Myths and Realities About Using Antibiotics With Alcohol

All get sick from time to time, and many of them have to take antibiotics. Society generally considers these drugs incompatible with alcohol, but what if the treatment period coincides with a holiday? Where is the truth and where is the myth in our understanding of the interaction of antibiotics and alcoholic beverages?

Antibiotics and Alcohol

Antibiotics are drugs designed to fight bacteria. They penetrate pathogenic microorganisms or interfere with their metabolism, destroying it completely or partially.

Doctors still have different attitudes about the compatibility of antibiotics with alcohol and when it is okay to drink alcohol after treatment. Many physicians strongly recommend that patients avoid alcohol entirely during treatment to avoid the consequences of taking both antibiotics and alcohol. They explain this by the fact that these drugs work with ethanol to damage the liver and negate the therapeutic effect.

To date, many studies have been carried out, the results of which allow us to assert with confidence that the pharmacological effects of most antibiotics under the influence of alcohol are not worsened and the load on the liver is not increased.

However, alcohol itself can cause intoxication and dehydration. If you take antibiotics while drinking in large doses, the body will become weak, and in this case, the therapeutic effect will of course be less.

A number of antibiotics have also been isolated that undergo disulfiram-like reactions with ethanol. Concomitant alcohol consumption is prohibited, as this can lead to intoxication, accompanied by nausea and vomiting, convulsions. In rare cases, death is possible.

myth and reality

Girl considering combining alcohol with antibiotics

Historically, there have been myths in society about the complications of drinking alcohol during antibiotic treatment.

The main myths are as follows:

  • Alcohol can neutralize the effects of antibiotics.
  • Alcohol and antibiotics can increase liver damage.
  • Alcoholic beverages can reduce the effectiveness of experimental treatments.

In fact, these arguments are only partially true, as confirmed by the results of numerous compatibility studies. In particular, available data suggest that the consumption of alcoholic beverages does not affect the pharmacokinetics of most antibiotics.

At the turn of the 20th and 21st centuries, there was a lot of research into the combined effects of antimicrobials and alcohol. The experiments involved humans and laboratory animals. The results of antibiotic treatment in the experimental group and the control group were the same, but there was no significant difference in the absorption, distribution and excretion of drug active substances in the body. Data from these studies suggest that alcohol can be consumed while taking antibiotics.

Back in 1982, Finnish scientists conducted a series of experiments in volunteers, which showed that the antibiotics in the penicillin group did not react in any way with ethanol, so they could be used with alcohol. In 1988, Spanish researchers tested the compatibility of amoxicillin with alcohol: only insignificant changes in the absorption rate and delay time of the substance were found in a group of subjects.

It was also found that the pharmacokinetic parameters of some antibiotics, such as the tetracycline group, were significantly reduced under the influence of alcohol. However, fewer drugs have been identified with this effect.

The common belief that alcoholic beverages and alcohol increase liver damage has also been refuted by scientists around the world. Conversely, alcohol increases the hepatotoxicity of antimicrobials, but only in rare cases. This fact becomes the exception rather than the rule.

The scientists also demonstrated that ethanol did not affect antibiotics used to treat experimental pneumococcal infections in rats.

Reason for incompatibility

Although the safety of most antibiotics with alcohol has been proven, there are many drugs that are incompatible with alcohol. The active substances of these drugs react disulfiram-like with ethanol - mainly nitroimidazoles and cephalosporins.

The reason why you can't take antibiotics and alcohol at the same time is that the components of these medicines contain specific molecules that can alter the exchange of alcohol. As a result, the excretion of acetaldehyde is delayed, and acetaldehyde accumulates in the body and causes poisoning.

The process is accompanied by characteristic symptoms:

  • severe headache;
  • Heartbeat;
  • feel sick and vomit;
  • heat in the face, neck, chest area;
  • Difficulty breathing;
  • twitch.

A disulfiram-like reaction is used to code alcoholism, but this method should only be used under the strict supervision of an expert. Even small doses of alcohol can cause intoxication during treatment with nitroimidazoles and cephalosporins. In this case, alcoholism can lead to death.

Doctors allow small amounts of alcohol to be used during treatment with penicillin, antifungal drugs, and some broad-spectrum antibiotics. Drinking a fortified drink while taking these medicines will not affect the therapeutic effect or negatively affect your health.

At what time is it fine

Clock sign and time after which you can drink alcohol after antibiotics

Although alcohol is permitted on most antibiotics, it should not be taken at the same time. Better to drink such drugs, the instructions state.

For example, the effectiveness of erythromycin and tetracycline is increased by drinking alkaline mineral water and sulfonamides, indomethacin and reserpine - with milk.

If the antibiotic does not have a disulfiram-like reaction with ethanol, you can drink alcohol, but no earlier than 4 hours after taking the medicine. That's the minimum amount of time the antibiotic can circulate in the blood, respectively, and the answer to the question of how much you can drink after taking the drug.

In any case, during treatment, only small doses of alcohol are allowed, otherwise the body will start to dehydrate and the antibacterial will simply be excreted in the urine.

The combination of alcohol with any antibacterial ingredient is dangerous to the body. By figuring out how long after taking your medication you can drink alcohol, you can rule out all possible side effects.

in conclusion

The myth that antibiotics and alcohol are incompatible emerged over the last century, and there are several hypotheses about why it happens. According to one of them, the authors of the legend belonged to venereologists who wanted to warn their patients not to get drunk.

Another hypothesis is that the myth was invented by European doctors. Penicillin was a drug in short supply in the 1940s, and soldiers liked to drink beer, which had a diuretic effect to flush the drug out of the body.

It has now been shown that, in most cases, alcohol does not affect the effectiveness of antibiotics and does not increase liver damage. You can drink alcohol during treatment if the active substance of the drug does not have a disulfiram-like reaction with ethanol. However, there are two main rules to follow: don't abuse alcohol, and don't drink it with antibiotics.