A champagne or two with Christmas lunch. A cold crisp beer on the beach. New Year in with friends over some cheeky cocktails. There seem to be many occasions to drink alcoholic beverages this summer.
But if you take certain medications while drinking alcohol, it can affect your body in different ways. Drinking alcohol with some medicines means they may not work as well. With others, you risk a life-threatening overdose.
Here’s what you need to know if you’re taking medication and planning to drink in the summer.
Why is this a big deal?
After you take a medicine, it travels to the stomach. From there, your body shuttles it to the liver where the drug is metabolized and broken down before entering your bloodstream. Each drug you take is delivered in a dose that takes into account the amount of metabolism that occurs in the liver.
When you drink alcohol, it is also broken down in the liver and can affect how well the drug is metabolized.
Some drugs are metabolized moreWhich means not enough reaches your bloodstream to be effective.
Some drugs are metabolized less. This means you get a much higher dose than intended, which can cause an overdose. Effects of alcohol (such as drowsiness) may act in addition to similar effects of drugs.
Whether you will have an interaction, and what interaction you have, depends on many factors. These include the medication you are taking, the dosage, how much alcohol you drink, your age, genes, gender and overall health.
Women, elderly people and people with liver problems are more likely to have drug interactions with alcohol.
What drugs do not mix well with alcohol?
Many medications interact with alcohol, whether prescribed by your doctor or bought over the counter, such as herbal medicines.
1. Drugs + Alcohol = Drowsiness, Coma, Death
Drinking alcohol and taking a drug that depresses the central nervous system to reduce excitement and stimulation may have an additive effect. Together, they can make you excessively drowsy, slow your breathing and heart rate, and in extreme cases lead to coma and death. These effects are more likely if you use more than one of these types of medicine.
Medicines should be sought for depression, anxiety, schizophrenia, pain (other than paracetamol), sleep disorders (eg insomnia), allergies, and colds and flu. It is best not to drink alcohol with these medications or to keep your alcohol intake to a minimum.
2. Drugs + alcohol = more effects
Mixing alcohol with some drugs increases the effect of that drug.
An example is the sleeping tablet zolpidem, which should not be taken with alcohol. A rare, but serious, side effect is strange behavior during sleep, such as sleep-eating, sleep-driving or sleep-walking, which is more common with alcohol.
3. Medication + craft beer or home brew = high blood pressure
Certain types of drugs only interact with certain types of alcohol.
Examples include some drugs for depression, such as phenelzine, tranylcypromine and moclobemide, the antibiotic linezolid, the Parkinson’s drug selegiline, and the cancer drug procarbazine.
These so-called monoamine oxidase inhibitors only interact with certain types of boutique and craft beers, beers with visible sediment, Belgian, Korean, European and African beers, and home-brewed beers and wines.
This type of alcohol contains high levels of tyramine, a naturally occurring substance that is normally broken down by your body without usually causing any harm.
However, monoamine oxidase inhibitors prevent your body from breaking down tyramine. It increases levels in your body and can raise your blood pressure to dangerous levels.
4. Drugs + alcohol = effects even after you stop drinking
Other drugs interact because they affect the way your body breaks down alcohol.
If you drink alcohol while using these medicines, you may experience nausea, vomiting, a flush in the face and neck, shortness of breath or dizziness, your heart may beat faster than normal, or your blood pressure may drop.
It can also happen after you stop treatment or drink alcohol. For example, if you take metronidazole, avoid alcohol both while using the drug and for at least 24 hours after you stop taking it.
An example of where alcohol changes the amount of drugs or related substances in the body is acitretin. This medicine is used to treat skin conditions such as severe psoriasis and to prevent skin cancer in people who have had organ transplants.
When you take acitretin, it changes to another substance – etretinate – before it is removed from your body. Alcohol increases the amount of etretinate in your body.
This is especially important because etretinate can cause birth defects. To prevent this, if you are a woman of childbearing age, avoid alcohol while using the drug and for two months after you stop taking it.
Myths about alcohol and drugs
Alcohol and birth control
One of the most common myths about drugs and alcohol is that you can’t drink while on the birth control pill.
Using alcohol with the pill is generally safe because it does not directly affect how well the birth control works.
But the pill is most effective when taken at the same time every day. If you drink a lot, you’re more likely to forget to do it the next day.
Alcohol can cause nausea and vomiting in some people. If you vomit within three hours of taking the pill, it will not work. It increases your risk of pregnancy.
Birth control pills can also affect your response to alcohol because the hormones they contain can change the way your body removes alcohol. This means you can get drunk faster, and you can stay drunk longer than usual.
Alcohol and antibiotics
Then there’s the myth about not mixing alcohol with antibiotics. This applies only to metronidazole and linezolid.
Otherwise, it is generally safe to use alcohol with antibiotics, as alcohol does not affect how well they work.
But if you can, it’s best to avoid alcohol while taking antibiotics. Antibiotics and alcohol have similar side effects, such as upset stomach, dizziness and drowsiness. Using the two together means you are more likely to have these side effects. Alcohol can reduce your energy and increase how long it takes you to recover.
Where can I go for advice?
If you plan to drink alcohol this holiday and are concerned about an interaction with your medication, don’t stop taking your medication.
Your pharmacist can advise you if it is safe for you to drink based on the medications you are taking and if not, advise on alternatives.
Nial Wheat, Associate Professor, Sydney School of Pharmacy, University of Sydney and Jessica Pace, Associate Lecturer, University of Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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