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Harmful Interactions Harmful Interactions mixing alcohol with medicines May cause DROWSINESS. ALCOHOL USE CARE or dangerous machinery. may intensify this effect. when operating a car Harmful interactions You’ve probably seen this warning on medicines you’ve taken. The danger is real. Mixing alcohol with certain medications can cause nausea and vomiting, headaches, drowsiness, fainting, or loss of coordination. It also can put you at risk for internal bleeding, heart problems, and difficulties in breathing. In addition to these dangers, alcohol can make a medication less effective or even useless, or it may make the medication harmful or toxic to your body. Some medicines that you might can result. The list gives the brand never have suspected can react with name by which each medicine is alcohol, including many medications commonly known (for example, which can be purchased “over-the- Benadryl®) and its generic name or counter”—that is, without a prescription. active ingredient (in Benadryl®, this Even some herbal remedies can is diphenhydramine). The list have harmful effects when combined presented here does not include all with alcohol. the medicines that may interact This pamphlet lists medications harmfully with alcohol. Most im- that can cause harm when taken with portant, the list does not include all alcohol and describes the effects that the ingredients in every medication. 1 Medications typically are safe and effective when used appropriately. Your pharmacist or other health care provider can help you determine which medications interact harmfully with alcohol. DID YOU KNOW… Mixing alcohol and medicines can be harmful. Alcohol, like some medi- cines, can make you sleepy, drowsy, or lightheaded. Drinking alcohol while taking medicines can intensify SOME MEDICINES these effects. You may have trouble CONTAIN ALCOHOL concentrating or performing me- Certain medicines contain up to 10 chanical skills. Small amounts of percent alcohol. Cough syrup and alcohol can make it dangerous to laxatives may have some of the high- drive, and when you mix alcohol with est alcohol concentrations. certain medicines you put yourself at even greater risk. Combining alcohol ALCOHOL AFFECTS with some medicines can lead to falls WOMEN DIFFERENTLY and serious injuries, especially among Women, in general, have a higher older people. risk for problems than men. When a MEDICINES MAY HAVE woman drinks, the alcohol in her MANY INGREDIENTS bloodstream typically reaches a higher level than a man’s even if both are Some medications—including many drinking the same amount. This is popular painkillers and cough, cold, and allergy remedies—contain more because women’s bodies generally than one ingredient that can react have less water than men’s bodies. Be- with alcohol. Read the label on the cause alcohol mixes with body water, medication bottle to find out exactly a given amount of alcohol is more what ingredients a medicine contains. concentrated in a woman’s body than Ask your pharmacist if you have any in a man’s. As a result, women are questions about how alcohol might more susceptible to alcohol-related interact with a drug you are taking. damage to organs such as the liver. 2 OLDER PEOPLE FACE TIMING IS IMPORTANT GREATER RISK Alcohol and medicines can interact Older people are at particularly harmfully even if they are not taken high risk for harmful alcohol– at the same time. medication interactions. Aging slows the body’s ability to break down REMEMBER... alcohol, so alcohol remains in a Mixing alcohol and medicines puts person’s system longer. Older people you at risk for dangerous reactions. also are more likely to take a Protect yourself by avoiding alcohol if medication that interacts with you are taking a medication and don’t alcohol—in fact, they often need know its effect. To learn more about to take more than one of these a medicine and whether it will inter- medications. act with alcohol, talk to your phar- macist or other health care provider. Commonly Used Medicines (Both Prescription and Over-the-Counter) That Interact With Alcohol Symptoms/ Medication Medication Some possible Disorders (Brand name) (Generic name) reactions with alcohol Allergies/ • Alavert® Loratadine Drowsiness, colds/flu • Atarax® Hydroxyzine dizziness; • Benadryl® Diphenhydramine increased risk • Clarinex® Desloratadine for overdose • Claritin®, Loratadine Claritin-D® • Dimetapp® Brompheniramine Cold & Allergy • Sudafed® Chlorpheniramine Sinus & Allergy • Triaminic® Chlorpheniramine Cold & Allergy • Tylenol® Chlorpheniramine Allergy Sinus • Tylenol® Chlorpheniramine Cold & Flu • Zyrtec® Cetirizine Angina • Isordil® Isosorbide Rapid heartbeat, (chest pain), Nitroglycerin sudden changes coronary in blood pressure, heart disease dizziness, fainting 3 Commonly