Skip to main content

Warning notification:Warning

Unfortunately, you are using an outdated browser. Please, upgrade your browser to improve your experience with HSE. The list of supported browsers:

  1. Chrome
  2. Edge
  3. FireFox
  4. Opera
  5. Safari

Drug interactions with alcohol

If you drink alcohol and take other drugs at the same time, the effects can be unpredictable or dangerous.

The combination of different drug effects is called a drug interaction.​

Interactions can happen with alcohol and:

  • prescription and over-the-counter medicines
  • illegal drugs

Interactions with prescription and over-the-counter medicines

Drug interactions vary from person-to-person and depend on the exact medicine being used.

Information:

Always check with your GP or pharmacist about your specific medicine.

Anabolic steroids

Taking some prescription steroids with alcohol can upset your stomach. For example, prednisolone.

Antimicrobials

There are a small number of antimicrobials that are not suitable to mix with alcohol. For example, mixing alcohol and metronidazole (Flagyl) can create a build-up of toxic chemicals.

Symptoms include:

  • headaches
  • stomach cramps
  • vomiting
  • irregular heart rhythm

Most antimicrobials will not cause any reaction. Talk to your GP or pharmacist about interactions if you are prescribed antimicrobials.

Antidepressants

Taking antidepressants with alcohol can increase the side-effects.

For example:

  • drowsiness
  • dizziness
  • coordination problem

Alcohol can also make depression worse.

Alcohol and depression

Antihistamines

Some antihistamines interact with alcohol to make you feel drowsy. They also affect your coordination.

Opioid painkillers

Opioid painkillers slow down your central nervous system (brain and spinal column). This affects every organ in your body as well as your mood. Examples of opioid painkillers are codeine, oxycodone, morphine and fentanyl.

The sedative effects of opioids and alcohol can combine to affect your breathing. This can cause unconsciousness, coma or death.

It can also:

  • affect your coordination
  • lower your breathing rate
  • increase the risk of choking on vomit or food
  • increase the risk of overdose

Aspirin

Aspirin increases the absorption of alcohol into your bloodstream.

Taking aspirin with alcohol can cause damage to stomach lining. There is also a risk of gastrointestinal bleeding.

Methadone

Methadone slows down your central nervous system. This affects every organ in your body as well as your mood.

Taking methadone with alcohol increases the risk of overdose. This can cause unconsciousness, coma or death.

It can also:

  • affect your coordination
  • lower your breathing rate
  • increase the risk of choking on vomit or food
  • increase the risk of liver problems if you have hepatitis C
  • increase the risk of hepatic cancer if you have hepatitis C

Paracetamol

Do not drink alcohol when you take paracetamol. This is because paracetamol can have a potentially lethal interaction with alcohol and increase the risk of liver damage. 

The exact amounts and timing of alcohol and paracetamol intake that could lead to liver damage are unknown. 

Sedatives (sleeping pills) and tranquillisers

Sedatives include drugs such as benzodiazepines, alprozolam (Xanax) and diazepam (Valium).

Taking sedatives with alcohol can cause:

  • poor coordination
  • dizziness
  • slower reaction time
  • memory loss
  • increased risk of overdose

It can also slow down your breathing or heart rate. This can cause death.

Interactions with alcohol and illegal drugs

Amphetamines (speed)

Taking amphetamines with alcohol increases the amount of alcohol needed to feel intoxicated.

It also increases the risk of:

  • overdose
  • heart failure

Cannabis

Interactions with cannabis and alcohol are unpredictable. Taking cannabis with alcohol can intensify the effects of both drugs.

Mixing alcohol and cannabis can cause your movements to slow down. It can also affect your coordination.

You may experience increased negative effects, such as:

  • vomiting
  • panic
  • anxiety
  • paranoia

Cocaine and crack cocaine

Taking cocaine with alcohol creates a substance in the liver called cocaethylene. This is more toxic than cocaine alone and increases the risk of a cardiac arrest.

Taking cocaine with alcohol can also:

  • increase the amount of alcohol you need to feel intoxicated
  • affect your coordination
  • give you a worse ‘come down’

Ecstasy and MDMA

Interactions with alcohol and ecstasy or MDMA are unpredictable. The effects of both drugs may last longer than expected if you take alcohol with ecstasy.

Mixing alcohol and ecstasy or MDMA can also:

  • increase the risk of dehydration - ecstasy deaths often involve alcohol
  • give you a worse ‘come down’

GHB and GBL

Taking GHB or GBL with alcohol can slow down your breathing or heart rate. This can cause death.

It can also cause:

  • poor coordination
  • slower reaction time
  • memory loss
  • choking on vomit or food

Ketamine

Taking ketamine with alcohol increases your risk of liver damage.

LSD (acid)

Interactions with alcohol and LSD are unpredictable. Taking LSD with alcohol can intensify the effects of both drugs.

Magic mushrooms

Interactions with alcohol and magic mushrooms are unpredictable. Taking magic mushrooms with alcohol can intensify the effects of both drugs.

Heroin

Heroin is an opioid drug. It slows down your central nervous system (brain and spinal column). This affects every organ in your body as well as your mood. Taking heroin with alcohol increases this effect.

It also increases your risk of overdose. This can cause unconsciousness, coma or death.

It can also:

  • affect your coordination.
  • lower your breathing rate
  • increase the risk of choking on vomit or food

Poppers

Taking poppers with alcohol increases your risk of extreme dizziness or fainting. It can also result in a dangerous drop in blood pressure.

Solvents

Using solvents such as glue with alcohol can cause your face to suddenly go red, on and off. It's similar to ‘hot flushes’.

Page last reviewed: 12 October 2022
Next review due: 12 October 2025