Bactrim and Alcohol, Risks, Side Effects, Reaction, & Alcohol Abuse Treatment
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 . It is used to treat infections including 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 very serious kind of pneumonia. This type of pneumonia occurs more commonly in patients whose immune systems are not working normally, 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 the formation of 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 class of medicines 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 negative effects, both known and unknown.
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
In regards to Bactrim and alcohol specifically, Bactrim can inhibit acetaldehyde dehydrogenase, which is largely 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:
- 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 normally prescribed amounts of Bactrim and reasonable alcohol consumption. In addition, the reaction is more associated with other drugs, like Flagyl (metronidazole). Nevertheless, the reaction has been reported and must be considered.
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 the amounts contained in liquid medication, or prepared meals are generally safe and shouldn’t cause any issues.
Side Effects of Mixing Bactrim and Alcohol
The side effects of both 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 the main reason that doctors tell patients not to consume alcohol while taking antibiotics.
Your body relies on specific enzymes to break down alcohol into something that can be 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:
- 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 consuming 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.
How Do Alcohol Impact Infections and Healing?
Many people are aware that excessive drinking can be harmful to the liver and other vital organs; however, there is another, less obvious, body system that is vulnerable to the negative effects of alcohol: the immune system. Because of alcohol’s effects on the immune system, people who drink to excess are at increased risk of contracting infectious diseases, may have more complications after surgery, and often take longer to recover from illness, compared with those who drink at lower levels. Disruptions in immune system function also contribute to organ damage associated with alcohol consumption.
Alcohol consumption can alter the number, survival, and function of most immune cells. Although these alterations alone may not be sufficient to adversely affect one’s health, if a person is exposed to a second “hit,” such as a virus, his or her immune system may be unable to respond properly, increasing the risk of infection. The specific effects of alcohol on the immune system depend largely on how often and how much a person drinks. Even a single episode of binge drinking can have measurable effects 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 and 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 a host of diseases, including alcoholic hepatitis, alcoholic pancreatitis, alcoholic cirrhosis, alcoholic steatohepatitis, inflammation in the gastrointestinal tract and brain, and cancer.
How Alcohol Interacts with Antibiotics?
Despite the fact that there are warnings not to consume alcohol on the majority of antibiotic packaging, it is a common misconception that drinking while on these medications is a relatively safe practice. In fact, 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 also cause a wide range of negative 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 very dangerous 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
Both alcohol and antibiotics have individual sets of side effects that impact an individual’s behavior and mental state. Because of this, the two should never be mixed together. 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.
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 absorbed within a few hours. If you want to avoid consuming alcohol while Bactrim is being absorbed from your stomach/GI tract, 3-4 hours seems to be that upper limit. This may help avoid any kind of 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 being in your system at the same time, wait at least 3 days. Waiting this period of time will greatly reduce the risk of any type of reaction.
Consuming Bactrim and alcohol does not usually result in death. However, you should remember 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.
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 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.
 FDA – https://www.accessdata.fda.gov/drugsatfda_docs/label/2020/017560s044lbl.pdf
 NCBI – https://pubchem.ncbi.nlm.nih.gov/compound/Sulfamethoxazole-and-trimethoprim#section=Absorption-Distribution-and-Excretion
 NIAAA – https://pubs.niaaa.nih.gov/publications/AA89/AA89.htm#:~:text=Because%20of%20alcohol%E2%80%99s%20effects%20on%20the%20immune%20system%2C,compared%20with%20those%20who%20drink%20at%20lower%20levels.