You were responsible enough to go to the doctor and get antibiotics for your pesky urinary tract infection, but you also have a happy hour tonight that you do not want to miss. Technically, you're not "supposed to" drink when you're taking antibiotics, but what's the worst thing that could happen if crack open a cold one tonight? You might have heard from a well-meaning friend that drinking on antibiotics just "makes you get drunker, faster," but it's actually more complex than that.
There are two main reasons why you should avoid alcohol while on a course of antibiotics: There's potential for increased side effects, and the alcohol could interact with the drug's ability to do its job, explains Stephen Ferrara, RN, DNP, RNC-BC, associate dean for clinical affairs at Columbia University School of Nursing, who oversees its faculty practice, ColumbiaDoctors Primary Care Nurse Practitioner Group. And those side effects are way worse than just your typical hangover.
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If you do decide to have a few drinks while on antibiotics, you could experience a slew of gorgeous symptoms, such as increased heart rate, changes in blood pressure, nausea, vomiting, diarrhea, gastrointestinal pain and discomfort, headaches, redness of the skin, dizziness, drowsiness, and damage to the liver, Dr. Ferrara says. Yikes. There are certain antibiotics (such as Metronidazole, Ketoconazole, and Griseofulvin, for example) that will definitely cause an intense and significant reaction to alcohol, so you really shouldn't drink, he says. "Outside of these medications, a drink or two should not cause significant reactions while on antibiotics, although the potential always exists." So, it's better to be safe than sorry.
Besides possibly making you feel terrible, if you drink alcohol on antibiotics it'll take you longer to recover from whatever infection you're treating, Dr. Ferrara says. "Moderate to heavy alcohol consumption increases liver enzymes released in the bloodstream," he says. "Since the liver is responsible for metabolizing antibiotics, the effects of antibiotics can be reduced." So, while that carafe of wine might be calling your name at the end of a long week, you'll just end up having to take your antibiotics longer, so it's better to just wait until you're recovered..
As for the whole "getting drunker, faster" thing? That's somewhat true, according to Dr. Ferrara. Drinking alcohol causes dehydration, increasing the amount of alcohol in the bloodstream, he says. "When someone has an infection, they may already be partially dehydrated." Alcohol is also a central nervous system depressant, so when it's combined with antibiotics (or medications) that also affect the central nervous system, "the effects of both can be potentiated," he says. "In other words, symptoms like poor coordination, dizziness, somnolence are increased since both are acting on the central nervous system." And those are all symptoms associated with being drunk, so you can see how people assume that they're just getting "drunker."
Let's be clear: Drinking on antibiotics to fast-track your buzz isn't a good idea. While you're treating an infection, whether it's a UTI or bacterial infection, it's extra-important to rest, stay hydrated, and take the entire course of the antibiotic as prescribed, Dr. Ferrara says. Even though you can't get sloshed with your friends this weekend, you will be feeling better sooner — which is worth it, right?