Is it safe to mix antibiotics and alcohol? 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Doctors will give different recommendations about a person’s alcohol intake depending on the type of antibiotic they prescribe. Antibiotics are drugs that target bacteria to treat and prevent infections. There are many types of oral antibiotics. Although the risks of consuming alcohol may be lower with some types of antibiotics than others, it is still advisable to avoid alcohol intake while taking any antibiotics. This article discusses the risks of mixing antibiotics and alcohol. It also explores the effects of alcohol on the immune system. Is it safe to mix alcohol and antibiotics Share on PinterestOleksandra Stets/StocksyNot all antibiotics interact with alcohol. Depending on the type of antibiotic someone is taking, doctors may recommend limiting or avoiding alcohol intake. It is not safe to mix some types of antibiotics, such as tetracyclines and nitroimidazoles, with alcohol. This can cause dangerous side effects or make them less effective at removing bacteria. Nausea is a common side effect of antibiotics, and drinking alcohol may worsen this symptom in some people. Although nausea is a common side effect of both antibiotics and alcohol, not all people will experience this when using both at the same time. The risks of drinking alcohol are lower with some types of antibiotics. However, drinking any amount of alcohol still poses risks to a person taking antibiotics. Avoiding alcohol entirely during treatment will help a person avoid discomfort and other more serious consequences. Effects of mixing alcohol and antibiotics This section considers the recommendations and possible side effects of consuming alcohol with different antibiotics. Tetracyclines The tetracycline class of antibiotics includes doxycycline and minocycline. This class can treat a wide range of bacterial infections. People should avoid or limit their alcohol consumption while taking doxycycline. Alcohol can affect this antibiotic, and it may be less effective for people with a history of excessive drinking or those with alcohol use disorder (AUD). Liver toxicity is a rare side effect of taking minocycline. Since alcohol can also have negative effects on the liver, people should avoid mixing alcohol with minocycline. Oxazolidinones Linezolid belongs to the oxazolidinone class of antibiotics. Doctors use oxazolidinones to treat abdominal, skin, lung, and urinary tract infections. As well as its antibacterial effect, linezolid reduces the action of enzymes called monoamine oxidase-A and monoamine oxidase-B. Monoamine oxidases break down tyramine. Tyramine is a substance present in tap beers and red wine, among other products. When people drink tap beers and red wine with linezolid, the amount of tyramine in the blood may rise. They may experience side effects due to the increased tyramine levels, rather than the alcohol itself. People may experience the following mild, moderate, or severe side effects after drinking these types of alcohol while taking oxazolidinones:MildModerateSevere• agitation• unusual sweating • rapid heartbeat• fever• altered mental status• rapid breathing • vomiting• abnormal heart rhythm • elevated blood pressure• seizures• coma• cardiorespiratory depression• muscle rigidity• muscle spasms People should avoid red wine and tap beers when taking linezolid. They should also avoid other foods that contain tyramine, such as strong cheeses and smoked meats. Sulfonamides Physicians prescribe sulfonamide antibiotics to treat urinary, respiratory, and abdominal infections. Sulfonamide antibiotics include the combination drug trimethoprim-sulfamethoxazole, which healthcare professionals also call Septra. Trimethoprim-sulfamethoxazole can affect the metabolism of folic acid in bacteria. In rare cases, it can also affect the metabolism of folic acid in human cells. People deficient in folic acid may be at risk of further reducing their folic acid levels while taking trimethoprim-sulfamethoxazole. People who regularly drink alcohol may have lower levels of folic acid and should use trimethoprim-sulfamethoxazole with caution. Although an occasional drink is safe with sulfonamides, healthcare professionals should exercise caution when prescribing trimethoprim-sulfamethoxazole to people who drink alcohol regularly. Fluoroquinolones In 2018, the Food and Drug Administration (FDA) published updated safety warnings on all fluoroquinolone antibiotics. The labels of all fluoroquinolones now highlight the drug’s possible mental health side effects. These side effects may include:disturbances in attentiondisorientationagitationnervousnessmemory lossconfusion Mixing alcohol with fluoroquinolone antibiotics such as ciprofloxacin may increase these mental health side effects. In rare cases, people may experience seizures with fluoroquinolone treatment. People with a history of seizures are most at risk. Since alcohol lowers the seizure threshold, doctors advise people with a history of seizures to avoid mixing alcohol and fluoroquinolones. An occasional drink with fluoroquinolone can be safe, but regularly drinking alcohol may cause central nervous system side effects. Nitroimidazoles Metronidazole is a nitroimidazole antibiotic that doctors prescribe to treat abdominal infections, sexually transmitted infections, and other anaerobic bacteria-related infections. Metronidazole affects the function of a key enzyme that helps the body digest alcohol. When metronidazole inhibits the enzyme aldehyde dehydrogenase, the levels of acetaldehyde accumulate in the blood. This causes the toxic effects of alcohol. Mixing alcohol with metronidazole may cause:abdominal crampingnauseavomitingheadachesfacial flushing People should avoid drinking alcohol during treatment and up to 3 days after the last dose. Despite this interaction, not everyone will experience these reactions when drinking while taking metronidazole. Still, people should avoid drinking alcohol while taking metronidazole. Summary table The table below summarizes the recommendations and effects of