Amoxicillin and Alcohol: Is There a Problem?

“Doctor Pullen,  can I take the amoxicillin and alcohol together?  I heard that using antibiotics will prevent the antibiotic from working?”  I get more questions in the office about whether the use of antibiotics like amoxicillin and alcohol are okay to use together. I’m not sure where the concerns about the use of alcohol with antibiotics originated, but with the exception of metronidazole the use of alcohol and antibiotics is really not a major concern. I suspect that the myth that somehow alcohol reduces the effectiveness of antibiotics originated from spouses or parents trying to find an excuse to get their loved one to stop drinking.

Let’s take amoxicillin as an example. Amoxicillin is in the penicillin class of antibiotics that is essentially 100% excreted in the urine unchanged. Alcohol on the other hand is largely metabolized in the liver and so there’s no significant metabolic interaction between amoxicillin and alcohol. A potential concern with the use of alcohol and essentially any medication is that when under the influence of alcohol many patients may be less likely to remember to take their medication and compliance could potentially be reduced. Additionally in alcoholics when drinking heavily may not be getting good sleep, eating properly, and generally taking good care of themselves. These behaviors could lead to poor ability to recover from bacterial infections.

Overall the risk of alcohol and amoxicillin or any other antibiotic except metronidazole is relatively insignificant. When patients ask whether they can drink while taking their antibiotic I tell them that they need to focus on taking good care of themselves by getting rest, drinking plenty of non-alcoholic fluids and that one or two drinks is likely to affect their ability to either fight their infection or to interfere with the therapeutic benefits of the amoxicillin.

Another concern about use of some antibiotics and alcohol is that their side effects can be similar. Examples include doxycycline, erythromycin, trimethoprim-sulfamethoxazole, and the tetracycline antibiotics which can cause nausea and upset stomach, also common side effect drinking alcohol.

As mentioned above metronidazole is the major exception to antibiotics and alcohol use together. Metronidazole has an effect similar to Antabuse;  a medication used purposely to lead to sometimes severe illness symptoms when taken with alcohol. The effects with metronidazole are not as consistent or severe is with Antabuse but metronidazole and alcohol need to be avoided in combination.

So unless you have another reason to abstain feel free to have a  glass of a nice cabernet or a mug of porter while on your amoxicillin.  Just remember to take good care of yourself, and maybe add a bowl of chicken soup.

Resource: Amoxicillin side effects

Leave a reply