Can you drink on antibiotics? A full breakdown of which antibiotics you shouldn't mix with alcohol
- Drinking on some antibiotics, like metronidazole (Flagyl) and Bactrim, can cause vomiting, cramping, and rapid heart rate.
- Though some antibiotics, like amoxicillin, don't warn against alcohol, drinking can worsen side effects.
- In most cases, you can safely drink alcohol again three days after the last dose of antibiotics.
While a drink or two per day normally isn't cause for alarm, when you're on antibiotics even one drink can cause adverse side effects. In fact, mixing antibiotics with alcohol may add to, trigger, or complicate the side effects of your medication.
Here's why you should never mix alcohol with antibiotics.
It's important to avoid drinking alcohol on antibiotics
There are some antibiotics that are almost certain to cause strong, negative side effects when mixed with drinking alcohol, says Jessica Nouhavandi, PharmD, a pharmacist in Los Angeles, California, and co-founder of Honeybee Health, an online pharmacy.
According to Nouvahandi, antibiotics that have a particularly strong reaction with alcohol include:
- Metronidazole (Flagyl) is an antibiotic used to treat bacterial or parasitic infections in the vagina, stomach, liver, or brain.
- Tinidazole (Tindamax) is an antibiotic that is used to treat infections in the vagina and intestines.
When taking these antibiotics, you should stay away from liquor, wine, and beer — and also avoid anything that contains alcohol, including cough syrup and mouthwash, Nouvhavandi says.
If you consume alcohol while taking these antibiotics, you will most likely experience strong side effects, such as:
If you do accidentally drink while taking antibiotics, your side effects will usually disappear within a few hours. However, if you are experiencing a severe reaction after taking antibiotics and drinking alcohol, seek medical attention from your doctor or head to urgent care.
Other common antibiotics that should not be mixed with alcohol, even though side effects may be less severe, include:
- Sulfamethoxazole-trimethoprim (Bactrim DS), which is used commonly for UTIs or skin infections. It has similar side effects as metronidazole.
- Cefotetan (Cefotan), which is used to treat bacterial infections in the lungs, skin, and bones, also has similar side effects to metronidazole.
- Linezolid (Zyvox), which is prescribed to treat skin infections and pneumonia, has strong interactions with beer — even non-alcoholic beer — and red wine. Drinking while taking linezolid can cause your blood pressure to spike.
- Isoniazid (Nydrazid) is used to treat tuberculosis and can overwhelm your liver, leading to toxicity, when combined with alcohol.
You can resume drinking alcohol once the antibiotic has cleared from your system, which is usually three days after the last dose.
Are there any antibiotics you can drink with?
While it's best not to drink on antibiotics, there are some commonly prescribed medicines that won't become less effective with moderate alcohol intake. They include:
- Flucloxacillin (also known as floxacillin) is used to treat skin, bone, and ear infections. Its side effects include nausea and diarrhea.
- Amoxicillin (Amoxil) is commonly prescribed for respiratory and urinary tract infections. It may also be prescribed along with other medications for stomach infections and ulcers, and it can cause gastrointestinal upset.
- Amoxicillin and clavulanate (Augmentin) may be prescribed for sinus, respiratory, or urinary tract infections. Side effects include diarrhea. The drug also carries a warning about use in patients with liver dysfunction, citing rare instances of liver toxicity. For this reason, you might want to skip any alcoholic beverages during the course of this medication.
- Azithromycin (Zithromax) is often prescribed to treat respiratory infections like pneumonia. Its side effects include gastrointestinal issues like nausea and diarrhea.
- Cephalexin (Keflex) may be prescribed for respiratory tract or skin infections and its side effects include gastrointestinal upset. A rare but serious side effect is liver injury.
- Ciprofloxacin (Cipro) is prescribed to treat a number of illnesses, including skin and bone infections, infectious diarrhea, and UTIs. Fluoroquinolones like Ciprofloxacin come with warnings about rare but serious reactions including tendonitis, neuropathy, and liver toxicity.
Though drinking moderately won't reduce the effectiveness of these common antibiotics, it could still inhibit healing, put stress on the liver, cause dehydration, and increase the risk of or worsen side effects.
For example, doxycycline (Vibramycin, Monodox) and amoxicillin (Amoxil) are known to frequently cause digestive problems, says Nouhavandi. Since having alcohol in your system can also cause these symptoms on its own, using both antibiotics and alcohol together increases your risk of these side effects.
Additionally, since drinking alcohol weakens your body's immune system, drinking when you've been prescribed an antibiotic is never a great idea.
"Not all antibiotics result in a serious interaction when mixed with alcohol, but generally, when someone is on antibiotic therapy, it is because they are trying to fight an infection and their immune system is weak," says Nouhavandi.
Does alcohol make antibiotics less effective?
Alcohol consumption won't directly impact how effective your antibiotics are. But, drinking alcohol can mean that it takes your body longer to recover from whatever infection or illness you are taking antibiotics for in the first place.
Nouhavandi says this is partly because when you're sick, you need to be properly hydrated. One of the side effects of drinking alcohol can be dehydration, which can make it harder for you to get well.
Like many types of antibiotics, alcohol is broken down and processed by your liver before it can exit your body. When your liver is already working to help fight infection, adding alcohol to the mix can overwork it. In rare cases, this can cause drug-induced liver toxicity (swelling of your liver).
You should never skip a dose of antibiotics to drink alcohol
Even if you want a drink, it's important not to skip a dose or a day of your antibiotics until your prescribed course of medication is complete. Skipping a single dose won't really protect you from side effects, anyway, as it takes several days for the medication to clear from your system.
When you take antibiotics, you typically start feeling better within 48 hours. But that doesn't mean that there's no more infection present in your body. If you stop taking antibiotics early so that you can drink, you are giving the bacterial or fungal infection a chance to return.
Insider's takeaway
Some antibiotics, like metronidazole and tinidazole, have strong interactions with alcohol that may cause nausea, headaches, and cramping.
Even if you are taking another antibiotic, it's best to avoid all alcohol because drinking may impair your body's ability to fight the infection.
Furthermore, even antibiotics that don't have strong interactions with alcohol still come with a risk of nausea, vomiting, and diarrhea that could be exacerbated by drinking.
Additionally, never skip a dose of your antibiotics just to drink.