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Mixing With Other

Mixing Alcohol with other drugs--prescription and non prescription--can have complicated, and at times dangerous . Alcohol is a literally hundreds of can lead to alcohol (also called ) interactions, it is important to review your with your pharmacist or other care provider to check for clinically significant -alcohol reactions. Even though some research suggests that moderate alcohol consumption is healthy, certain medications and alcohol have the capacity to interfere with your successful treatment The danger is real. Mixing alcohol with certain medications can cause and , , drowsiness, fainting, or loss of coordination. It also can put you at risk for internal bleeding, heart problems, and difficulties in . In addition to these dangers, alcohol can make a less effective or even useless, or it may make the medication harmful or toxic to your body.

Some medicines that you might never have suspected can react with alcohol, including many medications which can be purchased “over- the-counter”—that is, without a prescription. Even some herbal remedies can have harmful effects when combined with alcoho Check with You Doctor and/or Pharmacist. 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.

Medication Some possible Medication (Generic Symptom/Disorders (Brand reactions with name) name) alcohol

Allergies/Colds/Flu • Alavert® Drowsiness, ; increased risk for overdose • Atarax®

®

• Clarinex®

• Claritin®, Loratadine Claritin-D®

• Dimetapp® Cold &

• Sudafed® Chlorpheniramine Sinus & Allergy

• Triaminic® Chlorpheniramine Cold & Allergy

® Chlorpheniramine Allergy Sinus

• Tylenol® Cold Chlorpheniramine & Flu

• Zyrtec®

Angina (), • Isordil® Isosorbide Rapid heartbeat, coronary heart Nitroglycerin sudden changes in pressure, dizziness, fainting

Anxiety and • Ativan® Drowsiness, dizziness; increased risk for overdose; • BuSpar® Medication Some possible Medication (Generic Symptom/Disorders (Brand reactions with name) name) alcohol

• Klonopin® slowed or difficulty breathing; impaired ; • Librium® unusual behavior; problems • Paxil®

• Valium®

• Xanax®

• Herbal damage, preparations drowsiness ( Kava)

Arthritis • Celebrex® Ulcers, bleeding, liver damage • Naprosyn®

• Voltaren®

Attention and • ® /dextro- Dizziness, concentration amphetamine drowsiness, impaired (Attention concentration deficit/hyperactivity (, disorder) • Concerta®, Methylphenidate ); Ritalin® possible increased risk for heart problems • Dexedrine® (amphetamine, dextroamphetamine, • Focalin® Dexmethylphenidate ); liver damage () • Strattera® Atomoxetine

• Vyvanse® Lisdexamfetamine

Blood clots • Coumadin® Occasional drinking may lead to internal bleeding; heavier drinking also may cause bleeding or may have the opposite effect, resulting in possible blood clots, , or heart attacks

Cough • Delsym®, Dextromethorpan Drowsiness, Robitussin dizziness; increased ® risk for overdose

• Robitussin A– +

Depression • Abilify® Aripriprazone Drowsiness, dizziness; increased risk for overdose; • Anafranil® increased feelings of or hopelessness (all • Celexa® Medication Some possible Medication (Generic Symptom/Disorders (Brand reactions with name) name) alcohol

• Clozaril® medications); impaired motor control (, • Cymbalta® ); increased alcohol effect (); • Desyrel® liver damage (duloxetine) • Effexor®

• Elavil® inhibitors (MAOIs), such as • Geodon® and , when combined with • Invega® alcohol, may result in serious heart-related • Lexapro® side effects. Risk for dangerously high is • Luvox® increased when MAOIs are mixed with , a • Nardil® Phenelzine byproduct found in and red • Norpramin®

• Pamate® Tranylcypromine

• Paxil® Paroxetine

• Pristiq® Desevenlafaxine

• Prozac®

• Remeron® Mirtazapine

• Risperdal®

• Seroquel® Quetiapine

• Serzone®

• Symbyax® Fluoxetine/

• Wellbutrin® Bupropion

• Zoloft®

• Zyprexa® Olanzapine

• Herbal preparations (St. John’s Wort)

Diabetes • Diabinese® Abnormally low blood levels, reaction • Glucotrol® Medication Some possible Medication (Generic Symptom/Disorders (Brand reactions with name) name) alcohol

• Glucophage® (nausea, vomiting, , rapid heartbeat, sudden • Glynase®, Glyburide changes in blood DiaBeta®, pressure); symptoms Micronase® of nausea and weakness may occur (metformin) • Orinase®

• Tolinase®

Enlarged prostate • Cardura® Dizziness, light headedness, fainting

• Flomax®

• Hytrin®

• Minipress®

Heartburn, • Axid® Rapid heartbeat; , sour increased alcohol stomach effect; sudden • Reglan® changes in blood pressure (metoclopramide) • Tagamet®

