If you read the fine print on many FDA-approved over-the-counter substances, you’ll be familiar with a certain common warning: “Do not take with alcohol.” But you’re not alone if you don’t take heed. According to research conducted by the American Addiction Centers (AAC), more than 55 percent of people mix everyday OTC meds with alcohol.
This isn’t good, of course. Mixing booze with medication can cause a whole range of negative side effects, and can sometimes even go so far as to negate whatever benefits you’d get from the meds in the first place. In some cases, overdose can occur. To help ensure that doesn’t happen to you, we’ve rounded up all the substances that health experts say you shouldn’t combine with a drink. So read on, and remember to drink—or not drink—responsibly.
Wine enthusiasts might suggest pairing morel mushrooms with a glass of earthy red wine, but you won’t find any doctors recommending the pairing. According to the Michigan Department of Community Health, morel mushrooms—especially if they’re raw or undercooked—coupled with alcohol will result in nausea and vomiting. On Wine Wednesday, pick another pairing.
Energy drinks are a twofold danger, when it comes to mixing with alcohol. For starters, caffeine isn’t the best thing to mix with liquor; it’ll perk you up, and dull the effects of alcohol, causing you to drink more than you perhaps need to. But, additionally, according to the Centers for Disease Control, those who mix energy drinks with alcohol tend to binge-drink more often and engage in other reckless activities like driving under the influence, having unprotected sex, and getting into fights that result in serious injuries.
According to the AAC, mixing marijuana with alcohol (“crossfading”) is dangerous. For one, drinking alcohol while using marijuana enhances the effects of the drug’s main psychoactive ingredients, THC, making it last longer in your system. Since your liver can only metabolize one substance at a time (and it always tackles alcohol first), your body won’t have the adequate time to break down the marijuana, causing it to stay in your system for hours on end.
But the biggest risk is that combining these two substances puts you at a higher risk of dehydration. Alcohol—as everyone knows—is a diuretic. And, according to recent research published in the Journal of Pharmacology and Experimental Therapeutics, marijuana is, too. Other possible issues include increased anxiety, hallucinations, and the possibility of liver and kidney disease occurring later in life.
Taking pain relief medication like Tylenol, Ibuprofen, and Aleve with alcohol won’t likely lead to any health problems in the immediate future. But, according to the folks at Ashwood Recovery, an outpatient treatment center in Boise, Idaho, mixing these two things frequently over a longer period of time can have serious repercussions.
Over time, if you find yourself often mixing over-the-counter pain relief medications and alcohol, you will likely begin experiencing symptoms like nausea, stomach bleeding, ulcers, a rapid heartbeat, and, most commonly, liver damage. When you begin mixing medications with alcohol, your liver uses more energy to process all of these substances at once—meaning that it’s far more likely you’ll experience liver damage in your life than someone who doesn’t mix alcohol and medications.
On their own, opioid painkillers are deadly. In fact, drugs like Percocet, Vicodin, Demerol, and Fentanyl kill thousands of people each year, according to the National Institute of Drug Abuse. Mix them with booze, however, and they become even more deadly.
According to the AAC, the combination can result in severe drowsiness, extreme dizziness, breathing difficulty, impacted motor functions, memory problems, liver damage, and a higher likelihood of overdosing.
Though muscle relaxers (think: Flexeril) on their own don’t typically pose any risks to your health, when combined with alcohol, they have the potential to inflict quite a bit of damage on your respiratory system, according to Ashwood Recovery. Muscle relaxers target the part of the brain that regulates the central nervous system. When that slows down, it sends a signal to your respiratory system to slow down, too. Combine that with alcohol, and you can quickly find it incredibly hard to breathe.
What’s more, if you’re in the habit of frequently mixing these two substances, then you’re in danger of doing permanent damage to your respiratory system. Basically, you’re repeatedly forcing your lungs to speed up and slow down and speed up and slow down, putting an immense amount of strain on your respiratory system with every stop and go.
Though you’re already aware of the fact that you shouldn’t be driving or operating large machinery after taking sleep aids like Ambien, Lunesta, Prosom, Sominex, and Restoril (thanks in no small part to late-night infomercials), it’s important that you also realize what mixing these medications with alcohol can do to your body.
According to Ashwood Recovery, in the short-term, mixing these two substances will likely result in drowsiness, dizziness, breathing difficulties, impaired motor skills, and memory trouble. In the long-term, however, you can expect excessive damage to the liver and, in some cases, even an onset of addiction (to the sleeping pills).
