Why The Effects of Combining Alcohol with Other Drugs Can Be Dangerous: Side Effects, Interactions & Risks

Learn what happens when you mix alcohol with prescription drugs and why this can be a sign of an alcohol addiction.

Mixing alcohol¹ with medications can create a variety of health risks that range from uncomfortable to life-threatening. Combining alcohol and medications can cause the effects of each substance to become more severe, making you more likely to experience negative or increased side effects.

What Happens When You Mix Alcohol With Medications?

The effects of mixing alcohol with medications² can vary based on what medication is used. The effects of some medications could become artificially suppressed, while the effects of others could be enhanced beyond what is safe. Alcohol can affect how your body processes medications, but it can also combine with a medication’s effects and increase them to an unsafe extent.

Mixing alcohol and medications can be especially dangerous in older adults, as they have slower metabolisms that are more susceptible to the effects of substances. Further, they often depend more on medications for their health than younger people, making it more important for the medicine to function correctly.

Signs and Symptoms of Alcohol and Medication Interactions

The signs and symptoms of mixing alcohol and medications vary greatly based on the type of medication used. As a general rule, however, the interactions will be related to increased alcohol potency, increased medication potency or decreased effectiveness of the medication. Contact your doctor if you have specific questions about the effects of mixing a particular medication with alcohol.

Medications You Should Not Mix With Alcohol

It is always a good idea to check with your doctor or pharmacist before mixing alcohol and medications. However, there are certain medications that are generally understood to be unsafe to mix with alcohol.

Opioids and Painkillers

Opioid medications suppress your body’s nervous system and brain activity. Because alcohol has a similar effect, mixing alcohol and opioids can cause both substances to work together. This can increase the risk of alcohol poisoning or an opioid overdose. Examples of opioids include:

• Percocet
• Morphine
• Oxycodone
• Fentanyl

Benzodiazepines and Anti-Anxiety Medication

Benzodiazepines act on brain receptors that are very similar to ones that alcohol affects. Anti-anxiety medications and alcohol combine to make each other more potent, increasing the risk of overdose and alcohol poisoning. Examples of benzodiazepines include:

• Ativan
• Xanax
• Valium
• Klonopin

Antibiotics

Mixing alcohol and antibiotics³ is not recommended due to the possible side effects it can create. Antibiotics can cause nausea, stomach pain and dizziness, which are all side effects that can be worsened by alcohol use. Antibiotics containing propylene glycol can cause especially unpleasant symptoms when mixed with alcohol. Examples of antibiotics include:

• Metronidazole
• Penicillin
• Ampicillin
• Doxycycline

Stimulants and ADHD Medication

Mixing stimulants and alcohol can easily cause you to overdrink. Alcohol is a depressant that slows your neurological system, but stimulants have the opposite effect. This can hide alcohol’s effects, causing you to drink more without feeling the effects you normally would. Examples of stimulants include:

• Adderall
• Ritalin
• Concerta

Antidepressants

There are many reasons not to mix alcohol and antidepressants². Some of the main problems that can occur include decreased effectiveness of the antidepressants and toxicity from the medication. Alcohol can also worsen depression, countering the effects of antidepressants. Examples of antidepressants include:

• Celexa
• Zoloft
• Lexapro
• Prozac

Mood Stabilizers

Mood stabilizers⁴ are often a core part of treatment for patients with mental health conditions like bipolar disorder or schizophrenia. Alcohol mixed with mood stabilizers can worsen the condition that is being treated, increase the risk of liver problems and make the effects of alcohol more potent. Examples of mood stabilizers include:

• Depakote
• Lamictal
• Lithium

Blood Thinners

Blood thinners are used in those who are at an increased risk for developing blood clots or have an existing blood clot. Alcohol has a blood-thinning effect⁵, so when it is mixed with blood thinners, the blood can become too thin and severe bleeding could occur from a more minor injury. Common blood thinners include:

• Eliquis
• Coumadin
• Lovenox
• Heparin

Diabetes Medication

Alcohol can lead to low blood sugar levels due to the effects it has on metabolism. Diabetes medications primarily act by lowering blood sugar, creating a risk of excessively low blood sugar when alcohol is used. Low blood sugar levels can lead to seizures, coma and even death, making this combination particularly dangerous. Common diabetes medications include:

• Insulin
• Glipizide
• Metformin

Blood Pressure Medication

Alcohol can increase your blood pressure, causing it to counteract the effects of medications for high blood pressure. Additionally, alcohol can add to the side effects of dizziness and lightheadedness that blood pressure medications commonly create. Common blood pressure medications include:

• Lisinopril
• Metoprolol
• Cardizem
• Atenolol

OTC Allergy, Cold and Flu Medication

Alcohol should not be combined with many over-the-counter (OTC) medications that are commonly used for allergies or colds. These medications are primarily antihistamines, which can cause dizziness and drowsiness. Alcohol can worsen these side effects, and the medications may increase the potency of alcohol. Common OTC allergy, cold and flu medications include:

• Benadryl
• Claritin
• Zyrtec

Angina Medication

Angina medications are used to treat chest pain caused by decreased circulation to the heart. These medications cause dilation of the arteries in your brain, making you more susceptible to lightheadedness and dizziness. Alcohol can further increase these problems⁶ as well as cause heart palpitations and chest pain. Examples of angina medications include:

• Nitrostat
• Nitroquick
• Nitrolingual
• Nitro-bid

Epilepsy Medication

Epilepsy medications are used to reduce or prevent the occurrence of seizures. These medications can make you become intoxicated more quickly, and they may not be as effective when mixed with alcohol⁷. Additionally, since alcohol use can cause seizures, it can increase the risk of seizures in those with epilepsy. Examples of epilepsy medications include:

• Tegretol
• Dilantin
• Klonopin
• Neurontin

Anti-Nausea Medication

Anti-nausea medications can suppress certain types of brain activity and cause symptoms like drowsiness, disorientation and impaired motor control. When combined with alcohol, these effects can become even worse and can increase your risk of injuries. Alcohol can also cause nausea, making it counterproductive to use alongside these medications. Common anti-nausea medications include:

• Zofran
• Phenergan
• Reglan
• Scopolamine
• Promethazine

Muscle Relaxants

Muscle relaxants are used to treat spasms or tightness in the muscles, but they can cause dizziness, memory problems or behavioral changes when combined with alcohol. Alcohol also has a relaxing effect that can potentially cause excessive muscle weakness. Common muscle relaxants include:

• Robaxin
• Tizanidine
• Baclofen
• Cyclobenzaprine

Sleep Aids

Sleeping pills typically slow your respiratory rate and make you more tired. When these medications are combined with alcohol, the effects can become dangerous. This combination can also lead to impaired judgment and ability, significantly increasing your risk of injury. Commonly used sleep aids include:

• Ambien
• Lunesta
• Sonata

Addiction Treatment for Prescription Drug and Alcohol Abuse

Combining alcohol with prescription drugs despite harmful effects can indicate that an alcohol addiction is present. Alcohol addiction is a dangerous condition, but there are many options available for getting treatment.

Alcohol addiction treatment usually involves two major steps. The first step is detox, which involves ending alcohol use and allowing the body to adjust to the absence of alcohol. Alcohol detox can be very dangerous, so it typically requires supervision by health care professionals. The second key step is rehab, where strategies for staying sober, reducing cravings and maintaining lifelong recovery are learned.

If you or someone you know is mixing drugs with alcohol, The Recovery Village Cherry Hill at Cooper can help. Contact us today to speak with a helpful representative and learn more about treatment programs that can work well for your situation.