Many of us are familiar with the way alcohol can lower inhibitions and lead to behaviors we might not engage in otherwise. What might be less known is the potential danger of combining certain medications with alcohol.
Mixing alcohol with medications, be they prescription or over-the-counter, can intensify the effects and pose risks. The interaction between alcohol and medicines can lead to increased alcohol effects or heightened medication side effects and sometimes entirely new side effects.
How Alcohol and Medications Interact
The delicate balance of excitation and inhibition in our brains is regulated by various chemicals. Alcohol tends to decrease inhibition in the brain, creating a sense of relaxation.
Excessive alcohol consumption may result in impaired muscle coordination, slurred speech, dizziness, memory lapses, and even sleepiness. Medications can influence or magnify these effects when combined with alcohol. Alcohol may interfere with a medicine’s functionality in the body or affect its absorption in the stomach. When a medication shares similar side effects with alcohol intoxication, combining the two can exacerbate those effects.
Not all heightened effects need to mimic those of alcohol. For instance, combining alcohol with certain ADHD medicines can create an entirely new risk – by amplifying impacts on the heart, thereby increasing the risk of a heart attack. Pairing alcohol with ibuprofen may elevate the risk of stomach upsets and bleeding. Alcohol can accelerate the breakdown of certain medicines, like opioids, cannabis, anti-seizure medications, making these medications less effective or effective for shorter periods.
Furthermore, alcohol can alter the breakdown pathway of a medicine, potentially generating toxic chemicals that lead to severe liver complications. This is particularly relevant in the case of medications like paracetamol.
At its most extreme, the consequences of mixing alcohol and medications can be fatal. Combining brain-acting medications with alcohol may impair driving or operating heavy machinery, leading to serious accidents. It’s crucial to be aware of these risks and consult healthcare professionals for guidance on medication use while consuming alcohol.
Individuals at Highest Risk
Not everyone faces the same risks when combining alcohol with medication, as the effects can vary. Individuals most susceptible to interactions include older people, women, and those with smaller body sizes.
Older individuals typically metabolise medications more slowly than younger counterparts, often being on multiple medications simultaneously. Additionally, older people tend to be more sensitive to medications affecting the brain, experiencing heightened side effects like dizziness, which can lead to an increased risk of falls.
Women and individuals with smaller body sizes may have a higher blood alcohol concentration when consuming the same amount of alcohol as someone larger. This is due to having less water in their bodies to dilute the alcohol.
Which medications should not be mixed with alcohol?
Medications that should not be mixed with alcohol often carry prominent warnings on their packaging, and pharmacists usually provide counseling when dispensing prescriptions.
Common prescription medicines that interact with alcohol include benzodiazepines (for anxiety, insomnia, or seizures), opioids for pain, antidepressants, antipsychotics, and certain antibiotics like metronidazole and tinidazole. Over-the-counter medicines, such as those for sleeping, travel sickness, cold and flu, allergies, and pain, can also pose risks when combined with alcohol.
Before consuming alcohol while taking any medication, whether prescription or over-the-counter, it is essential to check the packaging for warnings and seek advice from pharmacists. If there is a desire to drink alcohol while on medication, consulting with a doctor or pharmacist beforehand is strongly recommended.
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