Similar to muscle relaxers, cough syrup works to suppress the cough reflex in the respiratory tract, essentially telling the respiratory system to slow down, according to Ashwood Recovery. As you can probably gather, combining the substance with alcohol poses serious risks to your health, and can cause you to experience trouble breathing—and can leave lasting effects on your respiratory system.
Mood stabilizer medications that contain lithium, like Depakote, Eskalith, and Lithobid—which are used to treat mental disorders like bipolar disorder and manic depression—are incredibly strong drugs on their own. More than any other symptom that occurs when mixing these mood stabilizers with alcohol, you’ll find that your mental state plummets, according to Ashwood Recovery.
This occurs because alcohol effectively clashes with the lithium in the drugs, which is intended to regulate neurotransmitter production to help you feel more “stable.” But alcohol triggers the brain to create even more dopamine, and most patients on mood stabilizers don’t need any more of the chemical. On top of that, the combination can also result in drowsiness, dizziness, tremors, joint pain, muscle pain, and liver damage.
Adderall and other ADHD medications—like Concerta, Strattera, Ritalin, and Vyvanse—are, when mixed with alcohol, most likely to increase your blood pressure, cause insomnia, and, in severe cases, cause seizures and heart problems.
On their own, according to the AAC, ADHD medications aren’t exactly great for your heart, as they’re still amphetamines that increases your heart rate and breathing patterns, sometimes causing heart palpitations and irregular heartbeats. When mixed with alcohol, the drug’s effects are increased, and can cause arrhythmias, an accelerated heart rate, and increased blood pressure, and can amp up your risk of suffering a stroke or heart attack.
According to Ashwood Recovery, there’s a common connection between anxiety and alcoholism. Aside from experiencing the typical effects of mixing these substances—like slowed breathing, impaired motor functions, and memory trouble—many people are at a greater risk of overdosing on both substances.
The risk of overdose is higher when mixing the two, since anti-anxiety medications, like Xanax, eliminate anxiety by slowing down the part of the brain that anxiety stems from—which inevitably slows down your central nervous system, and makes it that much harder for your body to process the alcohol that you’re consuming.
Though diabetics can drink under certain conditions, they should always do so carefully, and under constant supervision. In fact, according to the American Diabetes Association, diabetics should never skip a meal before consuming alcohol, should never drink when their blood glucose is low, and should avoid drinking craft beers or any other mixer that contains high amounts of sugar, like Coca-Cola.
Aside from these issues, drinking alcohol also lowers the amount of sugar in a person’s blood—bad news for any diabetic. What’s more, diabetes drugs, like Glucotrol, Glynase, DiaBeta, Orinase, and Tolinase, when mixed with alcohol, cause weakness, a rapid heartbeat, headaches, and, occasionally, nausea and vomiting, according to Ashwood Recovery.
Those taking arthritis medications—like Celebrex, Naprosyn, and Voltaren—are advised to only drink in moderation, if at all. As the Arthritis Foundation points out, those who have been taking their arthritis medication for a longer period of time are more at risk for developing stomach ulcers and bleeding. And long-term use can even increase the risk of liver damage.
However, for those who only take such drugs on occasion, drinking a glass of wine doesn’t pose the same risk—so long as you wait approximately three to four hours to drink after you have taken the drug, to give you body the time it needs to fully process the substance.
Even on their own, both alcohol and medications created to treat patients with high cholesterol can cause liver damage. Statins like Advicor, Crestor, Lipitor, Pravigard, Vytorin, and Zocor, despite the fact they effectively lower dangerous cholesterol levels, have also been shown to cause liver inflammation, according to the Mayo Clinic. This is why, since statins are already considered a mild stressor for your liver, doctors typically advise against drinking (or, at the very least, advise drinking in careful moderation) while taking cholesterol drugs.
Though they’re not quite as intimidating or deadly as other substances out there, allergy medications can still wreak havoc on your system when combined with alcohol. To take it from Ashwood Recovery: “The mixture has a depressant effect on the central nervous system. As all of these drugs are depressants, they can really slow the central nervous system down.”
