These drugs do not mix well with alcohol. An expert explains the risks: ScienceAlert

A glass or two of champagne with Christmas dinner. A cool crisp beer on the beach. Some cheeky cocktails with friends to see in the New Year. It seems there are so many occasions to relax with an alcoholic drink this season.

But if you take certain medications while drinking alcohol, it can affect your body in different ways. Drinking alcohol with some medicines means they may not work as well. With others, you risk a life-threatening overdose.

Here’s what you need to know if you’re taking medication over Christmas and plan to drink.

Why is it a big deal?

After you take a medicine, it travels to the stomach. From there, your body takes it to the liver where the drug is metabolized and broken down before entering your bloodstream.

Each drug you take is given in a dose that takes into account the amount of metabolism that occurs in the liver.

When you drink alcohol, it is also broken down in the liver and can affect how much of the drug is metabolized.

Some drugs are metabolized morewhich may mean that it does not reach enough of your bloodstream to be effective.

Some drugs are metabolized less. This means that you receive a much higher dose than intended, which could lead to an overdose.

The effects of alcohol (such as drowsiness) can act in addition to similar effects of a drug.

Whether or not you have an interaction, and what interaction you have, depends on many factors. These include the medicine you take, the dose, the amount of alcohol you drink, your age, genes, gender and general health.

Women, the elderly and people with liver problems are more likely to have an interaction with alcohol.

What drugs do not mix well with alcohol?

Many medications interact with alcohol whether they are prescribed by your doctor or bought over the counter, such as herbal medicines.

1. Drugs + alcohol = drowsiness, coma, death

Drinking alcohol and taking a central nervous system depressant drug to reduce agitation and agitation can have additive effects. Together, these can make you extra sleepy, slow your breathing and heart rate and, in extreme cases, lead to coma and death. These effects are more likely if you use more than one medicine of this type.

Medicines to look out for include those for depression, anxiety, schizophrenia, pain (except paracetamol), sleep disorders (such as insomnia), allergies and cold and flu.

It is best not to drink alcohol with these medications or to keep alcohol consumption to a minimum.

2. Drugs + alcohol = more effects

Mixing alcohol with certain drugs increases the effect of those drugs.

An example is the sleeping pill zolpidem, which should not be taken with alcohol. Rare, but serious, side effects are strange behavior during sleep, such as sleep eating, sleep driving, or sleep walking, which are more likely with alcohol.

3. Drugs + craft beer or homebrew = high blood pressure

Certain types of medications only interact with certain types of alcohol.

Examples include certain depression medications such as phenelzine, tranylcypromine and moclobemide, the antibiotic linezolid, the Parkinson’s drug selegiline, and the cancer drug procarbazine.

These so-called monoamine oxidase inhibitors only interact with certain types of boutique and craft beer, beers with visible sediment, Belgian, Korean, European and African beers, and domestic beers and wine.

These types of alcohol contain high levels of tyramine, a natural substance that is normally broken down by your body and usually does not cause any harm.

However, monoamine oxidase inhibitors prevent your body from breaking down tyramine. This increases the levels in your body and can cause your blood pressure to rise to dangerous levels.

4. Drugs + alcohol = effects even after you stop drinking

Other drugs interact because they affect the way your body breaks down alcohol.

If you drink alcohol while using such medicines, you may experience nausea, vomiting, flushing of the face and throat, shortness of breath or dizziness, your heart may beat faster than usual or your blood pressure may drop.

This can happen even after you stop treatment and then drink alcohol. For example, if you are taking metronidazole you should avoid alcohol both while using the medicine and for at least 24 hours after stopping it.

An example where alcohol changes the amount of the drug or related substances in the body is acitretin.

This medicine is used to treat skin conditions such as severe psoriasis and to prevent skin cancer in people who have had organ transplants.

When you take acitretin, it is converted to another substance – etretinate – before it is removed from your body. Alcohol increases the amount of etretinate in your body.

This is especially important as etretinate can cause birth defects. To prevent this, if you are a woman of childbearing age, you should avoid alcohol while using the medicine and for two months after stopping it.

Myths about alcohol and drugs

Alcohol and birth control

One of the most common myths about drugs and alcohol is that you can’t drink while on the pill.

It is generally safe to use alcohol with the pill, as it does not directly affect how well the birth control works.

But the pill is most effective when taken at the same time every day. If you drink a lot, you’re more likely to forget to do it the next day.

Alcohol can also cause nausea and vomiting in some people. If you vomit within three hours of taking the pill, it won’t work. This increases the risk of pregnancy.

Birth control pills can also affect your response to alcohol, as the hormones they contain can change the way your body gets rid of alcohol. This means you can get drunk faster and stay drunk longer than usual.

Alcohol and antibiotics

Then there’s the myth about not mixing alcohol with any antibiotics. This only applies to metronidazole and linezolid.

Otherwise, it is generally safe to use alcohol with antibiotics, as alcohol does not affect how well they work.

But if you can, it’s best to avoid alcohol while taking antibiotics. Antibiotics and alcohol have similar side effects, such as upset stomach, dizziness and drowsiness.

Using the two together means you are more likely to have these side effects. Alcohol can also decrease your energy and increase the time it takes to recover.

Where can I go for advice?

If you plan to drink alcohol this holiday season and are concerned about any interaction with your medication, don’t just stop taking your medication.

Your pharmacist can advise you on whether it is safe for you to drink based on the medicines you are taking and, if not, advise you on alternatives.The conversation

Nial Wheate, Associate Professor, Sydney School of Pharmacy, University of Sydney and Jessica Pace, Associate Lecturer, University of Sydney

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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