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 medications
• illegal drugs

How alcohol interacts with prescription and over-the-counter medications

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

Anabolic steroids

Taking some steroids with alcohol can upset your stomach.

Antibiotics

There are a small number of antibiotics 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 antibiotics will not cause any reaction. Talk to your GP about interactions if you are prescribed antibiotics.

Antidepressants

Taking antidepressants with alcohol can increase the side-effects.

For example:

• drowsines
• dizziness
• coordination problem

Alcohol can also make depression worse.

Related topics

Alcohol and depression

Antihistamines

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

Opiate painkillers

Opiate 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 opiate painkillers are codeine, oxycodone, morphine, fentanyl.

The sedative effects of opiates 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

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

Years of heavy drinking can damage your liver. This makes it less able to metabolise other drugs, such as paracetamol. This means that it will take less paracetamol to cause a serious overdose.

Sedatives (sleeping pills) and tranquillisers

Taking sedatives with alcohol can cause:

• poor coordination
• dizziness
• slower reaction time
• memory loss

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

Illegal drug interactions with alcohol

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 / 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 / MDMA

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

Mixing alcohol and ecstasy / MDMA can also:

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

GHB / GBL

Taking GHB / 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

Ketamine

Taking ketamine with alcohol increases your risk of liver damage.

LSD

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 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.

Solvents

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