What Happen When You Mix Prescription Drugs and Alcohol?
You’ve probably seen this warning on medicines you’ve taken. The danger is real. Mixing alcohol with certain medications can cause nausea and vomiting, headaches, drowsiness, fainting, or loss of coordination. It also can put you at risk for internal bleeding, heart problems, and difficulties in breathing. In addition to these dangers, alcohol abuse can make a medication less effective or even useless, or it may make the medication harmful or toxic to your body.
Some medicines that you might never have suspected can react with alcohol, including many medications which can be purchased “over-the-counter”—that is, without a prescription. Even some herbal remedies can have harmful effects when combined with alcohol.
This pamphlet lists medications that can cause harm when taken with alcohol and describes the effects that can result. The list gives the brand name by which each medicine is commonly known (for example, Benadryl®) and its generic name or active ingredient (in Benadryl®, this is diphenhydramine). The list presented here does not include all the medicines that may interact harmfully with alcohol. Most important, the list does not include all the ingredients in every medication.
Medications typically are safe and effective when used appropriately. Your pharmacist or other health care provider can help you determine which medications interact harmfully with alcohol. 
What are the Dangers of Mixing Prescription Drugs With Alcohol?
If you’re taking any medications—either those prescribed by a doctor or over-the-counter cold and allergy medicine—it’s not a good idea to drink alcohol. Often, the medication label will warn you not to—because of the possible dangerous side effects. Read the label! You’ll find lots of good info, like:
- The medication’s active ingredients, including ingredient amounts in each dose
- The medication’s purpose and uses
- Dosage instructions—when and how to take it
- Specific warnings about interactions (with alcohol and other drugs)
- Activities to avoid
- The medication’s inactive ingredients (important to help people avoid an allergic reaction)
Some medications—including many popular painkillers and cough, cold, and allergy remedies—contain more than one ingredient that can react with alcohol. Read the label on the medication bottle to find out exactly what ingredients a medicine contains. Ask your pharmacist if you have any questions about how alcohol might interact with a drug you are taking.
What Prescription Drugs Should Someone Never Mix with Alcohol?
Combining medications (prescribed or not prescribed) with alcohol can have unpredictable and unwanted consequences. We can help ourselves, our friends, and our community by understanding the dangers and taking steps to prevent harm and get alcoholism treatment.
Flu, Cold, Cough Suppressants, and Allergy Medications
Certain medicines contain up to 10 percent alcohol. Cough syrup and laxatives may have some of the highest alcohol concentrations.
You should avoid drinking alcohol if you are taking allergy medications or any multi-symptom cold and flu formulation.
Drowsiness and dizziness are common side effects of medications used to treat allergies, colds, and the flu. These symptoms are also common when you drink alcohol. When the substances are combined, the effect is intensified, and your judgment and focus will be further impaired.
The risks associated with drowsiness caused by medication or alcohol are serious, which is why you should never drive or operate heavy machinery while under the influence of any substance.
Avoid alcohol if you are taking:
- Alavert (loratadine)
- Allegra (fexofenadine) or Allegra-D (fexofenadine/pseudoephedrine)
- Benadryl (diphenhydramine)
- Clarinex (desloratadine)
- Claritin (loratadine) or Claritin-D (loratadine/pseudoephedrine)
- Dimetapp Cold and Allergy (brompheniramine/phenylephrine)
- Sudafed Sinus and Allergy (chlorpheniramine/phenylephrine)
- Triaminic Cold and Allergy (brompheniramine/phenylephrine)
- Tylenol Cold and Flu (acetaminophen/dextromethorphan/guaifenesin/phenylephrine)
- Zyrtec (cetirizine)
Alcohol might affect how well some antibiotic medications work. It’s possible that if you use them together, antibiotics may be less effective at clearing up the infection that you are being treated for.
The research on mixing alcohol with antibiotics is somewhat limited and unclear, but the combination has been associated with symptoms such as tachycardia (rapid heartbeat), sudden changes in blood pressure, gastrointestinal upset, headache, flushing, and liver damage.
Other antibiotics that should not be mixed with alcohol include:
- Flagyl (metronidazole)
- Nizoral (ketoconazole)
- Nydrazid (isoniazid)
- Tindamax (tinidazole)
Anti-Anxiety and Epilepsy Medications
Mixing anti-anxiety and epilepsy medications with alcoholic beverages can cause slowed breathing, impaired motor control, abnormal behavior, and memory loss.
