Alcohol Drug Interactions
In This Article
Many over-the-counter and prescription medications can cause adverse effects when combined with alcohol. Some herbal supplements can even cause harm when mixed with alcohol.
Additionally, alcohol is especially dangerous when mixed with illicit drugs like heroin, cocaine, and opioids.
Because of this, it’s important to talk to your doctor or pharmacist before beginning any treatment course. Before using over-the-counter medications, make sure you read the directions.
What Drugs Interact with Alcohol?
People may combine drugs with alcohol to self-medicate or heighten the side effects of both substances. Some of the most common drugs combined with alcohol include:
Stimulants
Stimulants like Adderall and Ritalin have specific side effects that affect a person’s behavior and mental state. While stimulants speed up the central nervous system (CNS), alcohol slows it down.
Mixing stimulants and alcohol can damage the CNS, resulting in impaired memory, decision-making, and learning. It can also put stress on the liver, resulting in liver damage.
Additionally, both substances are highly addictive, so mixing them increases your risk of substance use disorders (SUD). Abusing these substances in this way can also increase your tolerance, leading to addiction and dependence over time.
Depressants
Depressants and alcohol both slow down CNS activity. Combining these two can cause extreme drowsiness, memory loss, reduced motor control, dizziness, and nausea.
It can also result in severe physiological effects, such as respiratory arrest, lowered blood pressure, decreased heart rate, and death.
Some examples of depressants commonly mixed with alcohol include:
Antidepressants
Antidepressants like selective serotonin reuptake inhibitors (SSRIs) are often used to treat anxiety and depression. However, both alcohol and SSRIs impair decision-making, thinking, and reaction time.
So, combining these substances can result in magnified effects. In the worst-case scenario, mixing alcohol and antidepressants can cause severe impairment, overdose, and death.
Some SSRIs are even packaged with a black box warning due to their increased risk of suicidal ideation, which can be worsened by alcohol. Some examples of antidepressants include:
- Lexapro (escitalopram)
- Celexa (citalopram)
- Prozac (fluoxetine)
Antihistamines
Antihistamines like Zyrtec and Nyqil are over-the-counter drugs used to treat allergies. However, both alcohol and antihistamines act as depressants at moderate to high doses.
Combining these substances can result in drowsiness, dizziness, nausea, and impaired coordination. The compounding effects can also strain the CNS and cause severe liver damage.
Corticosteroids
Corticosteroids, like Prednisone, are synthetic versions of the hormone cortisol, which is produced in the adrenal gland. These anti-inflammatory medications treat arthritis, inflammatory bowel disease, asthma, and Crohn’s disease.
Long-term corticosteroid and alcohol use can increase your risk of certain health problems. These include:
- Weakened immunity
- Mood swings
- High blood pressure
- Weight gain
- Liver damage
Pain Relievers
Gabapentin is typically used for pain relief and nerve-related conditions. Combining alcohol with gabapentin can increase alcohol side effects like drowsiness, dizziness, and respiratory issues.
Antibiotics
Antibiotics are generally safe to use. Although there are no serious dangers to combining alcohol and antibiotics, it can have some adverse effects.
For example, it can worsen stomach pain, drowsiness, and dizziness. It can also lead to dehydration, poor sleep, and delayed healing.
Ultimately, mixing alcohol and antibiotics can hinder your body’s ability to heal from infections, counteracting the medication’s effects.
What Other Medications Can Interact with Alcohol?
Aside from the ones mentioned above, alcohol can also interact with:
- Sedatives
- Hypnotics
- Sleeping pills
- Antipsychotics
- Blood pressure and cholesterol medications
- Diabetes medications
- Herbal remedies like St. John’s Wort
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What are the Severe Side Effects of Alcohol’s Drug Interactions?
The side effects of mixing alcohol and medications vary depending on the drug being used. How severe these reactions are depends on age and general health standing.
Some examples of severe side effects include:
- Internal bleeding and ulcers
- Heart problems
- Low or high blood pressure
- Difficulty breathing (respiratory depression)
- Liver damage
- Decreased effectiveness of medications due to alcohol use
- Seizures
- Drug overdose
- Death
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Who is at Risk of Drug Interactions?
Older adults have an increased risk of experiencing interactions from mixing alcohol and prescription drugs. This is because older people are more likely to be prescribed medications than younger adults and children.
Additionally, certain medications that are affected by alcohol use, including diazepam (Valium), last longer in older bodies. Women may also be at an increased risk of alcohol interactions.
Women tend to have a higher body fat percentage and lower body water percentage than men. As a result, they metabolize alcohol slower, increasing the risk of high blood alcohol levels after consuming the same amount of alcohol as men.
Can Alcohol Interact With Certain Medical Conditions?
Aside from drugs and medications, alcohol can also interact with certain medical conditions or diseases.
You should consider avoiding alcohol if you have:
- Cirrhosis
- Liver scarring (fibrosis)
- Gilbert's syndrome
- Hepatitis C virus (HCV)
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- Center for Drug Evaluation and Research. “Drug Interactions: What You Should Know.” U.S. Food and Drug Administration, FDA, 2013.
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- “Xanax.” Food and Drug Administration, 2016.
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- University of North Carolina Health Care. “How do antidepressants trigger fear and anxiety? Researchers map the anxiety circuit in the brain and use a compound to limit fearful behavior — an acute side effect of commonly prescribed SSRI antidepressants.” ScienceDaily, 2016.
- Jaeger et al. “Antidepressants and alcohol use disorder: A multicenter study on the mediating role of depression symptom changes.” Alcohol Clin Exp Res (Hoboken), 2024.
- “Adderall Label.” Food and Drug Administration (FDA).
