactrim is a brand (trade) name for a fixed combination medicine containing two antibiotics – sulfamethoxazole and trimethoprim.
  • Sulfamethoxazole stops bacteria from making “dihydrofolic acid,” and trimethoprim prevents the formation of tetrahydrofolic acid, both significant steps in constructing nucleic acids and proteins essential to many bacteria.
  • The combination of sulfamethoxazole/trimethoprim is bactericidal (kills bacteria).
  • Bactrim belongs to the class of medicines known as antibiotics. The sulfamethoxazole component belongs to the type of drugs known as sulfonamides, and the trimethoprim component belongs to the class of medicines known as folic acid inhibitors.

Mixing Bactrim And Alcohol

In general, it is recommended to avoid alcohol consumption while taking Bactrim (sulfamethoxazole/trimethoprim) as there could be known and unknown adverse effects.

Among other things, alcohol consumption can:

  • Affect drug metabolism (e.g. increase or decrease in metabolizing enzyme activity) 
  • Increase the risk of liver toxicity with medication 
  • Increase the risk of side effects (e.g. nausea/vomiting/diarrhea)
  • Decrease immune system function 

Regarding Bactrim and alcohol specifically, Bactrim can inhibit acetaldehyde dehydrogenase, which is mainly responsible for alcohol metabolism. If acetaldehyde dehydrogenase is less active, alcohol toxicity can build up and can cause what is known as a disulfiram reaction. This reaction is characterized by the following:

  • Extreme flushing
  • Increased heart rate
  • Low blood pressure

This potential ‘disulfiram reaction’ between Bactrim and alcohol is controversial as there is little data to support that it occurs with commonly prescribed amounts of Bactrim and reasonable alcohol consumption. Moreover, the reaction is more associated with other drugs, like Flagyl (metronidazole). Nevertheless, the interaction has been reported and must be considered.​ many are also looking into Bactrim and alcohol forums or through “bactrim and alcohol Reddit” discussions. It shows that it is not uncommon for people to mix these drugs.

In addition to the potential ‘disufiram reaction,’ mixing Bactrim and alcohol can increase the risk of nausea and other gastrointestinal effects. However, small amounts of alcohol, such as those in liquid medication or prepared meals, are generally safe and shouldn’t cause any issues.

Bactrim And Alcohol Death Statistics

Substance use disorders can involve illicit drugs, prescription drugs, or alcohol. Many are also mixing medications with alcohol. Effective treatments for substance use disorders are available, but very few people get the treatment they need. Strategies to prevent substance use and help people get treatment can reduce drug and alcohol misuse, related health problems, and deaths.


11,616

Over 5,000 people aged 65 and above in the U.S. died of a drug overdose in 2020, and more than twice that many (11,616) died of alcohol-induced causes. 

Source: CDC

85.6%

According to the National Survey on Drug Use and Health 2019 (NSDUH), 85.6% of people ages 18 and older reported drinking alcohol at some point in their lifetime.

Source: NSDUH

95,000

An estimated 95,000 people (approximately 68,000 men and 27,000 women) die from alcohol-related causes annually.

Source: NIAAA


Bactrim Antibiotic And Alcohol Fact Sheet

Trimethoprim/sulfamethoxazole, sold under the brand name Bactrim among others, is a fixed-dose combination antibiotic medication used to treat various bacterial infections. It consists of one part trimethoprim to five parts sulfamethoxazole.

Generic name: sulfamethoxazole and trimethoprim [ “SUL-fa-meth-OX-a-zole-and-trye-METH-oh-prim” ]
Brand names: Bactrim, Bactrim DS
Drug class: Sulfonamides


Warnings

You should not use Bactrim if you have severe liver disease, kidney disease that is not being monitored, anemia caused by folic acid deficiency, if you take dofetilide, or if you have had low platelets caused by using trimethoprim or a sulfa drug.

You should not take Bactrim if you are pregnant or breastfeeding.

