To find out the facts we spoke to our Chief Medical Advisor, Professor Paul Wallace.
We asked Professor Paul Wallace why doctors sometimes tell us not to
drink when we take prescription drugs, and what happens if we do.
Professor Wallace says it depends what medication you have been
prescribed. For most, it is fine to drink within the government’s
daily unit guidelines. However, for some, alcohol should be completely avoided.
Professor Wallace says that:
- People taking sedative drugs (like diazepam/Valium) or antidepressants (like fluoxetine/Prozac) should avoid alcohol altogether
- People taking long-term medications should be careful about
drinking, as alcohol can make some drugs less effective, meaning long
term conditions get worse. Examples include, people taking drugs for
epilepsy or diabetes, or drugs like warfarin to thin the blood.
- There are some antibiotics which simply do not mix with alcohol -
drinking with these will make you sick. But for most commonly prescribed
antibiotics, drinking is unlikely to cause problems so long as it is
within the daily unit guidelines
- There’s no evidence about the effects of alcohol on your immune
system – the benefits of a hot toddy are probably all in our head.
Read on to find out more about all of the above.
How alcohol can interfere with medication
Professor Wallace says there are two main reasons why doctors advise patients not to drink with some drugs.
“Firstly, because alcohol is
a depressant, it affects the way your brain works, numbing your senses so they don’t operate properly,” he says.
“Some types of medication also affect the way your brain works, and
if you’re drinking alcohol there will be a conflict. Alcohol will
increase the sedative effects of both, causing sleepiness and dizziness.
It could also change the way the brain responds to the medication,
making it less effective.”
If you’re taking a sedative drug such as diazepam/Valium, or any
other drug that can make you drowsy, and you drink alcohol, your
reaction times could decrease and you’ll get tired faster. If you’re
driving or operating machinery, this can be extremely dangerous.
“Secondly, alcohol can affect the way drugs are absorbed by the body and broken down in the liver,” says Professor Wallace.“
If you drink alcohol regularly and especially if you drink excessive amounts,
your liver produces
more enzymes so that it can get rid of the alcohol more quickly. Those
same enzymes might break down the medication you are taking so it no
longer has the same effect. An example of this is medications for
epilepsy".
Alcohol and antibiotics
When it comes to antibiotics, Professor Wallace says that the message
is slightly different than it is with sedative drugs. The NHS advises
that people who choose to drink alcohol when taking antibiotics do so
within the daily unit guidelines. (1)
There are antibiotics, like Metronidazole and Tinidazole, which you
should not drink alcohol with. Mixing them with alcohol can lead to
nausea, vomiting, flushing of the skin, accelerated heart rate or
shortness of breath. This is because they can interfere with the
breakdown of alcohol, leading to the production of nasty side effects
(2).
There are a wide variety of antibiotics available, penicillin and
amoxicillin are the most widely used. All of these can have different
interactions with alcohol, and, as with any medication you should always
consult with your doctor or pharmacist about the guidelines regarding
consumption.
Statins and alcohol
Statins are drugs which are taken to lower the levels of cholesterol
in your blood. High levels of ‘bad cholesterol’ can increase the risk
of developing cardiovascular disease due to fatty deposits building up
in your arteries.
According to the NHS there are no known interactions between statins
and alcohol (3). However, consumption of statins can occasionally result
in an increase in liver enzymes, which if left unchecked can lead to
liver damage. It is therefore important for those taking statins to stay
within the government’s daily unit guidelines and to have their liver
function tested periodically. As with any medication, you should always
consult the guidelines of consumption with your doctor.
What is an alcohol unit and how many is too many?
Can alcohol make you better?
So, can alcohol itself ever be a good medicine? Historically it once
had a very important medical application, says Professor Wallace.
“Before the advent of modern anaesthetics, when surgeons were
performing operations, they would use alcohol as an anaesthetic, getting
their patients drunk before they operated,” he explains. Professor
Wallace says the reason for this is because alcohol numbs the brain.
He explains that many people also feel better after having a hot
toddy when they have a cold because alcohol also numbs your senses; a
hot toddy can make you feel better but there’s no evidence to suggest
that it actually improves your health.
“Nobody should kid themselves that it is going to help you actually
get better,” says Professor Wallace. “You may experience an immediate
gain because if you are feeling rotten alcohol might make you feel less
bad for a short time. But the term ‘medicinal brandy’ is an oxymoron.”
Alcohol and the immune system
There’s no firm evidence about the effects of alcohol on the immune
system, but Professor Wallace thinks it’s probably not a good idea to
drink alcohol when you are feeling ill because it is likely to make you
feel worse. “Our state of mind can affect the way we respond to
illnesses and alcohol is, after all, a depressant,” says Professor
Wallace.
Can alcohol ever be good for the heart?
Finding out if you can drink on your medication
If you’re taking prescription drugs and are unsure whether it is safe
to drink alcohol, the best advice is to check with your doctor and the
pharmacist. Also check the leaflet that comes with the medication.
“If it doesn’t say 'Don’t drink alcohol' it’s probably okay to
drink within the daily unit guidelines," says Professor Wallace. "But if
you are in any doubt, don’t drink alcohol at all because you could put
your health at risk
