The biggest myth about antibiotics and alcohol, explained by a doctor

It’s also a good idea to avoid combining alcohol with antibiotics that depress the central nervous system. Combining alcohol with some medications for depression or seizures can lead to too much sedation and even coma or death in extreme circumstances. However, most antibiotics don’t usually affect the central nervous system in this way. You should definitely avoid alcohol while you are taking specific types of antibiotics. And drinking heavily, which is bad for your health at any time, may be even riskier if you are also taking an antibiotic. Healthcare providers recommend avoiding alcohol with metronidazole and tinidazole within 48 hours of starting or stopping them.

This is another reason to only take antibiotics when prescribed by your provider. A healthy diet, including foods containing probiotics, can help restore good bacteria to your gut. While some providers suggest getting a new toothbrush two or three days after starting an antibiotic for strep throat, expert opinions are mixed. More studies are needed on this topic to prove if it’s necessary. Isoniazid is used for the treatment of tuberculosis and nontuberculosis mycobacterial infections (98).

Can I take antibiotics with alcohol?

Many of the same considerations apply to antifungals used to treat fungal infections. By Lauren Panoff, MPH, RDPanoff is a registered dietician, writer, and speaker with over a decade of experience specializing in the health benefits of a plant-based lifestyle. Always seek medical attention if you experience symptoms that feel out of the ordinary or are concerning. Oxazolidinones may be used for certain infections, such as osteomyelitis, an infection in the bones, or endocarditis, an infection of the inner lining of the heart muscle.

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Warnings may vary depending on the pharmacy that dispense the prescription. Patients commonly are counseled or their prescription bottles carry a warning sticker to avoid consumption of alcohol while receiving antibiotics (1) (Table 1). It is a common belief that concomitant use of alcohol with antibiotics either will cause toxicity/ADR or will decrease efficacy (6, 7).

Can You Drink Alcohol with Antibiotics?

Rest, drink plenty of fluids (other than alcohol), and be sure to finish all your medication when you have an infection. Not all antibiotics have serious interactions with alcohol, but avoiding alcoholic beverages while you are sick is usually a good idea. Linezolid is a weak, nonspecific inhibitor of monoamine oxidase (MAO) enzymes (81). Studies have shown positive pressor responses in comparison with placebo with tyramine administration (81, 82).

1. While alcohol use should still be avoided with certain antimicrobials, use with select others appears to be acceptable.
2. Studies show booze won’t stop most treatments from working properly or cause unpleasant side-effects.
3. In rare cases, this can cause drug-induced liver toxicity (swelling of your liver).
4. The articles were chosen after a search of published English language medical literature.
5. Historical studies have suggested that alcohol use with nitrofurantoin resulted in a disulfiram-like reaction (40–42).

Cycloserine may decrease alcohol craving, and the package inset warns of seizures with concomitant alcohol use, but data to support this warning were not identified. Despite an FDA warning, we were unable to identify published data that demonstrate an increased risk with concomitant ethambutol and alcohol use. Use of alcohol with griseofulvin should be avoided due to risk of a disulfiram-like reaction, which may be severe. Nitroimidazoles are used for parasitic or anaerobic infections (45).

Which antibiotics should people not drink alcohol with?

Mixing moderate amounts of alcohol with an antibiotic will not usually lower your antibiotic’s effectiveness. Alcohol doesn’t make most antibiotics less effective, but consuming alcohol — especially if you drink too much — might increase your chance of experiencing certain side effects. The oxazolidinone class of antibiotics, including linezolid and tedizolid, are typically used in the treatment of resistant Gram-positive infections (80). Alcohol intake has been reported to diminish the antimicrobial effect of doxycycline. Amoxicillin and amoxicillin-clavulanic acid may lead to decreased alcohol consumption.

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Amoxicillin can cause other potential complications, including gastrointestinal issues, and alcohol can worsen these. People should avoid drinking alcohol during treatment and up to 3 days after the last dose. Although some antibiotics can interact with alcohol, the risks are not the same for all types. Doctors will give different recommendations about a person’s alcohol intake depending on the type of antibiotic they prescribe. Alcohol consumption won’t directly impact how effective your antibiotics are. But, drinking alcohol can mean that it takes your body longer to recover from whatever infection or illness you are taking antibiotics for in the first place.

People with an impaired immune system have a higher risk of infection. In 2018, the Food and Drug Administration (FDA) published updated safety warnings on all fluoroquinolone antibiotics. Additionally, never skip a dose of your antibiotics just to drink. For example, you should probably avoid using alcohol while taking the antifungals Nizoral (ketoconazole) or Gris-PEG (griseofulvin), due to risk of liver problems. However, some other antifungals, such as Diflucan (fluconazole), might be able to be used more safely with alcohol. Rarely, severe symptoms can occur, such as very low blood pressure or heart attack.

Isoniazid is often listed as an agent that can cause a disulfiram-like reaction with alcohol due to its inhibition of aldehyde dehydrogenase (106–108). Symptoms include headache, palpitations, sweating, flushing, and hypotension (109, 110). It has also been postulated that such a reaction may be due to isoniazid’s inhibition of monoamine oxidase, as symptoms have been reported after consumption of wine (109). Isoniazid was found to Alcohol Poisoning Symptoms & Treatment alter central monoaminergic neurotransmission (111). Although aldehyde dehydrogenase was inhibited with coadministration, blood acetaldehyde levels were not increased. Many antibiotics carry caution stickers that warn against alcohol consumption.