Alcohol: how it affects your meds, your health, and your day-to-day life
Alcohol is part of many social moments, but it’s also a drug that changes how your body and medicines work. This page gives clear, practical advice: what counts as moderate drinking, which medicines to watch out for, when to stop drinking, and simple safety steps you can use right away.
What counts as moderate and risky drinking
Moderate drinking is generally up to 1 standard drink per day for women and up to 2 for men. A standard drink equals about 14 g of pure alcohol — roughly 350 ml beer (5%), 150 ml wine (12%), or 45 ml spirits (40%). Binge drinking is 4+ drinks for women or 5+ for men in about 2 hours. Regularly drinking above these amounts raises your risk for liver disease, high blood pressure, some cancers, and mental health problems.
Medicines that commonly interact with alcohol
Alcohol can change how drugs work or add side effects. Here are practical examples you might recognize from our site: if you take Celexa (citalopram) or other SSRIs, alcohol can increase drowsiness, make mood swings worse, and reduce how well the antidepressant helps. For people on Dilantin (phenytoin), drinking can lower seizure control and affect liver enzymes that process the drug. With metformin, regular heavy drinking raises the risk of a rare but serious condition called lactic acidosis. Blood pressure meds like nifedipine can cause extra dizziness or fainting when mixed with alcohol.
Cancer drugs and some newer treatments can stress the liver. If you’re on drugs like nilotinib or other targeted therapies, ask your oncology team about alcohol — even small amounts can raise liver enzyme levels or worsen side effects.
Antibiotics vary. Most modern oral antibiotics don’t cause severe reactions with alcohol, but some do. If your treatment notes warn about alcohol, follow it. When in doubt, skip alcohol until your course is done.
Also think about day-to-day meds: sleeping pills, pain relievers (especially opioids), muscle relaxants, and many antihistamines become much stronger with alcohol and raise the risk of dangerous breathing problems or accidents.
Practical rules: always read your medication leaflet for alcohol warnings. If your doctor or pharmacist hasn’t discussed it, ask: "Is alcohol safe with this drug?" If you feel unusually sleepy, dizzy, confused, have trouble breathing, or faint after drinking while on medication, get medical help right away.
Pregnancy and driving are special cases — avoid alcohol completely in pregnancy and never drive after drinking. If you want to cut back, try tracking drinks, choosing alcohol-free alternatives, and setting limits before you go out. If you’re worried about dependence or can’t stick to limits, reach out to your healthcare provider for support.
Use this tag page to find related articles on interactions and safer choices. If you’re on any long-term medication, a short chat with your pharmacist can prevent serious problems and keep your treatment working as it should.
May, 21 2023