When my father died of alcoholic liver disease in 2016, I wanted to understand how this condition happened. As a former nurse, I should have known that he was sick, but the truth is we didn’t. Liver disease can be sneaky, and liver failure, especially from alcoholism, can happen quicker than you think.
However, I know my father’s medications also contributed to his rapidly failing liver because he mixed alcohol with liver-toxic medications. In the hospital, the doctors told us that doing so caused his liver disease to accelerate.
Indeed, according to research, mixing hepatotoxic medications with alcohol is highly dangerous for the liver. However, not all medications are toxic to the liver, but most people don’t realize which ones are toxic and which ones are not. Hepatotoxic drugs are metabolized in the liver and can put a lot of stress on the functions of the liver. Alcohol is also hepatotoxic, which adds even more pressure on the liver.
Medication safety warnings usually point to avoidance of alcohol when taking that specific medication but don’t explain why. Some medicines can make you more dizzy or drowsy when mixed with alcohol, but some warnings are due to the hepatotoxic nature of the medicine. But since these warnings don’t provide details, it’s hard for people to know why the warnings are there.
In writing these educational posts, my goal is to help people understand the information that is not often explained well to the general public. If people have the appropriate education, they can make better choices about their alcohol and medication use.
The following common medications are hepatotoxic, which means they put stress on the liver and shouldn’t be mixed with alcohol.
Acetaminophen is metabolized through the liver and can be hard on liver functions. An overdose of acetaminophen, however, can cause liver failure. Taking some Tylenol with alcohol is likely not going to cause liver failure. However, if Tylenol is mixed repeatedly with alcohol over a long period of time, it can contribute to worsening liver issues.
Similar to Tylenol, narcotics are toxic for the liver. Repeated use of narcotics can be hard on the liver, but it becomes a double-whammy when mixed with alcohol. For people who already have liver disease, mixing narcotics and alcohol can rapidly accelerate liver problems. This is what happened to my father — he had chronic pain from diabetes, and he used narcotic medication while drinking a lot of alcohol. Unfortunately, this combo was deadly for him.
Antibiotics and antifungals
These are common medications that are used for bacterial and fungal infections. These medications can be very hard on the liver and digestive tract. Using alcohol with these medications can make a person quite sick, particularly for antifungal medications. Fortunately, these medications are only used periodically and not long-term.
However, people with alcohol abuse issues are sometimes prone to repeated infections because their immune system has been lowered by heavy alcohol use. This means that antibiotics or antifungals may be used more frequently in this population.
Anticonvulsants are used to treat seizures and epilepsy. However, the medications taken to treat these conditions are hard on the liver. Medications like Valproic acid (anticonvulsant but also used for bipolar disorder and migraines) can sometimes raise liver enzymes even when taken alone. However, when used with alcohol, it can put a lot of stress on the liver and increase the potential for liver damage.
Some antipsychotic medications can be difficult for the liver. Medications like chlorpromazine are metabolized through the liver and should not be mixed with alcohol. Other medications include quetiapine, seroquel, and clozapine, to name a few. Unfortunately, many people with mental illnesses like psychotic disorders also struggle with alcohol use disorder. This makes liver issues a high potential for this group of people.
Medications like atorvastatin and simvastatin can cause problems with the liver and, as such, shouldn’t be mixed with alcohol. However, 85.6% of US citizens consume alcohol, and 25.8% binge drink. Also, 94 million US adults have high cholesterol and may require the use of medications to lower cholesterol levels.
Insulin and metformin are both used for type 1 and type 2 diabetes. Both these medications can be hard on the liver and therefore shouldn’t be mixed with alcohol. Interestingly, over 34.2 million people have diabetes in the US making it a relatively common condition. As such, many people with diabetes are taking medication to control their blood sugars and possibly mixing these medications with alcohol. Again, this is also what happened to my father. He had type 2 diabetes and also took medication to control his blood sugars. Unfortunately, he mixed several medications with alcohol which caused his liver disease to rapidly worsen.
These are the most commonly used medications that people may mix with alcohol. All of these medications can be toxic to the liver on their own, and when combined with alcohol, can accelerate liver disease. People who take these medications should exercise caution when drinking alcohol.