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Mixing Alcohol and Medicine

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 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.

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 are safe and effective when used appropriately. Your pharmacist or other health care provider can help you determine which medications interact harmfully with alcohol.

Did You Know

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.

Medicines may have many ingredients

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.

Some medicines contain alcohol

Certain medicines contain up to 10 percent alcohol. Cough syrup and laxatives may have some of the highest alcohol concentrations.

Alcohol affects women differently

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.

Older people face greater risk

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.

Timing is important

Alcohol and medicines can interact harmfully even if they are not taken at the same time.

Remember

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.

Symptom/Disorders Medication
(Brand name)
Medication
(Generic name)
Some possible reactions with alcohol

Allergies/Colds/Flu

Alavert?

Loratadine

Drowsiness, dizziness; increased risk for overdose

Allegra?, Allegra-D?

Fexofenadin

Benadryl?

Diphenhydramine

Clarinex?

Desloratadine

Claritin?, Claritin-D?

Loratadine

Dimetapp? Cold & Allergy

Brompheniramine

Sudafed? Sinus & Allergy

Chlorpheniramine

Triaminic? Cold & Allergy

Chlorpheniramine

Tylenol? Allergy Sinus

Chlorpheniramine

Tylenol? Cold & Flu

Chlorpheniramine

Zyrtec?

Cetirizine

Angina (chest pain), coronary heart disease

Isordil?

Isosorbide

Rapid heartbeat, sudden changes in blood pressure, dizziness, fainting

Nitroglycerin

Anxiety and epilepsy

Ativan?

Lorazepam

Drowsiness, dizziness; increased risk for overdose; slowed or difficulty breathing; impaired motor control; unusual behavior; and memory problems

Klonopin?

Clonazepam

Librium?

Chlordiazepoxide

Paxil?

Paroxetine

Valium?

Diazepam

Xanax?

Alprazolam

Herbal preparations (Kava Kava)

Liver damage, drowsiness

Arthritis

Celebrex?

Celecoxib

Ulcers, stomach bleeding, liver problems

Naprosyn?

Naproxen

Voltaren?

Diclofenac

Blood clots

Coumadin?

Warfarin

Occasional drinking may lead to internal bleeding; heavier drinking also may cause bleeding or may have the opposite effect, resulting in possible blood clots, strokes, or heart attacks

Cough

Delsym?, Robitussin Cough?

Dextromethorpan

Drowsiness, dizziness; increased risk for overdose

Robitussin A?C?

Guaifenesin + codeine

Depression

Anafranil?

Clomipramine

Drowsiness, dizziness; increased risk for overdose; increased feelings of depression or hopelessness in adolescents (suicide)

Celexa?

Citalopram

Desyrel?

Trazodone

Effexor?

Venlafaxine

Elavil?

Amitriptyline

Lexapro?

Escitalopram

Luvox?

Fluvoxamine

Norpramin?

Desipramine

Paxil?

Paroxetine

Prozac?

Fluoxetine

Serzone?

Nefazodone

Wellbutrin?

Bupropion

Zoloft?

Sertraline

Herbal preparations (St. John's Wort)

Diabetes

Glucophage?

Metformin

Abnormally low blood sugar levels, flushing reaction (nausea, vomiting, headache, rapid heartbeat, sudden changes in blood pressure)

Micronase?

Glyburide

Orinase?

Tolbutamide

Enlarged prostate

Cardura?

Doxazosin

Dizziness, light headedness, fainting

Flomax?

Tamsulosin

Hytrin?

Terazosin

Minipress?

Prazosin

Heartburn, indigestion, sour stomach

Axid?

Nizatidine

Rapid heartbeat, sudden changes in blood pressure (metoclopramide); increased alcohol effect

Reglan?

Metoclopramide

Tagamet?

Cimetidine

Zantac?

Ranitidine

High blood pressure

Accupril?

Quinapril

Dizziness, fainting, drowsiness; heart problems such as changes in the heart's regular heartbeat (arrhythmia)

Capozide?

Hydrochlorothiazide

Cardura?

Doxazosin

Catapres?

Clonidine

Cozaar?

Losartan

Hytrin?

Terazosin

Lopressor? HCT

Hydrochlorothiazide

Lotensin?

Benzapril

Minipress?

Prazosin

Vaseretic?

Enalapril

High cholesterol

Advicor?

Lovastatin + Niacin

Liver damage (all medications); increased flushing and itching (niacin), increased stomach bleeding (pravastatin + aspirin)

Altocor?

Lovastatin

Crestor?

Rosuvastatin

Lipitor?

Atorvastatin

Mevacor?

Lovastatin

Niaspan?

Niacin

Pravachol?

Pravastatin

Pravigard?

Pravastatin + Aspirin

Vytorin?

Ezetimibe + Simvastatin

Zocor?

Simvastatin

Infections

Acrodantin?

Nitrofurantoin

Fast heartbeat, sudden changes in blood pressure; stomach pain, upset stomach, vomiting, headache, or flushing or redness of the face; liver damage (isoniazid, ketokonazole)

Flagyl?

Metronidazole

Grisactin?

Griseofulvin

Nizoral?

Ketokonazole

Nydrazid?

Isoniazid

Seromycin?

Cycloserine

Tindamax?

Tinidazole

Muscle pain

Flexeril?

Cyclobenzaprine

Drowsiness, dizziness; increased risk of seizures; increased risk for overdose; slowed or difficulty breathing; impaired motor control; unusual behavior; memory problems

Soma?

Carisoprodol

Nausea, motion sickness

Antivert?

Meclizine

Drowsiness, dizziness; increased risk for overdose

Atarax?

Hydroxyzine

Dramamine?

Dimenhydrinate

Phenergan?

Promethazine

Pain (such as headache, muscle ache, minor arthritis pain), fever, inflammation

Advil?

Ibuprofen

Stomach upset, bleeding and ulcers; liver damage (acetaminophen); rapid heartbeat

Aleve?

Naproxen

Excedrin?

Aspirin, Acetaminophen

Motrin?

Ibuprofen

Tylenol?

Acetaminophen

Seizures

Dilantin?

Phenytoin

Drowsiness, dizziness; increased risk of seizures

Klonopin?

Clonazepam
Phenobarbital

Severe pain from injury, postsurgical care, oral surgery, migraines

Darvocet?N?

Propoxyphene

Drowsiness, dizziness; increased risk for overdose; slowed or difficulty breathing; impaired motor control; unusual behavior; memory problems

Demerol?

Merepidine

Fiorinal? with codeine

Butalbital + codeine

Percocet?

Oxycodone

Vicodin?

Hydrocodone

Sleep problems

Ambien?

Zolpidem

Drowsiness, sleepiness, dizziness; slowed or difficulty breathing; impaired motor control; unusual behavior; memory problems

Lunesta?

Eszopiclone

Prosom?

Estazolam

Restoril?

Temazepam

Sominex?

Diphenhydramine

Unisom?

Doxylamine

Herbal preparations (chamomile, valerian, lavender)

Increased drowsiness

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