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Antibiotics and Alcohol

Risks in Mixing Antibiotics and Alcohol. Treatment for Polysubstance Abuse

What are Antibiotics? 

Antibiotics are common agents used in modern healthcare. This was not always the case. From ancient times, people sought ways to treat those with infections. Dyes, molds, and even heavy metals were thought to hold promise for healing. Various microorganisms hold medical significance, including bacteria, viruses, fungi, and parasites. Antibiotics are compounds that target bacteria and, thus, are intended to treat and prevent bacterial infections.

All medications have the potential for an adverse reaction, and antibiotics are no exception. One in five hospitalized patients has been shown to develop an adverse reaction to an antibiotic, and nearly the same proportion of drug-related Emergency Department visits are due to adverse antibiotic reactions. An immune-mediated reaction or hypersensitivity is classified as an allergy. Medications often reach harmful levels in the body due to reduced metabolism and elimination, or high dosing regimens can cause toxicity due to supratherapeutic drug levels. If a reaction occurs that is not mediated by the immune system and is unrelated to the drug level, then it is considered a side effect.

Antibiotics and Alcohol
Mixing antibiotics and alcohol is not entirely safe.

The increased use of antimicrobial agents in clinical practice and other industries such as livestock farming has led to bacterial resistance to antibiotic agents. Bacteria have developed mechanisms to promote this resistance in order to survive. Taking antibiotics when they’re not needed won’t help you, and they can have side effects and can contribute to antibiotic resistance. Antibiotic resistance happens when the bacteria change and become able to resist the effects of an antibiotic [2]. This means that the bacteria continue to grow. 

Antibiotics can be taken in different ways:

  • Orally (by mouth). This could be pills, capsules, or liquids.
  • Topically. This might be a cream, spray, or ointment that you put on your skin. It could also be eye ointment, eye drops, or ear drops.
  • Through an injection or intravenously (IV). This is usually for more serious infections.
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Can You Take Antibiotics and Drink Alcohol?

Combining antibiotics and alcohol will not usually lower your antibiotic’s effectiveness, but it may cause side effects and hinder your body’s natural ability to heal itself. Drinking alcohol while you’re fighting an infection can lead to an upset stomach, and dehydration, lower your immune response and interrupt normal sleep. Some antibiotics can also be dangerous for your liver, so it’s important to check with your doctor or pharmacist before mixing alcohol with prescription drugs.

When the body breaks down alcohol, it produces acetaldehyde, which can cause nausea. Many people taking antibiotics already experience stomach or digestive side effects, and mixing antibiotics can increase feelings of nausea. In addition to gastrointestinal issues, both antibiotics and alcohol can hinder cognitive function, concentration, and coordination. Another thing to consider with antibiotics and alcohol is the fact that drinking interferes with the essential processes of the body like hydration, and sleep and these are critical components of recovering from a bacterial illness. Due to these factors, it’s best to stay away from alcohol for the duration of antibiotic treatment

Antibiotics and Alcohol Myth

For decades, doctors, pharmacists, and well-meaning relatives have advised staying away from alcohol when taking prescription antibiotics. This advice may have originated far back os the 1950s when penicillin came into use as the first really effective treatment for sexually transmitted infections (STIs) such as syphilis and gonorrhea.

Physicians were worried that alcohol intoxication could undo their expensive treatment with the new miracle drugs. So patients were advised to abstain from alcohol until things cleared up. This may be well-founded because patients receiving penicillin for STD (sexually transmitted disease) at that time were more likely to engage in risky sexual activity while intoxicated.

The advice that you shouldn’t mix antibiotics and alcohol does hold true for a small group of anti-infective drugs, including metronidazole (Flagyl, Metronide, or Metrogyl), tinidazole (Fasigyn or Simplotan), and sulfamethoxazole/trimethoprim (Bactrim, Co-trimoxazole). The side effects of both Bactrim and alcohol are similar, including, stomach upsets, dizziness, and drowsiness. Mixing Bactrim and alcohol can increase the side effects of both, making the person extremely uncomfortable 

Antibiotics and Alcohol
Potentially harmful side effects can occur if you mix antibiotics and alcohol

These antibiotics block one of the major pathways that metabolize alcohol and cause a rapid build-up of acetaldehydes, which are responsible for many of the uncomfortable physical effects of hangovers. With these antibiotics, you can be red-faced, fainting and vomiting after as little as one glass of beer.