• Zantac®

High blood pressure • Accupril® Dizziness, fainting, drowsiness; heart problems such as • Calan® changes in the heart’s regular heartbeat () • Capozide®

• Cardura® Doxazosin

• Catapres®

• Cozaar®

• Hytrin® Terazosin

• Lopressor® Hydrochlorothiazide HCT

• Lotensin® Benzapril

• Minipress® Prazosin

• Norvasc® mesylate

• Prinivil®, Zestril®

• Vaseretic®

High • Advicor® + Medication Some possible Medication (Generic Symptom/Disorders (Brand reactions with name) name) alcohol

• Altocor® Lovastatin

• Crestor® Rosuvastatin

• Lipitor®

• Mevacor® Lovastatin Liver damage (all medications); increased flushing • Niaspan® Niacin and itching (niacin), increased stomach • Pravachol® Pravastatin bleeding (pravastatin + )

• Pravigard™ Pravastatin + Aspirin

• Vytorin™ +

• Zocor® Simvastatin

Infections • Acrodantin® Nitrofurantoin Fast heartbeat, sudden changes in blood pressure; • Flagyl® stomach pain, upset stomach, vomiting, headache, or flushing • Grisactin® or redness of the face; liver damage • Nizoral® (, ketoconazole)

• Nydrazid® Isoniazid

• Seromycin®

• Tindamax® Tinidazole

• Zithromax® Azithromycin

Mood stabilizers • Depakene®, Valproic acid Drowsiness, Depakote® dizziness; ; increased risk for side effects, such as • Eskalith®, restlessness, impaired Eskalith®CR, motor control; loss of Lithobid appetite; stomach upset; irregular bowel movement; joint or muscle pain; depression; liver damage (valproic acid)

Muscle pain • Flexeril® Drowsiness, dizziness; increased risk of ; • Soma® increased risk for overdose; slowed or difficulty breathing; impaired motor control; unusual behavior; memory problems Medication Some possible Medication (Generic Symptom/Disorders (Brand reactions with name) name) alcohol

Nausea, motion • Antivert® Drowsiness, sickness dizziness; increased risk for overdose • Dramamine®

• Phenergan®

Pain (such as muscle • Advil® Stomach upset, ache, minor arthritis bleeding and ulcers; pain), , liver damage inflammation • Aleve® Naproxen (acetaminophen); rapid heartbeat • Excedrin® Aspirin, Acetaminophen

• Motrin® Ibuprofen

• Tylenol® Acetaminophen

Seizures • Dilantin® Drowsiness, dizziness; increased risk of seizures • Horizant®, (, Neurontin® phenytoin); unusual behavior and changes in mental health • Keppra® Levetiracetam (such as thoughts of ) () • Klonopin® Clonazepam

Phenobarbital

• Lamictal®

• Lyrica®

• Tegretol®

• Topamax® Topiramate

• Trileptal®

Barbiturates

Severe pain from • Darvocet–N® Propoxyphene Drowsiness, , postsurgical dizziness; increased care, oral surgery, risk for overdose; • Demerol® Merepidine slowed or difficulty breathing; impaired motor control; • Fiorinal® with + codeine unusual behavior; codeine memory problems

• Percocet®

• Vicodin®

Sleep problems • Ambien® Drowsiness, sleepiness, dizziness; slowed or difficulty • Lunesta™ Medication Some possible Medication (Generic Symptom/Disorders (Brand reactions with name) name) alcohol

• Prosom™ breathing; impaired motor control; unusual behavior; • Restoril® memory problems

® Diphenhydramine

• Unisom®

• Herbal Increased drowsiness preparations (, , lavender)

Commonly Used Medicines (Both Prescription and Over-the-Counter) That Interact With Alcohol

Additional Resources

MedlinePlus A service of the U.S. National Library of and the National Institutes of Health. http://www.nlm.nih.gov/medlineplus/druginformation.html

Provides information on prescription and over-the-counter medications.

National Institute on and http://www.niaaa.nih.gov Phone number: 301–443–3860

Makes available free informational materials on alcohol use, alcohol abuse, and alcoholism.

U.S. Food and Drug Administration Center for Drug Evaluation and Research: http://www.fda.gov/cder

Drug Interactions: http://www.fda.gov/drugs/resourcesforyou/ucm163354.htm

Source: National institute on Alcohol Abuse and Alcoholism. https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/harmful-interactions-mixing-alcohol-with-medicines , retrieved and updated July 31, 2020

More Information about mixing alcohol and other drugs can be found at: https://www.drugs.com/article/medications-and-alcohol.html (Drugs.com)