Use Bactrim only as directed. Tell your doctor if you use other medicines or have other medical conditions or allergies.

Drinking Bactrim and alcohol can increase the risk of nausea and vomiting occurring. In general, you should avoid consuming alcohol while taking Bactrim.

To make sure you can safely take Bactrim, tell your doctor if you have ever had:

  • Kidney or liver disease
  • A folate (folic acid) deficiency
  • Asthma or severe allergies
  • HIV or AIDS
  • A thyroid disorder
  • Malnourishment
  • Alcoholism
  • An electrolyte imbalance (such as low blood sodium or high potassium)
  • Porphyria, or glucose-6-phosphate dehydrogenase (G6PD) deficiency; or
  • If you use a blood thinner (such as warfarin) and have routine “INR” or prothrombin time tests.
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Popular Mixing Antibiotics Sulfamethoxazole Trimethoprim And Alcohol FAQs

  1. What are the risks of mixing Sulfamethoxazole Trimethoprim and alcohol? Or mixing alcohol and Sulfamethoxazole?

    A few antibiotics like metronidazole (Flagyl), tinidazole (Tindamax), sulfamethoxazole, and trimethoprim (Bactrim) should not be mixed with alcohol. When combined, these can interact to create a more severe reaction. Drinking alcohol with these medications can result in adverse side effects such as flushing, headache, nausea and vomiting, and rapid heart rate. Beware that mixing alcohol and sulfamethoxazole will also create negative interactions.

  2. Can you mix Sulfamethoxazole and alcohol?

    Sulfamethoxazole and alcohol can make for a dangerous combination. It would be best if you did not take Sulfamethoxazole and alcohol. Drinking alcohol while taking sulfamethoxazole/trimethoprim tablets may lead to undesirable side effects.  Mixing antibiotics like Bactrim / Sulfamethoxazole and alcohol can cause unsafe heart rate elevation and decreased blood pressure. This can result in secondary adverse effects.

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Potentially harmful side effects can occur if you mix Bactrim and alcohol.
Potentially harmful side effects can occur if you mix Bactrim and alcohol.

Side Effects Of Bactrim And Alcohol Experience

The side effects of alcohol and antibiotics are similar, including dizziness, stomach upsets, and drowsiness. Using alcohol and antibiotics together can increase the side effects of both, making patients extremely uncomfortable and tired instead of on their road to recovery from a bacterial infection. This is why doctors tell patients not to consume alcohol while taking antibiotics.

Your body relies on specific enzymes to seize up alcohol into something easily eliminated. Through this complex process, several byproducts are created. One of the byproducts is a toxic substance called acetaldehyde.

Bactrim may prevent the enzyme responsible for breaking down acetaldehyde from working, creating a toxic substance buildup. This interaction can lead to many side effects, including:

  • Flushing
  • Headaches
  • Nausea and vomiting
  • Difficulty breathing
  • Rapid heart rate

These effects may occur five to fifteen minutes after consuming alcohol. There have even been cases of people having heart palpitations and shortness of breath (dyspnea) after drinking Bactrim and alcohol. These more severe side effects have been reported with varying amounts of consumed alcohol. This makes it important for patients using Bactrim to avoid any quantity of alcohol, including alcohol found in various cold medications and even mouthwash.

Bactrim Side Effects

Bactrim (sulfamethoxazole and trimethoprim) is an antibiotic that is used to treat a variety of bacterial infections. Like all medications, Bactrim can cause side effects, although not everyone who takes the medication will experience them.

Common side effects of Bactrim may include:

  • Nausea
  • Vomiting
  • Diarrhea
  • Stomach pain
  • Loss of appetite
  • Rash

Less common side effects of Bactrim may include:

  • Dizziness
  • Headache
  • Fatigue
  • Fever
  • Muscle or joint pain
  • Chest pain
  • Shortness of breath

If you experience any of the above Bactrim side effects while taking the antibiotic, contact your healthcare provider. It is important to tell your healthcare provider about all medications you are taking, as well as any allergies you have, to help prevent potential interactions or allergic reactions.

