There are medications such as anxiolytics or opioids that should never be mixed with alcohol, not even with a glass of wine, because their health effects can be very serious. As Pablo Caballero, pharmacist in the Scientific Dissemination Area of the General Council, explains to CuídatePlus of Colleges of Pharmacists, “Opioids are drugs used to treat severe pain that does not respond to treatment with other medications (for example, breakthrough pain associated with cancer).” The combination with alcohol “can enhance the depressant effects on the central nervous system.” that both alcohol and these drugs present, and loss of consciousness and respiratory depression can occur that can be fatal without treatment,” warns the pharmacist.
In the case of anxiolyticshow can they be benzodiazepines, “the effects would be similar to those described for opioids, although less marked.” However, the expert recalls that “The effects of the interaction can become very serious when high doses of alcohol, the drug, or both are consumed.”.
In this case, it is also important to take into account that the alteration of the level of consciousness “can have dangerous consequences, especially in older patients, due to the possibility of falls.”
The use of these drugs is very common, especially benzodiazepines. In fact, according to data from the Spanish Agency for Medicines and Health Products, Spain is the country in the world where the most benzodiazepines are consumed. But What happens with other frequently used medications such as paracetamol, ibuprofen or antibiotics? Can they be taken with alcohol? Do they have serious effects?
Drink alcohol and take paracetamol
He paracetamol It is one of the most consumed medications in Spain since it is used to relieve pain. Although it is quite safe, this drug is not without risks. As you remember Gentleman, ““Alcohol is a toxic product for the liver.” For this reason, “If it is combined with paracetamol, the effects of both substances on this organ can be increased.”
During the metabolism of paracetamol “a very reactive compound is produced (called NAPQI or N-acetyl-para-benzoquinoneimine) that under normal physiological conditions and when paracetamol is used in the recommended dose does not causes toxicity to the liver because it is quickly eliminated by the action of glutathione, an intracellular molecule with high antioxidant capacity,” he explains. However, “Consumption, especially chronic and high consumption but also sporadic consumption, of alcohol can modify the liver’s ability to metabolize alcohol and increase its toxicity.”.
For this reason, “cautious use is recommended in people with chronic alcoholism problems or who consume three or more alcoholic drinks a day on a regular basis due to the risk of liver damage,” explains the pharmacist. In the case of chronic consumption, “a maximum dose of 2 grams per day of paracetam should not be exceeded.”l, although the specific recommendation will depend on the particularities of each case.”
What if I space taking the medication with alcohol consumption? In this sense, the pharmacist reports: “Regarding the waiting time between the consumption of the drug and the consumption of alcohol, many factors must be taken into account, such as the overall status of the patient (age, concomitant diseases that may affect the liver) olat dose usedfor example, so it is not possible to give an exact figure that can serve as a general reference.”
Drink alcohol and take ibuprofen
As for ibuprofen, this medication belongs to the group of NSAIDs (Non-steroidal anti-inflammatory drugs) and It is frequently used for pain and inflammation. In this case, its regular consumption “can cause gastrointestinal side effects such as pain, poor digestion or even a stomach ulcer if taken chronically and in high quantities,” explains the pharmacist. If mixed with alcohol, “this toxic can enhance these side effects and make them more frequent and serious.”“, so it is advisable to avoid drinking alcohol while we are being treated with this drug.”
Drink alcohol and take antibiotics
In the case of the antibioticsIt is important to go case by case since the effect may be an ineffectiveness of the medication. As Caballero points out, “interactions between alcohol and some antibiotics may or may not be clinically relevant depending on the type of medication.”
For example, “Certain antibiotics can lose their effectiveness or cause serious side effects when drinking alcohol, this is the case of nitroimidazoles such as metronidazole or tinidazole.”.
This effect can also occur with certain cephalosporins (such as cefamandole or cefoperazone), “due to its ability to inhibit an enzyme, aldehyde dehydrogenase, which metabolizes the aldehyde produced during the metabolism of alcohol.” On the other hand, in the case of aldehyde“this is a toxic compound whose accumulation causes numerous symptoms, such as dizziness, nausea, tachycardia or a severe headache (what is known as a “disulfiram-type reaction”).
It is important to note that, “this type of reaction when drinking alcohol has been observed up to 3 days after consumption of the drug.” Nevertheless, There are many factors that can influence the patient’s response.so (as in the previous cases) “it is not possible to give a specific figure on the waiting time that serves as a general reference.”
Alcohol with antihypertensives, statins and antidiabetics
In addition to these medications, there are three others that are taken very commonly in Spain, such as drugs to control blood pressure, cholesterol and diabetes.
In the case of the antihypertensivesAs Caballero recalls, “it must be taken into account that chronic alcohol consumption increases blood pressure, which may interfere with the effectiveness of the treatment.” Consuming small amounts of alcohol “would not produce this effect.” In fact, “punctual consumption of moderate doses of alcohol can have a hypotensive effect that can enhance the effect of the antihypertensive drug, so caution should be taken,” he warns.
In the case of drugs for cholesterolit should be noted that “in some cases, those used for the treatment of hypercholesterolemia (mainly statins) can cause an increase in liver transaminases, so it is also advisable to avoid consumption together with alcohol in high quantities.”
For the diabetics who take medications, they should know that “alcohol has a hypoglycemic effect, so alcohol consumption is discouraged in high quantities during diabetes treatment.”
Furthermore, he adds. “A rare adverse reaction has been described but the risk increases when drinking alcohol in patients treated with metformin. This reaction is lactic acidosis, which can be very serious.” The most common symptoms of lactic acidosis are “nausea, vomiting, muscle weakness and impaired breathing”.
Are there any medications that can be taken safely?
As the pharmacist explains, there are many medications whose activity “is not affected by alcohol or that do not increase the toxicity of alcohol.” However, “although in certain cases moderate alcohol consumption may not cause serious interactions with medications, It is always advisable to consult with your doctor or pharmacist to ensure safe use. taking into account that the recommendation must be adapted to each patient based on their specific situation,” he concludes.
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