If you are undergoing anxiety disorder treatment or epilepsy treatment, avoid alcohol if you take any of the following medications:
- Ativan (lorazepam)
- Klonopin (clonazepam)
- Valium (diazepam)
- Xanax (alprazolam)
- Dilantin (phenytoin)
Angina (ischemic chest pain) is caused by reduced blood flow to the heart. If you have angina, you might be prescribed a medication called nitroglycerin.
If you drink alcohol while you are taking nitroglycerin, it can cause a rapid heartbeat (tachycardia), sudden changes in blood pressure, dizziness, and fainting.
Avoid alcohol if you are taking any brand of nitroglycerin, including:
Prescription Sleep Aids
If you’re taking a sleep medication like Ambien, alcohol could cause increased drowsiness, difficulty breathing, and memory problems.
Narcotic Pain Medications
Prescription opiates (e.g., Vicodin, OxyContin, Tylenol 3 with codeine, Percocet) combined with alcohol can result in slowed or arrested breathing, lowered pulse, and blood pressure, unconsciousness, coma, and potential death. 
Note: It is illegal to misuse prescription medication, that is:
- Continue to use medication when the prescription is no longer valid
- Use prescribed drugs contrary to the prescription
- Use prescription drugs not prescribed to you
- Give or sell prescribed drugs to another person
Misusing prescription drugs can result in a conviction with jail time.
Potential harm can happen in three ways:
- When people do not know that there are significant alcohol and prescription opiate drug interactions and are caught by surprise when they inadvertently drink while using prescription medication
- When people knowingly combine alcohol with other drugs because they mistakenly believe it will be a “better” or “enriched” intoxication
- As a tool to facilitate a crime (sexual assault, robbery, etc) by making a victim incapacitated
In addition to worsening the side effects of antidepressant medications, mixing these drugs with alcohol can also make symptoms of depression worse.
If you are being treated for depression or another mental health condition such as an anxiety disorder, bipolar disorder, post-traumatic stress disorder, or obsessive- disorder, you may need to limit or completely avoid alcohol if you take one or more of the following medications:
- Anafranil (clomipramine)
- Celexa (citalopram)
- Effexor (venlafaxine)
- Elavil (amitriptyline)
- Lexapro (escitalopram)
- Luvox (fluvoxamine)
- Norpramin (desipramine)
- Paxil (paroxetine)
- Prozac (fluoxetine)
- Serzone (nefazodone)
- Wellbutrin (bupropion)
- Zoloft (sertraline)
Prescriptions for Arthritis
If you take medications for arthritis, it is important to know that mixing them with alcohol can increase your risk for stomach ulcers and bleeding in the stomach, as well as liver problems.
You should avoid alcohol if you are taking medication to treat arthritis, including:
- Celebrex (celecoxib)
- Naprosyn (naproxen)
- Voltaren (diclofenac)
Medications prescribed to lower cholesterol levels (known as statins) can cause flushing, itching, stomach bleeding, and liver damage. Combining these drugs with alcohol can make the risks and side effects worse, especially if you have liver disease.
Mild liver inflammation can occur in about 2% of people who take statins for a long time. While it typically gets better after stopping taking the medications, there has been concern that alcohol (which is metabolized by the liver) could potentially make liver inflammation worse.
If you have a medical condition (such as atrial fibrillation) that puts you at risk of developing a blood clot, your doctor might prescribe anticoagulant medications to “thin” your blood. While these drugs make it less likely your body will form blood clots, they also make you bleed more easily.
If you take a blood thinner, even an occasional drink can increase your risk of internal bleeding. Drinking often or heavily increases this risk and can also counteract the medication’s blood-thinning effects. If your body is forming blood clots, it increases your risk of having a stroke or a heart attack.
If you have diabetes, drinking alcohol can affect your blood sugar levels. Drinking alcohol with the medications you take to manage your diabetes can have the same effect, and the mix can also cause symptoms like nausea, vomiting, headache, rapid heartbeat, and sudden changes in your blood pressure.
You should not drink alcohol if you take medications to treat diabetes, including:
- Glucophage (metformin)
- Micronase (glyburide)
- Orinase (tolbutamide)
Prescriptions for Heartburn
Using alcohol with medications used to treat heartburn, both prescription and over-the-counter, can cause tachycardia (rapid heartbeat) and sudden changes in blood pressure. These drugs can also make the effects of alcohol more intense, leading to impaired judgment and sedation.
