What happens when you mix amoxicillin with alcohol and why it's not recommended

• Mixing amoxicillin and alcohol won't cause any severe, long-term damage to your health.
• However, it can intensity side effects like nausea, headache, diarrhea, and vomiting.
• To ensure a speedy recovery, it's best to abstain from alcohol when you're taking antibiotics.

Amoxicillin is a common antibiotic used to treat bacterial infections including bronchitis, ear infections, and urinary tract infections. Although some antibiotics cause severe reactions with alcohol, it's not dangerous to mix amoxicillin and alcohol.

Still, it's best to keep alcohol use minimal while you're not feeling well, says Hiten Patel, MD, a family medicine physician at The Ohio State University Wexner Medical Center.

"Patients are able to consume alcohol while on amoxicillin, in moderation. However, the use of alcohol may worsen underlying infection symptoms," says Patel.

You should discuss your specific case with your doctor or pharmacist, but it can also be helpful to know how alcohol impairs the immune system and may affect you while you're on antibiotics.

Alcohol and amoxicillin

Alcohol doesn't have dangerous interactions with amoxicillin, Patel says, and it won't make the antibiotic less effective.

However, alcohol and amoxicillin have similar side effects, including nausea, vomiting, diarrhea, and headache. If you take both at once, you might be more likely to experience those side effects, says Patel.

"Some doctors may recommend not using alcohol as it may cause dehydration and worsen the underlying infection symptoms being treated," he says.

That's why, in general, "it's best not to drink alcohol while you're sick, since alcohol affects the way we heal from infections," says Janeen C. Miller, MS, wellness coordinator with Providence St. Joseph Hospital. This could be because alcohol makes the immune system less effective.

Case in point, heavy drinkers, those that consume more than eight drinks a week for females and 15 drinks a week for males, are at increased risk for contracting bacterial infections when they're in a hospital settings, and often experience slower healing.

Amoxicillin is usually prescribed for 10-14 days, but it can vary widely depending on what you're treating. If you don't want to skip alcohol entirely for the time period, at least make sure to only drink in moderation, which means no more than two drinks a day for males and one drink a day for females.

Note: One drink is defined as either a 12 oz. beer, 8 oz. of malt liquor, 5 oz. of wine, or 1.5 oz. of hard liquor, or distilled spirits.

What to do if you mix alcohol and amoxicillin

Since alcohol and amoxicillin don't have any dangerous interactions, you don't need to worry if you have a few drinks while taking amoxicillin, says Patel.

Occasionally amoxicillin can cause severe side effects, which can be worsened by drinking alcohol. If you experience any of the following, call your doctor:

• Severe diarrhea or bloody stool
• Swelling of the face or throat
• Trouble breathing, or wheezing
• Rash, itchiness or hives

If you're concerned, it's always best to ask your doctor or pharmacist about the symptoms you experience after mixing alcohol and amoxicillin.

"When in doubt, ask for help from a medical professional," says Miller.

Antibiotics you should never mix with alcohol

Some antibiotics and other medications used to treat infection should never be mixed with any amount of alcohol. "When some antibiotics are mixed with alcohol, the reactions can be much more severe," says Miller. Avoid alcohol if you are on any of the following medications:

Metronidazole

Metronidazole is an antimicrobial medication used to treat bacteria infections throughout the body, including bacterial vaginosis, says Patel. Consuming alcohol while you're on metronidazole can lead to a racing heart, a flushed face, nausea, and vomiting. Don't drink for at least three days after your last dose.

Tinidazole

Tinidazole is an antimicrobial used to treat bacterial infections including STIs, gastrointestinal infections, and bacterial vaginosis. When combined with alcohol there's a moderate risk for experiencing a racing heart, nausea, low blood pressure, dizziness, and other symptoms. You should avoid alcohol for three days after you stop taking tinidazole.

Co-trimoxazole

Co-trimoxazole is an antibiotic used to treat bacterial infections including pneumonia, urinary tract infections, and diarrhea. There's a moderate risk for some people that drinking alcohol while taking co-trimoxazole can cause a racing heart, flushing, nausea, and vomiting, so it's best to avoid alcohol while taking it, says Patel.

Linezolid

Linezolid is an antibiotic used to treat bacterial infections, including pneumonia and skin infections. It's also an MAOI, or monoamine oxidase inhibitor. Like other MAOIs, linezolid interacts with foods containing the chemical tyramine, including beer and red wine.

If you consume beer or red wine while taking linezolid, you can experience a dangerously high increase in blood pressure. Alcohol can also raise the risk of side effects from linezolid, including confusion and restlessness. Don't drink for at least two weeks after stopping linezolid, says Miller.

Drugs that impact your liver

Anytime you're taking prescription medications that might have side effects on your liver, it's best to avoid alcohol in order to avoid overtaxing your liver, says Patel.

Antibiotics that can impact your liver include Rifampin and isoniazid, which are used to treat tuberculosis.

The antifungal medication ketoconazole, used in rare cases to treat skin infections, can also impact the liver and shouldn't be taken with alcohol, Patel says.

Insider's takeaway

For most people, drinking moderately while on amoxicillin is safe, Patel says. However, it's not the healthiest choice.

"Amoxicillin can be safely used with alcohol without causing a major interaction or side effects," he says. "The larger concern is that alcohol use when ill may worsen certain symptoms and side effects, such as nausea. So overall, it's best to limit alcohol use to 1-2 drinks when you are ill and on antibiotics."