For nearly all other types of antibiotics, there is no clear evidence of harm from moderate alcohol intake. But this doesn’t mean it’s a good idea to drink to excess when you’re in the grip of an infection, as the nauseating and sedative effects of the alcohol are likely to increase if you are battling infections.

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Can You Mix Antibiotics and Alcohol?

Both antibiotics and alcohol have individual sets of side effects that impact an individual’s mental and behavioral state. Because of this, the two should never be combined. 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 and antibiotics 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, 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 certain immune system processes and have a negative impact on the body’s ability to recover from an infection. Alcohol then not only slows the healing process and recovery time but additionally puts an individual at increased risk of developing another infection.

The Effects of Mixing Antibiotics and Alcohol

Combining antibiotics and alcohol can damage your organs. Both antibiotics and alcohol burden the liver and kidneys. Alcohol can also compromise the body’s immune system responses affecting the body’s recovery. Besides slowing down the healing process, alcohol can put a person at risk of getting new infections.

Many antibiotics are known to cause violent reactions when taken alongside alcohol. These reactions range from vomiting and nausea to dizziness, headaches, chest pains, anxiety, and heart palpitations. These symptoms match those of alcohol intolerance caused by medication like disulfiram (Antabuse medication) prescribed to individuals with alcohol addiction problems.

Below we have listed the names of antibiotics that you should strictly avoid alcohol while continuing the course of medication. These include:

  • Oxazolidinones: Oxazolidinones like Linezolid shouldn’t be mixed with alcohol because it can cause fever, agitation, rapid heartbeat, unusual sweating, rapid breathing, vomiting, elevated blood pressure, seizures, abnormal heart rhythm, coma, cardiorespiratory depression, muscle spasms, muscle rigidity, and altered mental status
  • Tetracyclines: Alcohol should be avoided when taking antibiotics like tetracyclines like doxycycline and minocycline because doxycycline reduces the effectiveness of antibiotics and minocycline can increase liver disease risks
  • Fluoroquinolones: Fluoroquinolones like levofloxacin and ciprofloxacin can cause confusion, nervousness, agitation, memory loss, disorientation, and attention disturbances when mixed with alcohol. The effects are, however, pronounced with high alcohol consumption.
  • Sulfonamides: Sulfonamides like trimethoprim and sulfamethoxazole shouldn’t be mixed with alcohol to avoid side effects like a folic acid deficiency
  • Nitroimidazoles: Nitroimidazoles like metronidazole can cause headaches, facial flushing, nausea, vomiting, and abdominal cramping when mixed with alcohol. In fact, you shouldn’t take alcohol for 3 days after your last dose of Nitroimidazoles.

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Side Effects of Antibiotics and Alcohol 

Alcohol is also considered a central nervous system (CNS) depressant. Some antibiotics, like metronidazole (Flagyl), may also lead to CNS side effects such as:

  • Drowsiness
  • Sedation
  • Dizziness
  • Confusion

When alcohol is combined with antibiotics that also have a CNS depressant effect, additive effects may occur. These effects can be serious when driving or operating machinery, in the elderly, and in patients who may take other CNS depressant medications, such as opioid pain relievers, muscle relaxants, antidepressants, anxiety or seizure medications, among others.

Antibiotics and Alcohol
  Combining some specific antibiotics and alcohol can be dangerous.

Stomach side effects

Stomach problems, such as nausea, vomiting, diarrhea, and stomach pain can be common with antibiotics, too. Consuming alcohol can worsen these stomach side effects.

Liver damage

Excessive alcohol use is well-known to cause liver damage like cirrhosis. Taking antibiotics that can also damage the liver may worsen these types of problems.

Does Alcohol Affect How Well an Antibiotic Will Work? 

Usually, alcohol does not affect how well an antibiotic works to fight infection. However, the combination may produce unpleasant side effects. Also, in some circumstances levels of a drug in your bloodstream might be changed which may affect its effectiveness.

Alcohol is broken down (metabolized) in the liver extensively by enzymes. Some drugs are also metabolized by the same or similar enzymes. Depending upon how much and how often alcohol is consumed, changes in these enzymes may alter how drugs are metabolized in your body. For example:

  • When alcohol is used on a daily basis (chronically) enzyme levels can be “induced”. This means the drug is being broken down more quickly in the body and the levels of antibiotics in the blood may decrease. Your infection may not be cured and antibiotic resistance may occur, too.
  • When an intoxicating, acute amount of alcohol (a large amount over a short period of time) is consumed, certain enzymes do not work as well to break down the drug for metabolism. The levels of the antibiotic in the body may increase because it is not fully metabolized and excreted, which could lead to greater drug toxicity and side effects.

