Alcohol and your medication: A dangerous mix

You may have seen the mention “avoid alcohol” on some of your prescription bottles in the past. You probably wondered why that warning was there. Perhaps you have even on occasion ignored those directions and consumed alcohol anyway. In some of you, that mix produced strong effects; in others, the effects went mostly unnoticed. Indeed, alcohol does not have the same effect on all medications. Alcohol increases the adverse effects of certain medications, while it increases the actual effect of the drug in other cases. Alcohol can also increase the toxicity, both short and long term, of certain types of medication. The following text explains the various characteristics of alcohol that make its combination with medication risky and sometimes downright dangerous.

Alcohol is a cerebral depressant

Other than its pleasant taste, the most commonly sought-after effect of alcohol is the feeling of relaxation that it produces. Alcohol actually has that effect because it very easily crosses the barrier that separates the blood vessels from the brain. Thus ideally situated to hinder our mental clarity, the alcohol molecules slow down our mental skills and decrease our reflexes and coordination. This is what we call the depressant effect. Alcohol can also cause or aggravate symptoms of depression and induce somnolence and even sedation when consumed in excess.

Some medications have effects similar to alcohol. One example is the benzodiazepine class of drugs, which are used to treat insomnia and anxiety. These medications are also brain depressants, since that effect is how they act. However, when benzodiazepines and alcohol are combined, the depressant effects are not just increased, they are multiplied and unpredictable: everyone reacts differently to such a mix. One person taking this medication might feel very pronounced effects after a single drink, while another may observe milder effects.

The benzodiazepines are not the only medications that produce intensified depressant effects when combined with alcohol. The effect is also very pronounced with antihistamines (e.g. Benadryl® and Gravol®) and antidepressants. Ultimately, any medication whose adverse effects include somnolence, diminished intellectual capacities or sedation can interact with alcohol. Incidentally, over-the-counter medication is no exception…

Alcohol is a liver stressor

The liver, that veritable filtration plant, is responsible for eliminating alcohol and most of the medication present in the blood. Generally speaking, the liver cannot eliminate several substances at the same time. It must therefore prioritize its work, which means that a drug might stay active for a longer period in the blood because alcohol is slowing down the work of the liver. This leads to an increased effect of the medication, which is not always desirable. For example, the elimination of Coumadin®, a drug used to reduce blood clot formation, is slowed down when we drink alcohol. We then observe an increase in the medication’s anticoagulation effect, which increases the risk of bleeding associated with taking this medication.

Alcohol can also cause liver cell damage. When we chronically consume too much alcohol, it becomes toxic to the liver and can cause irreversible damage, as seen with cirrhosis. Some medication can also be toxic to the liver. For example, while acetaminophen (Tylenol®) is safe when used properly, it can become toxic to the liver when taken in excess. When alcohol and acetaminophen are combined, the liver is doubly assaulted. Damage may then appear on the liver even without excessive quantities of alcohol or medication being consumed.

Many other drugs can be toxic to the liver. Ask your pharmacist whether there is any risk in consuming alcohol when taking your medication.

Alcohol can aggravate several diseases

Alcohol is incompatible with many diseases and health conditions. For one thing, drinking a lot of alcohol increases the volume of liquid circulating in the body. It can therefore aggravate the condition of individuals suffering from hypertension or heart failure, as these patients often must rigorously control their daily liquid intake.

Secondly, alcohol has a negative impact on the body’s sugar and lipid processing mechanisms. When we consume alcohol regularly and in great quantities, blood cholesterol levels tend to become unbalanced; levels of LDL (“bad” cholesterol) increase while levels of HDL (“good” cholesterol) decrease. This condition raises the risk of cardiovascular disease, which includes heart attacks and strokes. In persons with diabetes, excessive alcohol consumption promotes the use of lipids instead of sugars as a source of energy. This process results in the formation of products that are toxic to the brain, which can lead to serious consequences such as a diabetic coma.

Lastly, due to its depressant effect on the brain, alcohol can worsen or even cause several health problems. Examples include urinary incontinence, sleep apnea and erectile dysfunction. In addition, beware of the misleading effects of alcohol, which can give you the impression that it helps relieve your health problem when in fact it is only making it worse; this is the case with depression and insomnia, for example.

If you are taking medication or suffer from any health problem, you should always consult your pharmacist or physician to determine whether you can consume alcohol. While very few medications require complete abstinence (e.g. metronidazole (Flagyl®), an antibacterial drug), it is always best to reduce your alcohol consumption to a minimum. Bear in mind that the concomitant consumption of medication and alcohol can sometimes have serious and even irreversible consequences.

For most people, drinking in moderation is acceptable. This means 1 to 2 drinks per day, not exceeding 14 per week for men and 9 per week for women. If you’re not sure if alcohol interacts with your medication, don’t hesitate to consult your pharmacist!