Why You Should Avoid Alcohol on Antibiotics

Thank goodness for modern medicine! Just a few days of antibiotics can wipe out uncomfortable or painful illnesses or infections. And these drugs generally have few (or mild) side effects.

You may feel like you can go about your day as normal. But if your day includes unwinding with a beer or glass of wine … you’ll probably have to put that on hold while you take your medication.

“‘Can I drink alcohol when taking antibiotics?’ is a question I get several times a day,” says primary care provider Colleen Clayton, MD.

While the answer isn’t cut and dry, she advises against it.

Moderate alcohol consumption doesn’t usually reduce antibiotic effectiveness or cause serious interactions (although, there are a few exceptions). But alcohol can reduce your energy and delay recovery, so it’s best to avoid alcohol while on antibiotics.

Dr. Clayton explains what you need to know.

How alcohol affects recovery

Alcohol can have many negative effects on your health, including on liver function, digestion and heart health. Frequent alcohol use can also weaken your immune system, making it easier to pick up contagious illnesses.

And if you’re already sick, alcohol can delay how fast you recover from illness.

“Dehydration and poor sleep are the main side effects of alcohol that can slow your recovery,” clarifies Dr. Clayton.

Antibiotics and alcohol interactions

Healthcare providers write over 200 million antibiotic prescriptions every year, according to the U.S. Centers for Disease Control and Prevention (CDC). That’s 6 prescriptions for every 10 people. And they prescribe a wide range of antibiotics. While these medications aren’t appropriate for every illness, they’re effective for treating certain infections.

Most antibiotics don’t interact with alcohol, but there are two major exceptions:

1. Metronidazole (Flagyl®): A common antibiotic providers use to treat vaginal infections and skin infections.
2. Tinidazole (Tindamax®): A less common antibiotic for treating parasitic infections.

Avoid alcohol completely when taking metronidazole or tinidazole, states Dr. Clayton. Combining them can cause extreme:

• Dizziness.
• Facial flushing.
• Headaches.
• Nausea and vomiting.

Similar but less severe symptoms can also occur with Bactrim®, a sulfa antibiotic that contains sulfamethoxazole and trimethoprim. Providers use Bactrim for many types of infections, including urinary tract infections, diarrhea and pneumonia.

Is one drink safe when you’re taking antibiotics?

If you’re taking metronidazole or tinidazole, one drink is not safe. Stay away from all alcohol — even the small amounts found in some mouthwashes and cold medicines.

For other antibiotics, hold off until you’re feeling better. “If you’re fighting an illness that requires an antibiotic, be kind to your body and let it heal,” advises Dr. Clayton. “But if you’re improving and near the end of your prescription, a glass of wine with dinner is probably fine.”

How long after taking antibiotics can you drink alcohol?

There’s no waiting period to drink alcohol after taking most antibiotics. But for metronidazole or tinidazole, Dr. Clayton recommends waiting at least 72 hours after your last dose before consuming any alcohol.

Does alcohol affect antibiotic effectiveness?

You may have read online that alcohol reduces the effectiveness of some antibiotics. If you’re healthy, moderate alcohol use shouldn’t affect how well an antibiotic works, notes Dr. Clayton.

Can you wait to start an antibiotic?

What if you have an important event — like a bachelorette party or high school reunion — where you may want to have a drink? In most cases, Dr. Clayton says you should get nonalcoholic beverages instead (mocktails, anyone?), as you shouldn’t put off starting your antibiotic.

“But something like bacterial vaginosis, which I commonly treat with metronidazole, isn’t urgent,” he adds. “I tell patients they can start their antibiotic after the weekend if their symptoms aren’t too bothersome.”

Should you follow the alcohol warnings from the pharmacy?

Every prescription comes with a package insert that includes instructions for use and precautions. A 2020 study found the alcohol warnings for antibiotics on these inserts aren’t always the same.

One problem is there’s little scientific evidence regarding alcohol use with antibiotics. The recommendations are open to interpretation (often based on personal experience, observation and general knowledge of how alcohol and antibiotics act in the body).

“That’s why it’s always a good idea to talk to your provider about whether alcohol use is OK when taking antibiotics,” says Dr. Clayton. “They know you best and can help you understand the risks and what they mean for you.”