Treatment for Polysubstance Abuse

Alcohol is the most abused addictive substance in America, as more than 17 million people in the United States are considered to suffer from addiction to alcohol. The Substance Abuse and Mental Health Service Administration (SAMHSA) publishes that over 1.5 million American adults are considered to be currently abusing a prescription drug. 

Mixing antibiotics and alcohol can lead to addiction and dangerous side effects, including a greater risk of overdose. Not only can alcohol interact badly with some medications and cause severe side effects, but it can also potentially interrupt the natural healing process.. People with a history of problem drinking and alcohol dependence will need to inform their doctor about these problems. In addition, it’s crucial that these individuals get help from a qualified addiction rehabilitation center. 

antibiotics and alcohol
As a good rule of thumb, you should never mix drugs. This applies to antibiotics and alcohol. 

Polysubstance abuse is the consumption of more than one substance at the same time. While some drug users have a preferred drug, other users have several drugs they like to take. Polysubstance abuse is common, and these drug users are clinically classified as having multiple comorbid substance disorders. Because withdrawal from multiple substances is more complicated than withdrawal from one substance, inpatient medical detox is generally recommended. The goal of treatment is to restore some or all normal functioning to the liver by addressing the underlying issue of polysubstance abuse.

If you are struggling with alcohol use, it’s crucial to first get an accurate assessment of all the symptoms. When the symptoms have been evaluated by a mental health professional, it may be determined that another form of mental condition is present and needs a particular type of treatment. Very often, some combination of psychotherapy, medication, and/or lifestyle changes are effective for coping with functional. 

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Medically-Assisted Detox

Detox is often considered the first stage of treatment. It will help you navigate the complicated process of alcohol withdrawal, but it doesn’t address patterns of thought and behavior that contribute to drug use. Various treatment approaches and settings can help provide the ongoing support necessary to maintain long-term sobriety after you complete detox.

Cravings are very common during detox and can be challenging to overcome. This often leads to relapse. Constant medical care provided during inpatient treatment helps prevent relapse. Clinicians can provide necessary medication and medical expertise to lessen cravings and the effects of withdrawals.


Several different modalities of psychotherapy have been used in the treatment of mental health disorders along with addiction, including:

  • Cognitive Behavioral Therapy (CBT) – is an effective treatment that involves making changes in both the patterns of negative thoughts and the behavioral routines which are affecting the daily life of the depressed person for various forms of depression.
  • Dialectical Behavioral Therapy – is a comprehensive mental health and substance abuse treatment program whose ultimate goal is to aid patients in their efforts to build a life worth living. The main goal of DBT is to help a person develop what is referred to as a “clear mind.” 
  • Person-Centered Therapy – is a strategy that allows and encourages clients to understand and resolve their concerns in a safe, supportive environment.
  • Solution Focused Therapy – is an approach interested in solutions that can be quickly implemented with a simple first step leading to further positive consequences.

Dual Diagnosis Treatment

Drug abuse and mental health disorders often co-occur. In many cases, traumatic experiences can result in a mental health disorder and substance abuse. Dual diagnosis rehabilitation treats both of these issues together. The best approach for the treatment of dual diagnosis is an integrated system. In this strategy, both the substance abuse problem and the mental disorder are treated simultaneously. Regardless of which diagnosis (mental health or substance abuse problem) came first, long-term recovery will depend largely on the treatment for both disorders done by the same team or provider.

Medication-Assisted Treatments

 Medication-Assisted Treatments (MAT) for substance use disorders and mental health disorders are commonly used in conjunction with one another. This includes the use of medications and other medical procedures. During your rehab, the staff from your treatment facility will help you identify what caused your addiction and teach you skills that will help you change your behavior patterns and challenge the negative thoughts that led to your addiction. Sometimes, the pressures and problems in your life lead you to rely on substances to help you forget about them momentarily.

If you or a loved one are struggling with long-term drug abuse and a co-occurring mental health condition such as depression, contact one of our helpful treatment specialists today. We Level Up can provide information on dual diagnosis and detox programs that may fit your specific needs.

antibiotics and alcohol
Alcohol then not only slows the healing process and recovery time but additionally puts an individual at increased risk of developing another infection.

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[1] NCBI –

[2] NIH –

[3] CDC –

[4] SAMHSA –