Quick Answer
Most medications should NOT be mixed with alcohol. Alcohol can interfere with how your body processes medications, increase side effects, reduce effectiveness, or cause dangerous reactions. Even over-the-counter drugs can be risky when combined with alcohol.
⚠️ NEVER Mix These Medications with Alcohol
Pain Medications (Opioids)
Examples: Hydrocodone (Vicodin), Oxycodone (Percocet), Codeine, Morphine, Tramadol
Danger: Can cause severe drowsiness, respiratory depression, coma, or death. Both depress the central nervous system.
Risk Level: LIFE-THREATENING
Benzodiazepines (Anti-Anxiety)
Examples: Xanax (alprazolam), Ativan (lorazepam), Valium (diazepam), Klonopin (clonazepam)
Danger: Extreme drowsiness, impaired coordination, slowed breathing, memory problems, increased risk of overdose.
Risk Level: LIFE-THREATENING
Sleep Medications
Examples: Ambien (zolpidem), Lunesta (eszopiclone), Sonata (zaleplon)
Danger: Severe drowsiness, dizziness, impaired motor control, sleepwalking, dangerous behaviors.
Risk Level: LIFE-THREATENING
Acetaminophen (Tylenol)
Danger: Severe liver damage, especially with regular or heavy drinking. Can lead to liver failure.
Note: Even moderate alcohol use increases risk. Many combination medications contain acetaminophen (check labels).
Risk Level: SEVERE
NSAIDs (Pain/Anti-Inflammatory)
Examples: Ibuprofen (Advil, Motrin), Naproxen (Aleve), Aspirin
Danger: Increased risk of stomach bleeding, ulcers, liver damage (especially with chronic use).
Risk Level: HIGH
Other Dangerous Combinations
| Medication Type | Risk |
|---|---|
| Antidepressants (SSRIs, MAOIs) | Increased drowsiness, impaired coordination, worsened depression |
| Blood Thinners (Warfarin, Eliquis) | Increased bleeding risk, stroke risk |
| Diabetes Medications | Dangerous blood sugar changes, nausea, headache |
| Blood Pressure Meds | Dizziness, fainting, arrhythmias |
| Seizure Medications | Reduced effectiveness, increased seizure risk |
| Muscle Relaxants | Severe drowsiness, dizziness, risk of overdose |
| Cough/Cold Medicines | Drowsiness, dizziness, increased intoxication |
What About Antibiotics?
Common myth: “You can't drink on antibiotics.”
Reality: It depends on the antibiotic. Some are dangerous with alcohol, others are generally okay in moderation.
❌ NEVER mix alcohol with these antibiotics:
- • Metronidazole (Flagyl): Severe nausea, vomiting, headache, rapid heart rate
- • Tinidazole (Tindamax): Similar reaction to Flagyl
- • Sulfamethoxazole/Trimethoprim (Bactrim): Nausea, flushing, rapid heartbeat
⚠️ Use caution (not recommended but less dangerous):
- • Most other antibiotics (Amoxicillin, Azithromycin, Doxycycline)
- • Alcohol may reduce effectiveness and worsen side effects
- • Better to avoid while your body fights infection
Why Is Mixing Dangerous?
1. Additive Effects
Both alcohol and certain medications depress the central nervous system. Combined, they can dangerously slow breathing and heart rate.
2. Liver Overload
Your liver processes both alcohol and medications. When combined, it can't keep up, leading to toxic buildup or reduced drug effectiveness.
3. Unpredictable Reactions
Alcohol can alter how your body absorbs, distributes, and eliminates medications, making effects unpredictable.
General Guidelines
- 1.Always check the label - Look for alcohol warnings on prescription and OTC medications
- 2.Ask your pharmacist - They can tell you if your specific medication interacts with alcohol
- 3.Wait it out - If you must drink, wait until medication is out of your system (ask your doctor how long)
- 4.When in doubt, don't - It's always safer to skip alcohol while on medication
- 5.Read ALL labels - Many cold medicines, sleep aids, and supplements contain ingredients that interact with alcohol
Signs of a Dangerous Reaction
Seek immediate medical help if you experience:
- • Difficulty breathing or slow breathing
- • Extreme drowsiness or inability to wake up
- • Irregular heartbeat or chest pain
- • Severe nausea, vomiting, or stomach pain
- • Confusion or disorientation
- • Severe headache or dizziness
- • Unusual bleeding or bruising
- • Yellowing of skin or eyes (liver damage)
Medical Review
Reviewed by: Ricardo Hamilton, MD
Last Updated: November 26, 2025
Sources: National Institute on Alcohol Abuse and Alcoholism (NIAAA), FDA Drug Safety Communications, American Pharmacists Association, Mayo Clinic