Used Medicines (Both Prescription and Symptoms/ Medication Medication Some possible Disorders (Brand name) (Generic name) reactions with alcohol Anxiety • Ativan® Lorazepam Drowsiness, dizziness; and • BuSpar® Buspirone increased risk for epilepsy • Klonopin® Clonazepam overdose; slowed or • Librium® Chlordiazepoxide difficulty breathing; • Paxil® Paroxetine impaired motor control; • Valium® Diazepam unusual behavior; • Xanax® Alprazolam memory problems • Herbal preparations Liver damage, (Kava Kava) drowsiness Arthritis • Celebrex® Celecoxib Ulcers, stomach • Naprosyn® Naproxen bleeding, liver • Voltaren® Diclofenac damage Attention and • Adderall® Amphetamine/ Dizziness, drowsiness, concentration dextro-amphetamine impaired concentration (Attention • Concerta®, Methylphenidate (methylphenidate, deficit/ Ritalin® dexmethylphenidate); hyperactivity • Dexedrine® Dextroamphetamine possible increased risk disorder) • Focalin® Dexmethylphenidate for heart problems • Strattera® Atomoxetine (amphetamine, dex- • Vyvanse® Lisdexamfetamine troamphetamine, lis- dexamfetamine); liver damage (atomoxetine) Blood clots • Coumadin® Warfarin Occasional drinking may lead to internal bleeding; heavier drinking also may cause bleeding or may have the opposite effect, resulting in possible blood clots, strokes, or heart attacks Cough • Delsym®, Dextromethorpan Drowsiness, dizziness; Robitussin Cough® increased risk • Robitussin A–C® Guaifenesin + codeine for overdose 4 Over-the-Counter) That Interact With Alcohol Symptoms/ Medication Medication Some possible Disorders (Brand name) (Generic name) reactions with alcohol Depression • Abilify® Aripriprazone Drowsiness, dizziness; • Anafranil® Clomipramine increased risk for overdose; • Celexa® Citalopram increased feelings of • Clozaril® Clozapine depression or hopelessness • Cymbalta® Duloxetine (all medications); impaired • Desyrel® Trazodone motor control (quetiapine, • Effexor® Venlafaxine mirtazapine); increased • Elavil® Amitriptyline alcohol effect (bupropion); • Geodon® Ziprasidone liver damage (duloxetine) • Invega® Paliperidone • Lexapro® Escitalopram Monoamine oxidase • Luvox® Fluvoxamine inhibitors (MAOIs), • Nardil® Phenelzine such as tranylcypromine • Norpramin® Desipramine and phenelzine, when • Parnate® Tranylcypromine combined with alcohol, • Paxil® Paroxetine may result in serious heart- • Pristiq® Desevenlafaxine related side effects. Risk for • Prozac® Fluoxetine dangerously high blood • Remeron® Mirtazapine pressure is increased when • Risperdal® Risperidone MAOIs are mixed with • Seroquel® Quetiapine tyramine, a byproduct • Serzone® Nefazodone found in beer and red wine • Symbyax® Fluoxetine/Olanzapine • Wellbutrin® Bupropion • Zoloft® Sertraline • Zyprexa Olanzapine • Herbal preparations (St. John’s Wort) Diabetes • Diabinese® Chlorpropamide Abnormally low blood sugar • Glucotrol® Glipizide levels, flushing reaction • Glucophage® Metformin (nausea, vomiting, • Glynase®, Glyburide headache, rapid heartbeat, DiaBeta®, sudden changes in blood Micronase® pressure); symptoms of • Orinase® Tolbutamide nausea and weakness may • Tolinase® Tolazamide occur (metformin) Enlarged • Cardura® Doxazosin Dizziness, light prostate • Flomax® Tamsulosin headedness, fainting • Hytrin® Terazosin • Minipress® Prazosin 5 Commonly Used Medicines (Both Prescription and Symptoms/ Medication Medication Some possible Disorders (Brand name) (Generic name) reactions with alcohol Heartburn, • Axid® Nizatidine Rapid heartbeat; increased indigestion, • Reglan® Metoclopramide alcohol effect; sudden sour stomach • Tagamet® Cimetidine changes in blood pressure • Zantac® Ranitidine (metoclopramide) High blood • Accupril® Quinapril Dizziness, fainting, pressure • Calan® Verapamil drowsiness; heart • Capozide® Hydrochlorothiazide problems such as changes • Cardura® Doxazosin in the heart’s regular • Catapres® Clonidine heartbeat (arrhythmia) • Cozaar® Losartan • Hytrin® Terazosin • Lopressor® HCT Hydrochlorothiazide • Lotensin® Benzapril • Minipress® Prazosin • Norvasc® Amlodipine mesylate • Prinivil®, Lisinopril Zestril® • Vaseretic® Enalapril High • Advicor® Lovastatin + Niacin Liver damage (all cholesterol • Altocor® Lovastatin medications); increased • Crestor® Rosuvastatin flushing and itching • Lipitor® Atorvastatin (niacin), increased • Mevacor® Lovastatin stomach bleeding • Niaspan® Niacin (pravastatin + aspirin) • Pravachol® Pravastatin • Pravigard™ Pravastatin + Aspirin • Vytorin™ Ezetimibe + Simvastatin • Zocor® Simvastatin Infections • Acrodantin® Nitrofurantoin Fast heartbeat, sudden • Flagyl® Metronidazole changes in blood • Grisactin® Griseofulvin pressure; stomach pain, • Nizoral® Ketoconazole upset stomach, vomiting, • Nydrazid® Isoniazid headache, or flushing or • Seromycin® Cycloserine redness
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