4 Drugs To Absolutely Avoid With Alcohol

Journalist | Daeun Choi | daeundownchoi@naver.com Designer | Jinyoo Park | truthfree@yonsei.ac.kr

Almost all medicines should not be taken with alcohol. When medicine and alcohol interact, serious side effects may occur. Alcohol has the potential to interact with many medications by altering its metabolism or activity. However, during the beginning of a new semester when social events and gatherings become more frequent, it’s hard to avoid drinking alcohol. Also, it’s difficult to remember which drugs are okay and which are NOT to take with alcohol. As a pharmacy student, let’s try to remember at least the following 4 medicines that should absolutely be avoided when drinking alcohol.

4 Medicines That Should Be Avoided With Alcohol

1.Anti-Inflammatory And Antipyretic Painkillers

Acetaminophen-based antipyretic painkillers such as Tylenol are drugs with high liver toxicity. Tylenol and alcohol are both chemicals that are broken down in the liver. While each substance individually puts some strain on the liver, the strain multiplies when both are used together. Acetaminophen is metabolized in the liver in three ways, one of which uses an enzyme called “CYP2E1”. When acetaminophen is metabolized by CYP2E1, 5-15% of the enzymes can be converted to NAPQ1, a substance that destroys liver cells. Since alcohol is also metabolized by the same CYP2E1 enzyme, taking acetaminophen-based painkillers after drinking increases the amount of CYP2E1 in the body and the amount of NAPQ1 production. People who drink alcohol frequently may already have increased levels of the CYP2E1 enzyme. In turn, enhanced CYP2E1 activity increases the formation of the toxic acetaminophen product. Thus, such patients must take extra care in taking acetaminophen-based painkillers.

2.Drugs That Act On The Central Nervous System

Drugs such as sedatives, sleeping pills, and anesthetics that act on the central nervous system when taken with alcohol may lead to life-threatening side effects such as shortness of breath and hypoxia. For example, phenobarbital activates some of the same molecules in the CNS as does alcohol, resulting in pharmacodynamic interactions between the two substances. The interaction may be synergistic, resulting in an enhanced effect of central nervous system-acting drugs. Consequently, alcohol consumption while taking phenobarbital synergistically enhances the medication’s sedative side effects. This can increase dizziness, drowsiness and lead to decreased driving skills.

Antihistamines are available both by prescription and OTC(Over The Counter drugs) and are used in the management of allergies and colds. Through pharmacodynamic interactions, alcohol may substantially increase the sedating effects of these drugs and may cause increased drowsiness and sedation. The risk of walking accidents and falls may increase.

4.Antibiotics

Antibiotics such as metronidazole and linezolid can have various side effects when taken with alcohol. For example, ketoconazol, which is used as an antibiotic for treating fungal infections, can cause side effects such as nausea, vomiting, abdominal cramps, headaches, redness and liver damage. This is because alcohol prevents the decomposition of drugs in the liver. The drug remains in the form of acetaldehyde, a toxic substance of the drug, which eventually causes serious liver damage.

Drugs that do not cause serious Harm with alcohol

Contrary to the common belief that “Drugs should not be taken with alcohol”, there are some drugs that do not cause a big problem even if taken together with alcohol. For example, alcohol does not directly affect the effects of contraceptives, so contraceptive pills and alcohol are generally safe to use together. However, hormones contained in contraceptives affect alcohol reactions, so you may become drunk faster. Also, antibiotics that are not metronidazole and linezolid do not interact with alcohol. Moderate alcohol consumption probably does not interfere with antibiotic effectiveness.

Non-steroidal anti-inflammatory drugs (NSAIDs), Aleve, ibuprofen and aspirin can be used as alternatives to Tylenol. These drugs are generally safe to use with alcohol, but may cause gastrointestinal pain or even bleeding. Ultimately, you should always consult your doctor before using drugs at the same time as alcohol.

Conclusion

Not drinking alcohol at all is the best way to reduce side effects. However, if you must drink alcohol with medicine, avoid drinking within 30 minutes to 2 hours after taking the medicine. Most drugs show the highest blood concentration during this time. Due to the high blood concentration of the drug, the risk of side effects increases. If possible, you should take the medicine at least 8 hours before or after drinking. It is also recommended to drink less than two cups of alcohol. When taking either prescription or OTC medications, you should always read the product’s warning labels to determine whether alcohol may interfere with the desired therapeutic actions of the medication. B