drinking alcohol while taking different antibiotics.Antibiotic classAntibioticRecommendationsPossible effects of mixing alcohol and antibioticsTetracyclinesdoxycyclinepeople should avoid alcohol consumption• reduced effect of antibiotics in those with chronic AUDTetracyclinesminocyclinepeople should avoid alcohol consumptionno dataOxazolidinoneslinezolid• people should avoid tap beers, red wine, and other foods with tyramine present• people with high blood pressure should avoid alcohol during treatment• elevated blood pressure• vomiting• rapid heartbeat Sulfonamidestrimethoprim -sulfamethoxazole minimal risk for adverse reactions — people may consume alcohol in moderation and with caution• facial flushing • heart palpitations• headaches• nausea• reduced metabolism of folic acidFluoroquinolonesciprofloxacin,levofloxacin, and moxifloxacinpeople should limit alcohol consumptionaccording to the FDA:• disturbances in attention• disorientation• agitation• nervousness• memory loss• confusionNitroimidazolesmetronidazole andtinidazole• people should avoid alcohol completely during treatment• people should continue to avoid alcohol for 48 hours after the last dose of metronidazole or 72 hours after the last dose of tinidazole• abdominal cramping• nausea• vomiting• headaches• rapid or irregular heartbeat Alcohol s effect on the immune system Some research suggests that moderate alcohol consumption is linked to a lower risk of infection. The Centers for Disease Control and Protection (CDC) define moderate alcohol consumption as:one drink per day for womentwo drinks per day for men The CDC describes binge drinking as consuming four drinks for women and five drinks for men on a single occasion. Heavy drinking is eight or more drinks for women and 15 drinks or more for men per week. Scientists have linked heavy and binge drinking with an impaired immune system. People with an impaired immune system have a higher risk of infection. Frequently asked questions This section answers some common questions about antibiotics and alcohol. Which antibiotics should people not drink alcohol with There are several antibiotics that people should not mix alcohol with. Not only can they interfere with the way the antibiotics work, but they can also cause a number of harmful side effects. Antibiotics that a person should not take with alcohol include:metronidazoletinidazoledoxycyclineminocyclinelinezolid The above list is not exhaustive. A person should speak with a healthcare professional if they have concerns about alcohol consumption and antibiotics. Will alcohol cancel out antibiotics A type of antibiotic called doxycycline may be less effective in people with a history of heavy drinking. However, this is not the case for all antibiotics. A person may be able to drink alcohol in moderation and with caution while they are taking some types of antibiotics. However, a person should always consult a doctor before doing this. Taking antibiotics such as metronidazole and tinidazole while consuming alcohol can cause several unwanted and potentially dangerous side effects, such as liver damage and seizures. Summary Alcohol interferes with some antibiotics in different ways, which may alter the effectiveness or side effects. People should be aware that mixing alcohol with antibiotics may worsen some gastrointestinal symptoms, such as nausea and vomiting. A person should always consult a doctor before mixing alcohol and antibiotics, as some potential side effects can be dangerous. Last medically reviewed on September 6, 2022Alcohol / Addiction / Illegal DrugsPharmacy / PharmacistDrugs 15 sourcescollapsedMedical News Today has strict sourcing guidelines and draws only from peer-reviewed studies, academic research institutions, and medical journals and associations. We avoid using tertiary references. We link primary sources — including studies, scientific references, and statistics — within each article and also list them in the resources section at the bottom of our articles. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.Alcohol's effects on the body. (n.d.).https://www.niaaa.nih.gov/alcohol-health/alcohols-effects-bodyAlcohol use and your health. (2022).https://www.cdc.gov/alcohol/fact-sheets/alcohol-use.htmAntibiotics - Interactions. (2019).https://www.nhs.uk/conditions/antibiotics/interactions/Antibiotic use questions and answers. (2021).https://www.cdc.gov/antibiotic-use/q-a.htmlBarr, T., et al. (2016). Opposing effects of alcohol on the immune system.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4911891/Calhoun, C., et al. (2022). Antibiotics.http://www.ncbi.nlm.nih.gov/books/NBK535443/Food and Drug Administration. (2018). FDA updates warnings for fluoroquinolone antibiotics on risks of mental health and low blood sugar adverse reactions [Press release].https://www.fda.gov/newsevents/newsroom/pressannouncements/ucm612995.htmMeidahl Petersen, K., et al. (2016). The effect of trimethoprim on serum folate levels in humans: A randomized, double-blind, placebo-controlled trial.https://pubmed.ncbi.nlm.nih.gov/26566149/Mergenhagen, K. A., et al. (2020). Fact versus fiction: A review of the evidence behind alcohol and antibiotic interactions.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7038249/Metronidazole 500 mg - metronidazole tablet, film coated. (2021).https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=5184b08d-7250-4d82-b8d7-b24c0a40f915Minocin. (n.d.).https://www.accessdata.fda.gov/drugsatfda_docs/label/2010/050649023lbl.pdfProduct monograph: Ciprofloxacin. (2015).https://www.sandoz.ca/sites/www.sandoz.ca/files/Ciprofloxacin_TAB_Monograph.pdfProduct monograph: Linezolid. (2018).https://pdf.hres.ca/dpd_pm/00045786.PDFProduct monograph: Teva-Trimel. (2018).https://pdf.hres.ca/dpd_pm/00043787.PDFSarkar, D., et al. (2015). Alcohol and the immune system.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4590612/FEEDBACK:Medically reviewed by Alan Carter, Pharm.D. — By Jessica Caporuscio, Pharm.D. and Hana Ames on September 6, 2022 Latest newsWhat sets 'SuperAgers' apart? 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