In rare cases, Bactrim side effects can be serious, including:

  • Allergic reactions (rash, hives, itching, difficulty breathing, chest tightness, swelling of the face, lips, tongue, or throat)
  • Blood disorders (anemia, low white blood cell count, low platelet count)
  • Liver damage
  • Severe skin reactions (Stevens-Johnson syndrome, toxic epidermal necrolysis)
  • Pneumonia (inflammation of the lungs)
  • Kidney damage

If you experience any of these atypical Bactrim side effects, stop applying Bactrim and seek medical attention immediately.

How Does Alcohol Impact Infections And Healing?

Many people know excessive drinking can harm the liver and other vital organs. However, another less obvious body system vulnerable to the adverse effects of alcohol is the immune system. Because of alcohol’s effects on the immune system, people who drink excessively are at increased risk of contracting infectious diseases, may have more complications after surgery, and often take longer to recover from an illness than those who drink at lower levels. Disruptions in immune system function also contribute to organ damage associated with alcohol consumption.

Alcohol consumption can alter most immune cells’ number, survival, and function. Although these alterations alone may not be sufficient to affect one’s health adversely, if a person is exposed to a second “hit,” such as a virus, his or her immune system may be unable to respond appropriately, increasing the risk of infection. The specific effects of alcohol on the immune system depend mainly on how often and how much a person drinks. Even a single episode of binge drinking can have measurable results on the immune system, from within the first 20 minutes to several hours after alcohol ingestion.

Over the long term, alcohol abuse weakens the immune system. It increases the risk and severity of viral and bacterial infections, including human immunodeficiency virus (HIV), hepatitis B and C, and lung infections. It can reduce the effectiveness of vaccines and contribute to various diseases, including alcoholic hepatitis, alcoholic pancreatitis, alcoholic cirrhosis, alcoholic steatohepatitis, inflammation in the gastrointestinal tract and brain, and cancer.

Mixing Bactrim and alcohol is not entirely safe. Mixing Bactrim and alcohol can also cause dangerous heart rate elevation and decreased blood pressure. 
Mixing Bactrim and alcohol is not entirely safe. Mixing Bactrim and alcohol can also cause dangerous heart rate elevation and decreased blood pressure. 

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How Does Alcohol Interacts With Antibiotics?

Even though there are warnings not to consume alcohol on most antibiotic packaging, it is a common misconception that drinking while on these medications is a relatively safe practice. One of the most frequently asked questions that doctors get regarding prescription antibiotics is, “is it safe to drink on these?” The short answer is no – alcohol directly inhibits antibiotics’ effectiveness and can cause many adverse side effects.

Drinking any amount of alcohol while you’re fighting an infection may not be wise, as it can lead to dehydration, interrupt normal sleep, and may hinder your body’s natural ability to heal itself. In addition, some antibiotics can have a hazardous interaction with alcohol, so it’s essential to check with your doctor or pharmacist.

A few antibiotics — such as metronidazole (Flagyl), tinidazole (Tindamax), and sulfamethoxazole and trimethoprim (Bactrim) — should not be mixed with alcohol because this may result in a more severe reaction. Drinking any amount of alcohol with these medications can result in side effects such as flushing, headache, nausea and vomiting, and rapid heart rate.

Also, the antibiotic linezolid (Zyvox) interacts with certain alcoholic beverages, including red wine and tap beer. Drinking these beverages with this medication can cause a dangerous increase in blood pressure.

The Dangers Of Mixing Alcohol And Antibiotics

Bactrim DS and alcohol have individual side effects that impact an individual’s behavior and mental state. Because of this, the two should never be mixed. A handful of antibiotics can cause violent physical reactions when combined with alcohol. These include Metronidazole and Linezolid, 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, 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, and 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 specific immune system processes and have a negative impact on the body’s ability to recover from an infection.

