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.
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.
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’.