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Antibiotic Medications and Alcohol Interactions

Medically reviewed by Leigh Ann Anderson, PharmD. Last updated on Feb 18, 2022.

Antibiotic and Alcohol Drug Interactions

Antibiotics, also known as antibacterials, are one of the most commonly prescribed and important drug classes in medicine. However, some antibiotics used to treat various infections can have interactions with alcohol. Alcohol may also be referred to as "ethanol" or "ethyl alcohol".

Some antibiotics when mixed with alcohol may result in serious reactions, including:

Other antibiotics may lead to unpleasant side effects like nausea, vomiting, dizziness, or even drowsiness, which can also be made worse by drinking alcohol.

Not all antibiotics result in a serious interaction with alcohol. But over the years, "avoid alcohol" stickers have been put on many antibiotic prescription bottles at the pharmacy, because of general warning in the product label or because excess alcohol consumption may lower your body's immune system and ability to fight off any infection.

For example, patients often ask about interactions between alcohol and amoxicillin, a commonly used antibiotic. While there is not a specific interaction that will lower amoxicillin's effectiveness, in general, you should avoid drinking alcohol if you are sick and being treated for an infection. Alcohol can lead to dehydration, interrupt your normal sleep, and may hinder your body’s natural ability to heal itself.

Among several of the top brand name antibiotic brands, like Augmentin, Amoxil, Cipro, Keflex, and Zithromax, no specific interaction with alcohol exists. However, if you are taking one of these medications, you probably should avoid drinking anyway as you recover from your infection.

Instead, rest, drink plenty of fluids (other than alcohol, which can be dehydrating) and be sure to finish all your medication when you have an infection. Don’t stop any antibiotic early without checking with your doctor first, even if you feel 100% better. Your infection may worsen or return later and this could also lead to antibiotic resistance.

It's easy to see that different levels of drug interactions can occur when you mix certain antibiotics with alcohol, so be sure to review the drug interactions for each drug you are prescribed. Below is a small sampling of some important (major) antibiotic and alcohol drug interactions, but many more exist that may have a moderate or minor significance.

Read More: Antibiotics and Drinking Alcohol: Is It Safe?

Selected Examples

Metronidazole (Flagyl) or tinidazole (Tindamax)

Erythromycin ethylsuccinate (E.E.S.)

Trimethoprim

Cefotetan (Cefotan)

Cycloserine (Seromycin)

Ethionamide (Trecator)

Griseofulvin (Gris-Peg)

Isoniazid

Ketoconazole (oral)

Linezolid (Zyvox)

Pyrazinamide

Benznidazole

Table 1: Antibiotics That Can Interact With Alcohol

Generic Name Brand Name
benznidazole not available
cefotetan Cefotan
cycloserine Seromycin
erythromycin ethylsuccinate E.E.S
ethionamide Trecator
griseofulvin Gris-PEG
isoniazid not available
ketoconazole (oral) not available
linezolid Zyvox
metronidazole (oral and topical) Flagyl, MetroGel, others
nifurtimox Lampit
pyrazinamide not available
tinidazole Tindamax
trimethoprim with sulfamethoxazole Bactrim, Bactrim DS, Septra, Septra DS

*Note: This is not a complete list; always check with your pharmacist for possible drug-alcohol interactions each time you fill a new prescription or buy an over-the-counter medication, herbal product, or vitamin.

Antibiotics That May Be Safe If Used With Alcohol

Not all antibiotics have serious interactions with alcohol, but avoiding alcoholic beverages while you are sick is usually a good idea. Common antibiotics frequently prescribed for infections that do not include alcohol as a specific drug interaction in their product label include:

*Doxycycline is listed in some references as having a minor interaction with alcohol, but the clinical significance is unknown. Alcohol used in combination with this antibiotic may lead to a decreased level of the drug. These minor drug interactions will not usually require a change in your drug, but your doctor can determine if modifications to your medication doses are needed if you drink alcohol while taking doxycycline.

See Also

Sources

  1. Weatherman, R., Crabb, D. Alcohol and Medication Interactions. Alcohol Research & Health 1999:23;40-54. Accessed Feb. 18, 2022 at https://pubs.niaaa.nih.gov/publications/arh23-1/40-54.pdf
  2. Morasso MI, Chavez J, Gai MN, Arancibia A. Influence of alcohol consumption on erythromycin ethylsuccinate kinetics. Int J Clin Pharmacol 1990:28; 426-9. Accessed Feb. 18, 2022.
  3. Neuvonen PJ, Penttila O, Roos M, et al. Effect of long-term alcohol consumption on the half-life of tetracycline and doxycycline in man. Int J Clin Pharmacol Biopharm 14 (1976): 303-7. Accessed Feb. 18, 2022
  4. U.S. Centers for Disease Control and Prevention. (CDC). Be Antibiotics Aware: Smart Use, Best Care. Accessed Oct. 25, 2019 at https://www.cdc.gov/antibiotic-use/index.html
  5. NHS Choices. Can I drink alcohol while taking antibiotics? Accessed July 30, 2019. https://www.nhs.uk/common-health-questions/medicines/can-i-drink-alcohol-while-taking-antibiotics

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.