How bad is it really to drink while taking antibiotics? Here's what doctors and pharmacists want you to know.

By Julia Malacoff
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Photo: Fahroni / Shutterstock

It's common sense to be careful about the interactions of prescription medication, and most people are at least vaguely aware of the advice to not drink alcohol while taking antibiotics. To be fair, when you're feeling miserable with the cold or flu, it's likely that the *last* question on your mind is where's the tequila? But people take antibiotics for plenty of other issues-acne, UTIs, skin infections, and more. What most people ~can't~ tell you, though, is exactly why you're not supposed to consume alcohol while taking antibiotics. (BTW, it looks like you may not need to complete a full course of antibiotics after all.)

Here's why you shouldn't mix antibiotics and alcohol.

First, there's the whole common sense factor. "Even when you're healthy, drinking alcohol can affect your sleep cycle, dehydrate you, lower your energy, and in some cases give you a hangover," says Sonia Patel, Pharm.D., chief pharmacist at Capsule, a digital pharmacy in New York City. "It stands to reason that when you're sick and already not feeling well, extra symptoms like those are the last things you want to deal with."

There's also research showing that alcohol can get in the way of infection recovery by impairing your natural immune response, meaning that you'd potentially have to take antibiotics for longer, she says. So even if you're not really feeling that bad, there's a chance it will take you longer to get over whatever you have going on if you're drinking on the reg. (FYI, alcohol can also mess with your fitness performance and training.)

But how bad is it, really?

"The truth of the matter is that only a few antibiotics actually interact with alcohol," says Laura Hagopian, M.D., an emergency medicine physician at Lowell General Hospital. And while it's not super dangerous to have a drink or two while you're on antibiotics in general, there are a few medications that have serious interactions with alcohol that will make whatever you're going through feel a lot worse. "These include metronidazole, Tindamax, and sulfamethoxazole/trimethoprim," Patel says. Combining these medications with alcohol can lead to nausea and vomiting, abdominal pain, cramps, and more. "Alcohol should be completely avoided when taking any of these," Patel says.

The good news is that alcohol isn't likely to reduce the effectiveness of your meds (although as mentioned earlier, it could affect your body's immune response). "Mild to moderate alcohol intake generally doesn't reduce the efficacy of most antibiotics," Dr. Hagopian says.

While rare, some antibiotics can intensify the effects of alcohol. "For instance, erythromycin can increase the amount of alcohol that gets absorbed from your stomach," Dr. Hagopian says. That means you'll become intoxicated faster than you normally would. (Related: What Young Women Need to Know About Alcoholism)

There's also the fact that "alcohol is metabolized in the liver, as well as some antibiotics," according to Margarita Rohr, M.D., clinical instructor of medicine at NYU Langone Health. "Depending on how much alcohol is consumed, it may affect the way the liver processes the antibiotic," she says. This is one of the rare cases when an antibiotic could be less effective due to drinking. For all of these reasons, it's very common for doctors to recommend you skip out on alcohol if you're taking any type of antibiotic, even though many antibiotics are pretty okay to drink on.

Patel's bottom line: "Will drinking on antibiotics kill you? Nope. Will it make you feel like it did? Quite possibly." If you're already feeling pretty crappy, know that alcohol isn't likely to make you feel much better, but if you're feeling all right, there's one simple, safe way to find out the deal: "If you're not sure whether or not your antibiotic is safe, talk to your doctor or pharmacist," Patel says. "She can give you the lowdown." Better safe than sorry, right?!

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