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How many times have you heard that you shouldn't combine antibiotics with alcohol? While many of us take this recommendation at face value, few delve deeper into what kind of interaction actually occurs and how dangerous it is. In this article, we will discuss scientific facts, potential dangers, and which families of antibiotics may be somewhat compatible with alcohol.
What are antibiotics?
Antibiotics are medications used to treat or prevent bacterial infections. They target specific bacteria by inhibiting their growth and destroying them. It is important to note that antibiotics are not effective against viral infections (such as colds and flu) and that their use is under the supervision of health institutions due to the increasing occurrence of resistant strains of bacteria. Irresponsible use of antibiotics can lead to the development of bacterial resistance, making the treatment of infections more difficult in the future. By using antibiotics properly, we can help preserve their effectiveness for generations to come.
How can alcohol affect antibiotics?
The list of all biochemical mechanisms by which alcohol affects the body is too extensive for this article, and if we add the mechanisms of interaction from antibiotics – and even different types of antibiotics – we would have a whole book.
Alcohol is metabolized in the liver, where it is converted into acetaldehyde under the influence of the enzyme ADH. Acetaldehyde is a toxic substance responsible for many of the side effects associated with alcohol consumption. In the presence of alcohol, the liver prefers to oxidize ethanol rather than fatty acids. This leads to the accumulation of fatty acids in the liver, which can cause fatty liver and other liver diseases. Besides the liver, alcohol affects hormone levels in the body, irritates the gastric mucosa, and promotes fluid elimination from the body, which often leads to dehydration and hangovers. The effect of alcohol on neurotransmitters in the brain results in that well-known state of intoxication – feelings of relaxation, reduced anxiety, and impaired motor coordination.
Antibiotics primarily affect bacteria, although they are often metabolized in the liver and can affect all other bodily systems as well.
Alcohol can thus:
Interfere with the drug's metabolism and elimination processes
Enhance the side effects of antibiotics
Reduce the effectiveness of antibiotics due to the decreased ability of the body to absorb the drug
Due to a series of complex biochemical interactions and the general unpredictability of the components in various alcoholic beverages, the safest course of action is to completely avoid combining alcohol and antibiotics (as well as practically all other medications)!
Most common side effects of the combination of antibiotics and alcohol
Due to increased toxicity, the following often occurs:nausea, vomiting, headache, chest pain, and sudden changes in blood pressure. Alcohol can also enhance the side effects of antibiotics such asdizziness, drowsiness, and stomach problems. Increased strain on the liver due to processing alcohol and antibiotics can increase the risk ofliver damage.Antibiotics particularly dangerous in interaction with alcohol
Metronidazole (Medazol, Metrozol, Noridem)
Metronidazole is the drug of choice for bacterial vaginosis and is also used in Crohn's disease. It is effective against meningitis, brain abscesses, endocarditis, and septicemia. In combination with alcohol, it can cause intense and dangerous symptoms – vomiting, flushing, palpitations (racing or skipped heartbeats), and headaches.
Trimethoprim/sulfamethoxazole (Sulotrim, Sinersul)
Commonly used for chronic prostate infections in men and urinary bladder infections in women. They are also used to treat some intestinal infections and infections caused by bacteria that are resistant to other antibiotics, including methicillin-resistant Staphylococcus aureus (MRSA). Combined with alcohol, they enhance its effect and may cause unexpected side effects.
Doxycycline
An antibiotic used for a wide range of bacterial infections – from respiratory infections, sexually transmitted diseases, intestinal diseases, eye infections, to skin conditions like acne. Although not particularly dangerous with alcohol, it can reduce the effectiveness of this antibiotic and enhance side effects.
Isoniazid (Eutizon B6)
Used for treating tuberculosis and can cause liver damage when combined with alcohol.
Antibiotics that do not have significant interactions with alcohol
Although alcohol consumption with any medication
IS NOT RECOMMENDED, alcohol rarely enhances side effects and generally does not affect the action of these antibiotics.Amoxicillin, with and without clavulanic acid (Klavocin, Amoksiklav, Klavobel, Amoxil...)
An antibiotic used to treat a wide range of bacterial infections, especially middle ear infections, throat infections, pneumonia, and skin infections.
Ciprofloxacin (Ciflox, Ciprol)
Similar to amoxicillin.
Clindamycin
Used for severe joint and pelvic infections, as well as throat and lung infections, sepsis, and other serious infections.
Erythromycin
Used for treating infections of the oral cavity and respiratory tract, skin and subcutaneous infections, sexually transmitted diseases, and various other conditions. Alcohol can enhance its side effects, especially gastrointestinal issues.
Azithromycin (Sumamed)
A medication for infections of the upper and lower respiratory tract, various skin conditions, sexually transmitted diseases, stomach infections, and other infections. There are no known direct interactions with alcohol, but as always, alcohol can reduce the body's ability to recover from an infection.
How to properly take antibiotics?
Proper antibiotic use is crucial not only for effectively treating an infection but also for preventing the development of bacterial resistance to antibiotics. To achieve both functions, it is necessary to adhere to the following:
Only by prescription:
Never take antibiotics without a doctor's prescription. Only a doctor can decide whether an antibiotic is necessary and which is best for your condition.Carefully follow the instructions:
Take the prescribed dose of the antibiotic at the exact designated times and continue taking the medication until you have taken the entire course, even if you feel better.Do not stop treatment prematurely:
If you stop treatment too early, some bacteria may survive and develop resistance to the antibiotic.Do not share antibiotics with others:
The medication prescribed to you may not be suitable for someone else. Furthermore, taking the wrong antibiotic can complicate the treatment of an infection.Do not use leftover antibiotics:
If you have leftover tablets from a previous therapy, do not take them without consulting a doctor.Do not pressure your doctor to prescribe antibiotics:
If a doctor believes that an antibiotic is unnecessary, trust their judgment.Be aware of interactions:
Some medications, supplements, and foods can interact with antibiotics, reducing their effectiveness or increasing the risk of side effects. Discuss potential interactions with your doctor or pharmacist.Watch for side effects:
While antibiotics are often safe, they can cause side effects such as diarrhea, rash, headache, and others. If you notice severe side effects, contact a doctor immediately.Stay informed:
Read the instructions that come with the medication to understand how to take it properly and which side effects to look out for. If you're reading this article, you're already on the right track!Store antibiotics properly:
Keep antibiotics in a cool, dark place and out of reach of children. Discard any medication that is past its expiration date.
Antibiotics + Alcohol = YES or NO?
In most cases, the answer is – NO. The combination of alcohol and antibiotics can lead to an increased risk of side effects, reduced effectiveness of antibiotics, and potential interactions that can be harmful to your health. Additionally, both substances can put a strain on your liver, and by combining them, you increase the load on this vital organ.
If a drink does somehow end up in your hand, check the list above and ensure that the antibiotic you're using does not belong to the group of the most dangerous to consume with alcohol.
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