Use caution and consider limiting your alcohol intake if you take medications for heartburn, including:
- Axid (nizatidine)
- Reglan (metoclopramide)
- Tagamet (cimetidine)
- Zantac (ranitidine)
High Blood Pressure Prescriptions
Combining alcohol with medications used to treat hypertension (high blood pressure) can cause dizziness, fainting, drowsiness, and arrhythmia (irregular heartbeat).
You should avoid drinking alcohol if you take medications to treat high blood pressure, such as:
- Accupril (quinapril)
- Capozide (captopril/hydrochlorothiazide)
- Cardura (doxazosin)
- Catapres (clonidine)
- Cozaar (losartan)
- Hytrin (terazosin)
- Lopressor HCT (metoprolol/hydrochlorothiazide)
- Lotensin (benazepril)
- Minipress (prazosin)
- Vaseretic (enalapril/hydrochlorothiazide)
If you have an injury or medical condition that causes pain or spasms in your muscles, you might be given medications to relax them. Muscle relaxants are commonly used to treat back and neck pain, as well as certain kinds of headaches.
Combining these medications with alcohol can cause serious side effects, including drowsiness, dizziness, slowed or impaired breathing, abnormal behavior, memory loss, impaired motor control, and seizures.
If you have schizophrenia, your doctor may treat it with a type of medication called antipsychotic drugs. These medicines change the balance of chemicals in your brain, helping ease symptoms such as paranoia and seeing or hearing things that aren’t there (hallucinations).
The drugs work well, but they depress your central nervous system and slow brain activity. This can lead to side effects such as dizziness, sleepiness, or trouble thinking or concentrating.
Alcohol is also a central nervous system depressant, so the combination of the two can make these side effects worse. 
Who is most at-risk for mixing prescription drugs and alcohol?
Women, in general, have a higher risk for problems than men. When a woman drinks, the alcohol in her bloodstream typically reaches a higher level than a man’s even if both are drinking the same amount. This is because women’s bodies generally have less water than men’s bodies. Because alcohol mixes with body water, a given amount of alcohol is more concentrated in a woman’s body than in a man’s. As a result, women are more susceptible to alcohol-related damage to organs such as the liver.
Mixing alcohol and medicines can be harmful. Alcohol, like some medicines, can make you sleepy, drowsy, or lightheaded. Drinking alcohol while taking medicines can intensify these effects. You may have trouble concentrating or performing mechanical skills. Small amounts of alcohol can make it dangerous to drive, and when you mix alcohol with certain medicines you put yourself at even greater risk. Combining alcohol with some medicines can lead to falls and serious injuries, especially among older people.
Older people are at particularly high risk for harmful alcohol–medication interactions. Aging slows the body’s ability to break down alcohol, so alcohol remains in a person’s system longer. Older people also are more likely to take a medication that interacts with alcohol—in fact, they often need to take more than one of these medications.
Does Alcohol Impact Everyone the Same Way?
Mixing alcohol and medicines puts you at risk for dangerous reactions. Protect yourself by avoiding alcohol if you are taking a medication and don’t know its effect. To learn more about a medicine and whether it will interact with alcohol, talk to your pharmacist or other health care provider.
Mixing any combination of prescription drugs, over-the-counter drugs, illicit drugs, and alcohol can be unpredictable and dangerous.
Most fatal overdoses involve the use of more than one type of drug (poly-drug use).
Mixing prescription drugs with alcohol is dangerous because different drugs act on our bodies in different ways. The harmful effects are magnified by using more than one drug type. For example, the more alcohol in the body, the less heroin needed to cause an overdose.
Treatment for alcohol and drug addiction includes medications that can help people get control without a high chance of addiction. Typically, a key part of treatment is counseling or psychotherapy. It may also require withdrawal detoxification, addiction medicine, and recovery support.
Call today to speak with one of our treatment specialists here at We Level Up TX. Our specialists know what you are going through and will answer any of your questions.
Your call is private and confidential and there is never any obligation.
 Harmful Interactions – National Institute on Alcohol Abuse and Alcoholism
 The Effects of Combining Alcohol with Other Drugs – https://uhs.umich.edu/combine
 The Dangers of Mixing Alcohol and Medications – https://www.verywellmind.com/mixing-alcohol-and-medication-harmful-interactions-67888
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