I’m a former nurse and recovering alcoholic, and I’ve been very concerned by the lack of health education given to the general public about the dangers of mixing alcohol with certain medications. The common practice is to place warnings on medications that they should not be combined with alcohol. Doctors will also provide warnings and some education, but not always. Often this is because education takes up a lot of time in a busy healthcare environment. Plus, many doctors underestimate the ability of patients to retain education. Lastly, discussing this may prompt people to stop taking their vital medications so it becomes a risk/benefit issue.
Therefore, very little education has been done to explain why certain medications are dangerous when mixed with alcohol. The more people become aware of these issues, the more they can make informed choices about their health and alcohol use.
The following medications are the riskiest to mix with alcohol. If you take these medications, you may want to reconsider how much alcohol you consume. I’ll also explain why they are risky and what health issues happen when these medications are taken with alcohol.
Painkillers
Most potent painkillers contain some kind of opioid-type ingredients. Combining alcohol with these medications can increase toxicity and cause respiratory depression. Respiratory depression means that breathing slows down considerably and can even stop altogether. By toxicity, I mean that both alcohol and painkillers, when taken together, increase the potency of both medicines, causing a potential for overdose. Also, the toxicity of this combination dramatically increases the risk for organ damage, especially for the liver and brain.
Another painkiller that is not an opioid, and should also not be mixed with alcohol is Tylenol or acetaminophen. Both alcohol and Tylenol are hard on the liver and can increase liver damage when taken together. Usually, these adverse effects happen over a long period of use for both alcohol and Tylenol.
Benzodiazepines
Benzodiazepines are medications like Xanax and Ativan that are usually taken to calm anxiety. Both alcohol and benzodiazepines cause a similar action in the nervous system. Therefore, when mixed together, they can increase the effect of both substances, causing an increase in side effects and toxicity like drowsiness, respiratory depression, blackouts, and dangerous withdrawal.
Cough and cold medication
Whether it’s over the counter or prescribed by a doctor, cough and cold medications can be hazardous when mixed with alcohol. The reasons are pretty similar to what happens with painkillers. When taken together, these medications can cause an increase in overdoses and severe toxicity to the brain and organs. The real dangers of these medications is that the ingredients are often not understood by the general public. Cough and cold medications often contain sedatives, painkillers, antihistamines and cough suppressants, all of which increase toxicity when mixed with alcohol.
Diabetes and cholesterol medications
Diabetes medications like Insulin and Metformin are hard on the liver — unfortunately, so is alcohol. When these medications are taken with alcohol, it can increase the potential for liver disease, especially when combined over a long period of time. Often, doctors will say it’s ok to have a drink or two, here and there. However, when alcohol consumption goes past a drink or two, the probability of liver problems increases.
The same can be said about combining cholesterol-lowering medications and alcohol. Medications like Rosuvastatin and Atorvastatin are hard on the liver, so when combined with alcohol, can increase liver problems. It’s also worth mentioning that both of these conditions (diabetes and high cholesterol) can also increase problems with the liver and are associated with liver damage. But when you add in the medication interaction, it can be deadly.
Mental health medications
Almost all medications for mental illness, whether it’s depression or psychosis, should not be taken with a lot of alcohol. For one, some of these medications are hard on the organs, so combining them with alcohol can increase damage to some bodily organs.
And for two, alcohol can often decrease the effectiveness of these medications when taken together. Mental illness is associated with substance abuse, so this combination can increase the symptoms of mental illness, making abuse of substances like alcohol more likely. In a sense, it can become a vicious cycle.
Antibiotics and Antifungals
Antibiotics are used fairly frequently by many people. Unfortunately, they are very hard on the liver and so when combined with alcohol can increase the risk of liver damage.
Also, antifungal medications can increase acetaldehyde accumulation in the body when mixed with alcohol. This creates a very uncomfortable reaction causing flushing, nausea, and vomiting. These symptoms are unpleasant but can also be dangerous. Too much acetaldehyde can also induce blood vessel dilation, low blood pressure, and rapid heartbeat which can be dangerous for people with coronary artery or vascular issues.
These are the most common and important medications that should not be mixed with alcohol. The combinations either cause serious drowsiness and a high potential for overdose or increase damage to the organs, especially the liver. Some of these issues happen immediately, while others happen over years of combining alcohol and medications. The critical issue is to know more about which medicines are problematic and why. The more people understand this, the better decisions they can make. This is the goal of public health education, and I’m committed to providing this for the general population.
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