When cocaine and alcohol are both present in your system, they actually work together to create a third chemical, Cocaethylene, which, according to the AAC, can pose significant problems for your immediate and long-term health: “Cocaethylene temporarily enhances the high associated with both cocaine and alcohol, but this euphoria also increases blood pressure, aggressive and violent thoughts, and poor judgment. It will build up to toxic levels in the liver. An increase in cocaethylene has also been linked to sudden death.”
One of the most common varieties of antibiotics, Flagyl, will cause those who mix the medication with any amount of alcohol to suffer severe nausea and vomiting symptoms. And, according to the University of Michigan, these two substances should not be mixed for up to three days after the full round of antibiotics have been consumed. What’s more, other antibiotics medications—like Nitrofurantoin, Isoniazid, and Azithromycin—can cause the same unpleasant symptoms, though they don’t pose the same heightened risk for them to occur.
According to the University of Iowa, those who are taking Coumadin, a drug that treats and prevents blood clots, should either not drink at all or do so in moderation. The University suggests drinking no more than two consecutive drinks if you’re a man and just one drink if you’re a woman. If you consume more alcohol than this recommended amount, you put yourself at a greater risk of developing additional bleeding issues—issues that only exacerbate the more you drink.
Doctors advise against mixing ED meds and alcohol. Drugs for erectile dysfunction—like Cialis, Viagra, and Levitra—enhance the effects of nitric oxide, a chemical in your body that relaxes your muscles. According to the Mayo Clinic, even without alcohol, the blood rush that follows can already result in symptoms like nasal congestion, headaches, visual changes, backaches, and stomach issues. When combined with alcohol, such negative symptoms will only get worse.
Consuming alcohol while taking medications for an enlarged prostate—like Flomax, Uroxatral, Cardura, Minipress, Rapaflo—can make patients feel dizzy, weak, and can even lead them to faint. In fact, according to one study out of the University of Zurich, alcohol consumption in those suffering from an enlarged prostate only made their condition worse. You’re especially likely to suffer these symptoms if you’ve just started taking the drug, or if your dosage was recently increased.
If you’ve ever had too much to drink, it’s likely that you’ve experienced feelings of dizziness and lightheadedness. And, while you’re probably not ready to reach for yet another glass of wine when you’re already feeling nauseous and dizzy, it’s still important to point out the risks that come along with consuming nausea and motion sickness medications like Dramamine with alcohol. As the AAC points out, combining the two will only make you more nauseous and drowsy (and, not to mention, poses an elevated risk of overdose).
One seizure medication, Topamax, has actually been linked to increased suicidal thoughts and tendencies on its own, according to research out of the Medical University of Gdańsk in Poland. And when combined with alcohol, such lines of thought can in fact be exacerbated.
Even on their own, hallucinogens like LSD, mushrooms, and Ketamine are known to wreak havoc on the body, resulting in increased paranoia, aggression, vomiting, diarrhea, and cardiac arrhythmia, and brain damage. According to the Delphi Health Group, when alcohol is thrown in the mix, such risks are elevated, leading also to immediate dehydration and, in the long-term, the possibility of cancer and a weakened immune system.
Though health professionals suggest eating a meal before hitting the bars, Nate Masterson, a certified health expert and head of natural product development for Maple Holistics, points out that anything containing an excess of salt will only further dehydrate your body.
“Sodium dehydrates the body, so when combined with alcohol which is a diuretic, your body can become severely dehydrated,” he says. “This can lead to more serious consequences if the drink that you reach for to quench your thirst is alcoholic.” If you’re munching on peanuts at the bar, see if your bartender has an unsalted option.
When taking antidepressants like Prozac, Wellbutrin, Zoloft, Effexor, Marplan, and Lexapro, it’s important to regulate the amount of alcohol that you’re consuming. As the Mayo Clinic explains, mixing these substances could result in a number of unwanted—and yes, dangerous—symptoms: “Drinking can counteract the benefits of your antidepressant medication, making your symptoms more difficult to treat. Alcohol may seem to improve your mood in the short term, but its overall effect increases symptoms of depression and anxiety.”
And if you’re on monoamine oxidase inhibitors (MAOIs, like Marplan and Nardil), watch out. This combo can heart-related side effects. According to the National Institute on Alcohol Abuse and Alcoholism, you’ll especially want to steer clear of red wine and beer, which, in combination with MAOIs, can cause your blood pressure to spike. And for more things to watch out for with everyday substances, learn all about The 20 Craziest Side Effects of Common Drugs.
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