Alcohol and medicines Introduction
Which medicines ?
A summary article from TEST GEZONDHEID … Summary article from TEST GEZONDHEID
Medicines and alcohol are not good friends. Or so we tend to think. But can you drink not alcohol at all if you are on medication? The answer to the question comes in very subtle nuances, as may be seen from a summary article from TEST GEZONDHEID. In principle, we must follow the advice of the leaflet. Sometimes, though, it’s a tad exaggerated. We run through some medicinal products and offer the relevant advice.
Aspirin (aspro, Aspirine Bayer, Sedergine,…) and the NSAIDs (non-steroidal anti-inflammatory drugs: anti-inflammatories). These drugs are sometimes bad for the stomach, just like alcohol. Easy does it then. However, according to the American FDA (Food and Drug Administration), there is no problem with moderate drinking when you take aspirin and NSAIDs. Preferably not more than 3 glasses of alcohol per day, and as your doctor may advise you.
Paracetamol (Perdolan, Paradol, Witte Kruis Mono,, Paracetamol EG, Sanicopyrine, Dolol Instant, Lemgrip, Dolprone, Algostase Mono, Paraphar,…) is an analgesic or painkiller. Anyone not suffering with their liver may quite happily take the occasional drop of alcohol with their normal daily dose of paracetamol. Moderate drinking does no harm.
Antihistamines (Phenergan, Benylin, Theralene, Polaramine, Nuicalm, Nustasium, …) are used to combat the symptoms of allergies, as sedatives or as drugs to alleviate travel sickness. These products have the side effect of inducing drowsiness. Alcohol increases the drowsiness, and senior citizens are more at risk of falling over. Such is not the case for more recent antihistamines (Loratadine, fexofenadine, cetirizine, ebastine, mizolastine, ), so no special precautions are in fact necessary when taking alcohol.
Cough medicines (Bronchosedal Codeine, Actifed New, Vicks Vaposyrup, Nosca Mereprine, …). These medicines contain constituents that can induce drowsiness, at least on overdose. It is therefore not advisable to drink if you have to drive. But a little beer at home won’t do any harm.
Antidepressants (Redomex, Tofranil, Anafranil, Nortrilen, …). Certain antidepressants can induce drowsiness. The effect is intensified by alcohol. This mainly applies for tricyclic antidepressants. The SSRIs (selective serotonin reuptake inhibitors), e.g., citalopram, fluoxetine, paroxetine, setraline, should not have this soporific effect. Moderate enjoyment of alcohol is not necessarily ruled out for all cases.
Nitroglycerine and Propranolol (Nitrolingual, Nysconitrine, Willong, Cedocard, Trinipatch, Isordil, Promocard, Inderal, …), used in the treatment of heart conditions. Side effects may include a sudden drop in blood pressure. The risk increases when you drink alcohol. Ditto for propranolol. So best not to drink if you are taking these particular products.
Statins(Zocor, Lipitor, Pravasine, Lescol, Prareduct, Simvastatine Bexal,…), used to reduce the cholesterol level. These drugs are known to produce muscular problems. If so, consult your doctor. Large amounts of alcohol increase the risk. So, don’t overdo it.
Warfarin and Co (Marevan, Sintrom, Marcoumar, …)are anticoagulants. Alcohol can intensify their effect, with an increased risk of bleeding. Heavy drinking is risky. One or two glasses a day is a safe limit.
MAO inhibitors (Aurorix (moclobemide), Merck Moclobemide, Nardelzine(fenelzine), …) are anti-depressants. Only the non-selective MAO inhibitors (e.g., fenelzine) require great caution with beer. Not because of the alcohol, but more because of the presence of tyramine. There are no reliable lists of the tyramine content in beer.
Metronidazol(Flagyl, Tiberal, Fasigyn, Nagoxin,…) are used for infections, and are thought to trigger antabuse reactions in combination with alcohol, with nausea, palpitations, hot flushes, etc. However, no studies confirm the suspicion, so the antabuse effect of Metronidazol and its derivates would appear still to hover between shadow and substance.
Antibiotics. Whatever people say, drinking a single alcoholic beverage will not cancel out the effect of antibiotics, and no interactions are to be expected. Except perhaps with seldom-prescribed cephalosporins, which are thought to have an antabuse effect.
Medicines to treat diabetes (Glucophage, Metformax, Daonil, Gilbeneze, …). Using the medicine Metformine involves the risk of lactacidosis, a dangerous side effect. Sulphonyl urea derivates in combination with alcohol are believed to cause serious hypoglycaemia. Diabetics may still drink alcohol in moderation. But always check with your doctor first.
Drugs and medicines to treat stomach ulcers (Tagamet, Nuardin, Zantac, Panaxid, Cimephar, …). Some of these products against gastric acid and stomach ulcers are believed to increase the blood alcohol level. Only a single small study indicates that ranitidine (Zantac, Pylorid, Raniphar, Docraniti, ) induces the effect in persons who regularly drink at least 4 glasses of alcohol a day.
Drugs and medicines to treat tuberculosis (Rifadine, Nicotibine). Large amounts of alcohol will reduce the effectiveness of these products, and may even render them toxic in the liver.
Source: TEST GEZONDHEID No.56, August-September 2003