Can You Drink on Metronidazole?
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It’s a common story: you go to a doctor, walk away with a prescription for your condition, then drive to your local pharmacy to pick it up. You’re excited, thinking how much better you’ll feel soon. You take it out of the crinkly paper bag, tear off what seems like an entire stack of papers with information in tiny print stapled onto it, and glance at it before tossing it into the recycling bin. Then something on the orange bottle catches your eye — that little wine glass with a line across it: “Don’t consume with alcohol!”
Yikes. It’s too late to get all those papers back to find out why, so you take your questions to Google: “Can you drink on metronidazole?” It’s probably not that bad, right? What’s all this about the disulfiram-like reaction between metronidazole and booze? Before you give yourself a panic attack searching for things like “Can metronidazole and alcohol kill you?” let’s get the facts straight. What exactly happens if you accidentally drink alcohol while taking metronidazole?
According to the National Library of Medicine, metronidazole (better known by the brand name Flagyl) is one of the go-to drugs for the treatment of infections. It’s equipped to handle several conditions:
That’s quite a long job description! And there’s even more. Topical metronidazole can treat a few gnarly infections, such as rosacea and bacterial vaginosis. Plus, it has several off-label uses:
Flagyl works by attacking bacterial DNA through a four-step process. Here’s the gist:
While metronidazole is quickly absorbed, it might take a couple of days to start feeling better. However, once it gets going, the medication does a powerful job of clearing out the infection.
In general, Flagyl doesn’t mix well with other substances, including alcohol. This isn’t all that surprising — for one thing, alcohol tends to intensify the side effects of many medications. In the case of metronidazole, there are quite a few:
In addition to these common side effects, there are some potentially serious (but rare) side effects of metronidazole that don’t mix well with booze:
If you’re taking disulfiram — a medication used to treat alcohol use disorder (AUD) — there’s yet another reason to pause and reconsider before taking metronidazole.
Disulfiram works by causing extremely unpleasant side effects, such as facial flushing, nausea, and cardiovascular abnormalities. The idea is that taking disulfiram will make drinking so unenjoyable we won’t want to do it anymore. (For more details, check out our blog “How Does Disulfiram Work?”)
What does any of this have to do with Flagyl? As it turns out, metronidazole has a negative, and potentially dangerous, interaction with both alcohol and disulfiram.
Let’s look at both effects in a bit more detail:
Some scientists now think that the side effects of mixing metronidazole and alcohol are a myth.
According to an Emergency Medical News article, doctors have been warning patients against mixing the two for years to avoid a “disulfiram-like reaction.” And yet, the author asks:
“If this interaction is so important, where were the cases? Millions of prescriptions for metronidazole are written each year. Despite clear warnings, it's inevitable that a significant number of patients would continue to consume alcohol with the drug. Yet I've never seen a patient come in with a disulfiram-like reaction from that combination. Is the metronidazole-ethanol drug interaction really a thing?”
The author goes on to explain how the accumulation of acetaldehyde is responsible for the disulfiram reaction and how the “original thinking” was that metronidazole also blocked its breakdown. However, as he points out, recent evidence shows that this might not be the case. When 18 patients who were on metronidazole were compared with a control group who had a similar blood alcohol concentration, none seemed to show any signs of a disulfiram-like reaction.
Likewise, a study in WMJ set out to investigate whether or not there was any truth to the disulfiram-like reaction claims and found that the answer isn’t as clear as scientists once thought. Their findings suggest that there’s no increase in acetaldehyde when both substances are present in our system.
Still, disulfiram-like reaction or not, metronidazole does interact with alcohol in potentially problematic ways, so the recommended wait period is at least two weeks for disulfiram and three days for alcohol after taking it.
Some of us might be thinking, “Oh no! What if I already had a drink before that warning label on the medicine package caught my eye?”
First of all, don’t panic. This probably happens quite often, and usually leads to no harmful effects, according to the Emergency Medical News study. However, it’s good to keep in mind that this is just one study arguing against the negative effects, and even if the “metronidazole and alcohol myth” is responsible for the alcohol warning, there are still other reasons why Flagyl and alcohol are not a good mix.
So, can metronidazole and alcohol kill you? It almost certainly won’t, especially given the evidence that there might not be a disulfiram-like reaction at play after all.
Still, it’s best to stay vigilant and avoid mixing metronidazole and alcohol. And if there’s any doubt in your mind at all that you’re having a dangerous reaction, please don’t hesitate to call your doctor immediately! There are many individual factors at play here, so erring on the side of safety is key.
So, how can we stay safe while taking metronidazole as we’re trying to stay away from booze for the time being (or, perhaps, for even longer)? Here are a few ideas:
In the end, as with any situation that compels us to set alcohol aside for a bit, it’s always best to see the situation as an opportunity. Perhaps it’s even a blessing in disguise! Who knows, by going booze-free for a few days or weeks, you might discover new activities you love or find that you enjoy waking up feeling refreshed. Maybe your skin looks better or maybe you’ve even dropped some weight. All in all, you might see that cutting back is something you want to continue in the long run to see what new benefits are waiting for you (and trust us, there are lots!). If so, Reframe is here to help you and cheer you on every step of the way.
1. What is metronidazole, and what infections does it treat?
Metronidazole is an antibiotic and antiprotozoal medication used to treat a wide range of infections. It's effective against anaerobic bacterial infections, protozoal infections, and microaerophilic bacterial infections, among others.
2. Can you drink on metronidazole?
No, you should not drink alcohol while taking metronidazole. Doing so can intensify side effects, such as headaches, nausea, vomiting, and a metallic taste in the mouth. More seriously, it can cause a disulfiram-like reaction, leading to severe nausea, vomiting, and cardiovascular issues.
3. Is there any truth to the metronidazole and alcohol interaction myth?
Recent studies and articles suggest that the disulfiram-like reaction between metronidazole and alcohol may not be as common or severe as previously thought. Investigations have shown that many patients do not experience significant adverse reactions from mixing the two. However, it’s still best to be careful!
4. How long should I wait to drink alcohol after taking metronidazole?
It's recommended to wait at least three days after finishing your course of metronidazole before drinking.
5. What should I do if I accidentally drink alcohol while taking metronidazole?
If you accidentally drink on metronidazole, don't panic. Most people will not experience severe effects from a single incident. However, monitor yourself for any adverse reactions, such as nausea, vomiting, or severe headaches, and seek medical advice if you're concerned or if symptoms persist. It's always better to err on the side of caution and discuss any concerns with your healthcare provider.
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