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Bactrim And Alcohol Reaction

In terms of when it would be safe to drink alcohol after taking Bactrim, the drug is rapidly absorbed after taking a dose by mouth, with most of the medication being immersed within a few hours. If you want to avoid consuming alcohol while Bactrim is absorbed from your stomach/GI tract, 3-4 hours seems to be that upper limit. This may help prevent any nausea or vomiting the combination might bring about.

Bactrim has a half-life of 8-12 hours (half-life refers to the time it takes your body to reduce the concentration of the drug by 50%), meaning it would take a few days at least for the entire drug to be metabolized and out of your system. If you want to avoid alcohol and Bactrim simultaneously in your body, wait at least three days. Waiting for this period will significantly reduce the risk of any reaction.

Consuming Bactrim and alcohol does not usually result in death. However, it would be best if you remembered that drinking alcohol excessively makes a person’s immune system weaken. It can be addictive and can cause death. In addition, there are side effects associated with combining Bactrim and alcohol.

Alcohol slows the healing process and recovery time and puts an individual at increased risk of developing another infection. If you are struggling with Bactrim and alcohol use disorder, connect with We Level Up NJ alcohol rehab center.
Alcohol slows the healing process and recovery time and puts an individual at increased risk of developing another infection. If you are struggling with Bactrim and alcohol use disorder, connect with We Level Up NJ alcohol rehab center.

Avoid Alcohol While Taking Bactrim

Mixing Bactrim 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 Bactrim is completed; until 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.

Someone who has become dependent on or addicted to a drug or alcohol should seek professional assistance. Prescription drug treatment programs are designed to support drug and alcohol-dependent individuals medically.

During your rehabilitation, the We Level Up NJ treatment facility staff will help you identify what caused your dependency and abuse and teach you skills that will help you change your behavior patterns and challenge the negative thoughts that led to your addiction. 

The We Level Up NJ addiction treatment center provides proper care with round-the-clock medical staff to assist your recovery through our medically-assisted Bactrim and alcohol detox program. So, reclaim your life. Call us to speak with one of our treatment specialists. Our counselors know what you are going through and will answer any of your questions.

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3 Most Bactrim and Alcohol Frequently Asked Questions

  1. Can you drink alcohol and take antibiotics like Bactrim?

    No. Although modest alcohol use doesn’t reduce the effectiveness of most antibiotics, it can reduce your energy and delay how quickly you recover from illness. So, it’s a good idea to avoid alcohol until you finish your antibiotics and feel better.

  2. Can you drink alcohol while on antibiotics and steroids?

    No. Both corticosteroids and alcohol can suppress your immune system, raising your risk of infection. While alcohol may not directly interact with corticosteroids, it can potentially worsen the underlying condition being treated. Antibiotics and alcohol can cause similar side effects, such as stomach upset, dizziness, and drowsiness. Combining antibiotics and alcohol can increase these side effects.

  3. What happens when you mix alcohol and antibiotics such as Bactrim?

    Drinking some antibiotics, like metronidazole (Flagyl) and Bactrim, can cause vomiting, cramping, and rapid heart rate.

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[3] Alcohol’s Effects on Immunity—Increasing the Risks for Infection and Injury – National Institute on Alcohol Abuse and Alcoholism (NIAAA)

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[5] Alcohol Use in the United States – NIAAA/National Institute on Alcohol Abuse and Alcoholism

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[7] Jung YC, Namkoong K. Alcohol: intoxication and poisoning – diagnosis and treatment. Handb Clin Neurol. 2014;125:115-21. DOI: 10.1016/B978-0-444-62619-6.00007-0. PMID: 25307571.

[8] Newman RK, Stobart Gallagher MA, Gomez AE. Alcohol Withdrawal. [Updated 2022 Aug 29]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441882/

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[10] Witkiewitz K, Litten RZ, Leggio L. Advances in the science and treatment of alcohol use disorder. Sci Adv. 2019 Sep 25;5(9):eaax4043. DOI: 10.1126/sciadv.aax4043. PMID: 31579824; PMCID: PMC6760932.