7 Medication Classes Affected by Alcohol Consumption

Patients celebrating St. Patrick’s Day while taking medications affected by alcohol are going to have a bad time.

According to the National Institutes of Health (NIH), 42% of Americans admit to drinking while taking medications that can negatively interact with alcohol. Americans are increasingly engaging in heavy drinking and binge drinking in general, and this behavior is seen even more frequently during times of celebration.

Amid the maelstrom of St. Patrick’s Day and March Madness, pharmacists and pharmacy technicians should remind patients to avoid alcohol if they receive the following medications.

1. Antibiotics

Fast heartbeat, sudden changes in blood pressure, stomach pain, upset stomach, vomiting, liver damage, and facial redness are just a few of the side effects a patient might experience if they mix their cocktails with antibiotics.

Beyond these potential effects, mixing alcohol with antibiotics can reduce overall energy levels and slow recovery time.

2. OTC Pain and Fever Medications

Patients who take these medications while drinking in an attempt to avoid a hangover may actually do themselves more harm than good.

According to the FDA, most cases of severe liver injury occur when patients take multiple products containing acetaminophen at the same time, exceed the current recommended maximum dose of 4000 mg within a 24-hour period, and/or consumer alcohol while taking these medications. The FDA also warns that taking nonsteroidal anti-inflammatory drugs such as aspirin, ibuprofen (Motrin, Advil), or naproxen (Aleve) while drinking can increase the risk of stomach bleeding.

Notably, the popular hangover remedy Excedrin contains both acetaminophen and aspirin.

3. Rheumatoid Arthritis Medications

Celecoxib (Celebrex), naproxen (Naprosyn), and diclofenac (Voltaren) are all associated with an increased risk of ulcers, stomach bleeding, and liver damage when mixed with alcohol.

Additionally, consuming alcohol while taking rheumatoid arthritis medications may make it difficult for health care providers to assess a patient’s tolerance to the associated increase in liver enzymes. Drinking alcohol can also decrease bone density, which increases the risk of greater complications for arthritis patients.

4. OTC Allergy, Cold, and Flu Medications

Mixing alcohol with Tylenol Cold & Flu, Zyrtec, Benadryl, Claritin, and other drugs in the allergy, cold, and flu category may increase the risk of drowsiness, dizziness, and overdose, according to NIH.

5. Prescription Stimulants

Patients should be extremely wary of mixing alcohol with prescription stimulants.

Consuming alcohol while taking a prescription stimulant could cause patients to not fully recognize how intoxicated they are. This is especially true when the stimulant is being abused, but it can also happen when the patient is taking the drug as prescribed.

On a day like St. Patrick’s Day, when 13 million pints of Guiness are consumed worldwide, a patient’s friends may not notice if he or she is dangerously intoxicated. It’s better to just avoid the situation entirely.

6. Diabetes Medications

Alcohol intake can have both short- and long- term effects in patients with diabetes, including interactions with diabetes medications and worsening of preexisting complications. For example, mixing insulin and oral hypoglycemic with alcohol may increase the risk of hypoglycemic reactions, while chronic alcohol intake may predispose a patient taking metformin to lactic acidosis.

According to the American Diabetes Association, a diabetic patient should ask the following 3 questions before drinking:

1. Is my diabetes under control?

2. Does my health care provider agree that I am free from health problems that alcohol can make worse?

3. Do I know how alcohol can affect me and my diabetes?

7. Antidepressants and Anxiety Medications

Alcohol can counteract the benefits of anxiety or antidepressant medications, making treatment for the conditions more difficult, according to the Mayo Clinic.

For patients taking monoamine oxidase inhibitors, drinking alcohol could cause blood pressure to spike dangerously high. Other side effects associated with mixing prescription anxiety drugs and alcohol include difficulty breathing, impaired motor control, strange behavior, and memory problems.