How un/safe is it to drink alcohol while on antibiotics?

August 17, 2007 3:37 PM

Is there anything really wrong with (moderate? binge?) drinking while taking a course of antibiotics... or is my (frequently preachy, moralizing, unctuous, underfunded, dodgy-quality) free clinic just trying to pull one over on me?

I wouldn't normally try to second-guess any professional advice, but in the past I've really kind of gotten some overly-simplified, watered down, and sometimes just plain off-the-wall advice from the various low-income clinics I've utilized. I'm not calling the caregivers there incompetent or anything close--they're saints for doing what they do--but by and large they will dole out a pretty huge helping of homiletics about, say, making sure to avoid salty foods while they're stitching up a cut on your finger. They also won't usually go out of their way to clearly delineate the distinctions between or reasoning behind various instructions they give you.

They're working for the greater good... but it makes me suspicious.

So I got prescribed a 7-day course of antibiotics (doxycycline, if it matters [to treat my recently-contracted chlamydia... anonymity is fun!]) and was told to abstain from alcohol.

I'm no alky... but I'm having about a once-in-every-two-years gathering of 13 of my closest guy friends this weekend and I might want to tip a few back.

Is this a big deal?

I realize that whatever is said in this thread does not constitute medical advice and that by posting here we are absolutely NOT establishing a patient-doctor relationship.

posted by anonymous to health & fitness (17 comments total)

Yes its a real and serious risk. Read about it here.

I wouldnt even drink 48 hours after stopping antiobiotics. I kinda like have a nice and healthy liver.
posted by damn dirty ape at 3:44 PM on August 17, 2007

The first result from Google says "There are no interactions with alcohol, but combining doxycycline and alcohol should be avoided if you have active liver disease." So I'm guessing there's no real consensus and the free clinic has seen a few bad experiences in the past. Ultimately, it's your body.

I'm a computer programmer, not a doctor, and I pretty much take medical advice from Google with 25 grains of salt.
posted by crinklebat at 3:44 PM on August 17, 2007

My best friend is a pharmacist and a lush, but even she advises against drinking while on antibiotics.
posted by tastybrains at 4:04 PM on August 17, 2007 [1 favorite has favorites]

I ended up in the emergency room vomiting blood the last time I drank heavily on top of antibiotics, so take that for what it's worth.
posted by scody at 4:05 PM on August 17, 2007

I've taken antibiotics and a drink or two with no problem in the past, but had a friend hanging over the toilet for an hour after having drunk a rum and coke then taken an aspirin.

All that said, to be on the safe side, I really wouldn't recommend it.
posted by LN at 4:27 PM on August 17, 2007

One or two drinks you should be fine. One or two drinks plus a couple of shots you start playing with fire. Pounding back beers with friends? It depends, not everyone is the same, and it certainly is not a guaranteed trip to the emergency room, but if you're older than say, 25, it is a risk I wouldn't take (not that being under 25 makes it necessarily healthier, I just remember from college people would drink on antibiotics and generally have no side effects).
posted by geoff. at 4:28 PM on August 17, 2007

Never had a problem drinking on top of any antibiotic. It would be rash to describe these stories as scaremongering, but you should be able to judge the likelihood of any problem occuring from your past reactions to both with prescription medication and alcohol.
posted by fire&wings at 4:28 PM on August 17, 2007

Yes its a real and serious risk. Read about it here.

despite the comment from damn dirty ape, the link is actually very useful and informative. but read the link, don't take dirty ape's summary as correct (my best guess is that he found some fermented banana juice a while back and is now having trouble focusing).
posted by andrew cooke at 4:48 PM on August 17, 2007

Antibiotics isn't one thing, it's a bunch of different pure compounds. Each drug needs to be understood individually, not as a class of things that behave alike.

Doxycycline is one thing, and there's already a link describing the interactions between doxycycline and ethanol.

Most STD clinics prescribe metronidazole from time to time (because it's the only drug that kills trichomonas, if you care) and that drug has a horrible interaction with alcohol that makes you very sick, vomiting and feeling awful for a day or two. For that reason it's easier for the practitioners to remember to tell people not to drink alcohol with their antibiotics.
posted by ikkyu2 at 5:00 PM on August 17, 2007

I once drank while on antibiotics for bronchitis (i forget which antibiotic). I was fine for a little while, but after about my fourth drink (not very many for me) I blacked out. I later found out I did numerous stupid things, including vomiting on our fraternity's front lawn after wrestling an all-american wrestler (guess who won). It didn't kill me or anything, but it wasn't my best night. I'd recommend against it, or at least against having more than one or two drinks.
posted by hihowareyou at 5:40 PM on August 17, 2007

Here's a link to doxycycline's prescribing information. Scroll down to interactions with other drugs, and you'll see that the interaction between doxycycline and alcohol is that the antibiotic's half-life is reduced. Meaning your binge drinking might make your drug less effective (because there might be less of it in your system). But you won't trash your liver any more than you would have without the doxycycline on board.

WEAR SUNSCREEN! Doxycycline can make people quite photosensitive and you don't want to be hung over and sunburned at the same time.
posted by selfmedicating at 5:45 PM on August 17, 2007

Same opinion here: antibiotics + alcohol can damage your liver. I like my liver. It's one of those organs that doesn't come with a spare.

That aside - alcohol generally intensifies the side effects of a lot of antibiotics (and other medications). The side effects it most intensifies are nausea-related (dizziness & vomiting) which are not generally considered the the "fun" parts of drinking.

Another link for you.
posted by Crosius at 6:30 PM on August 17, 2007

That's the same link, actually, and it still makes the point that ikkyu2 does: that mixing some antibiotics with alcohol is notably bad for you, but doxycycline is not one of those antibiotics.
posted by redfoxtail at 7:54 PM on August 17, 2007

Antibiotics either a) kill the bacteria directly or b) stops the bacteria from dividing/doing bacteria-ey stuff.

a) are called bactericidal. b)'s are bacteristatic* antimicrobials.

Most commonly prescribed antibiotics are 'static and basically tries to 'hold back' the infection so the endogenous immune system can have time to try to actually kill and remove the bacteria.

Heavy drinking really screws with the immune system. False inflammatory signals, or slugish lymphocytes when timing of interactions determine the outcome, &c&c.

One argument against binging while on antibiotics is that if you do, you're potentially turning yourself into a training ground for antibimicrobial microbes that are resistant to whatever antimicrobial that you're taking.

Why do you hate Homo sapiens?!

*or whatever the prefix
posted by porpoise at 9:12 PM on August 17, 2007

I was about to say what selfmedicating says. It will cut the effectiveness of your antibiotic, not exactly by half cos that's not how half-lives work but you don't want the chlamydia to get any advantages, stick around longer with it's new super doxycycline immunity!!!!!
Only joking, if you absolutely have to have a drink I would probably take an extra dose that night. But IANAD.

and yeah, the liver damage.....
sigh!
posted by Wilder at 1:20 AM on August 18, 2007

Since most of the times I needed antibiotics were a direct result of stuff I did while binge drinking, I'd suggest to you that you should stop drinking before you even need antibiotics. Hehe.
posted by furtive at 6:33 AM on August 18, 2007

I've had alcohol and a bit of booze and suffered no ill effects (z pack I think) . My doctor told me the myth of not mixing the drink and antibiotics arose from treating soldiers for the clap. They didn't want them to drink and get busy again thus infecting others.
posted by pywacket at 9:09 PM on August 19, 2007