What Happens If You Mix Phentermine and Alcohol?

When it comes to losing weight, there are all types of solutions out there. And while it’s not for everyone, medication can help. Among the many options, phentermine (known by the brand name Adipex) is a favorite for some thanks to its powerful hunger-blocking cues. That muffin in the bakery shop window? No longer enticing. Extra helping of mashed potatoes at Thanksgiving? No thanks.

But what about that glass of wine? Can you drink on phentermine? What are the dangers of combining Adipex and alcohol? Let’s find out!

What Is Phentermine?

Phentermine acts like a sort of neurological amp, increasing the signals of fullness in the brain and dialing down the hunger cues. 

According to Drugbank.com, phentermine came onto the scene in 1959 as an anti-obesity drug and became widely used in the ‘60s and beyond. If the “phen” part brings back the memory of lawsuits and long-term health effects, there’s a reason: originally, phentermine was part of a combo that also included fenfluramine and dexfenfluramine. The notorious “fen-phen” did, indeed, cause serious heart damage and was discontinued after creating a media stir in the ‘90s. Phentermine eventually came back onto the scene, making a solo re-entrance in 2012.

What’s the Science Behind Phentermine?

Phentermine works by causing a release of norepinephrine. This neurotransmitter is known for its role in the fight-or-flight response, which evolved to help us drop everything and jump into necessary action. (With a buffalo chasing us, who has time to finish carving that pineapple?!)

In addition to triggering norepinephrine, phentermine also boosts our dopamine levels. This neurotransmitter is part of the so-called “reward pathway” and is in charge of motivating us to do things that feel good. (So, in addition to getting the boost of alertness we feel from the norepinephrine surge, we also get a motivation kick and feel eager to run from that metaphorical buffalo.)

Is Phentermine Safe?

For those with lingering doubts about phentermine’s safety — yes, it is. Kind of. Needless to say, phentermine is not a “forever” solution and is only prescribed when the dangers of excessive weight outweigh the potential strain on our body if we use it for a longer period of time than recommended. 

That said, we should be vigilant and tell our doctor about anything else we’re taking in order to avoid potentially dangerous interactions. For example, phentermine doesn’t mix well with many antidepressants and shouldn’t be taken by anyone with a heart condition as it can increase blood pressure. Pregnant women and folks over the age of 65 should also avoid this medication. It can be habit forming because its stimulant properties and dopamine-boosting effect can have a mood-altering effect for some of us who are particularly sensitive to psychoactive substances.

Finally, phentermine works best if it’s combined with a diet and exercise program to create a solid foundation for sustainable weight loss. As much as some of us would like to have a “magic pill” to shed pounds for good, it simply doesn’t exist.

Can You Drink Alcohol While Taking Phentermine?

Drinking on phentermine is not a good idea for several reasons. Let’s dig deeper and find out why.

Heart Trouble 

Phentermine doesn’t just decrease our appetite — it also increases our heart rate and blood pressure. (Remember about norepinephrine and running from the buffalo? In addition to putting our hunger cues on hold, a situation that demands our energy in an instant also calls for a cardiovascular spike to give our muscles and sensory organs all the resources we’ve got)

At the same time, alcohol itself isn’t as heart-friendly as the media sometimes leads us to believe. (Many of the “heart benefits” in wine, for instance, come from antioxidants that are easily found in grapes or pomegranate — without the dangerous add-ons of booze.) In fact, alcohol can cause heart palpitations and sometimes lead to the so-called “holiday heart syndrome” if we overdo it. Alcohol also tends to lower our blood pressure at first due to vasodilation before leading to a rebound spike later on. (For more information, check out “How Does Alcohol Affect the Heart?”)

The combination of alcohol and phentermine can lead to dangerous cardiovascular side effects, such as blood pressure fluctuations and increased heart rate. Since both substances alone are hard on the heart, combining them ups the risk even more.

The Stimulant-Depressant Seesaw

Moreover, mixing stimulants (such as phentermine) and depressants (alcohol) can cause unpredictable cognitive effects. In addition to taxing our cardiovascular system, the combination can lead to neurological effects such as memory glitches, disruptions in normal thinking and decision-making processes, and increased drug-seeking behavior. (To learn more, take a look at “The Side Effects of Mixing Alcohol and Caffeine.”)

The Dehydration Dilemma

Both alcohol and phentermine can lead to dehydration. According to NIAAA, alcohol suppresses vasopressin, a hormone that tells the kidneys to hold on to fluids. The result? Those incessant trips to the bathroom throughout the evening (and night) and a nasty hangover headache the morning after. (For an in-depth look, check out “Breaking the Seal: Why Does Alcohol Make You Pee So Much?”)

Phentermine is known to cause dehydration and dry mouth as well, so combining it with alcohol can leave us feeling extra parched.

Phentermine and Alcohol: Long-Term Risks

Over time, combining phentermine with alcohol can lead to more serious problems.

Weight in Limbo: A Counterproductive Combo

Combining alcohol and phentermine is counterproductive in the long run. Why? If our goal is to lose weight, alcohol is not our friend. Let’s take a deeper look.

• Filling up on empty calories. First and foremost, alcoholic drinks tend to be a diet disaster. One margarita packs about 168 calories, while a piña colada is a veritable diet disaster with as many as 526 calories.
• Revving up hunger hormones. Alcohol stimulates ghrelin — the hunger hormone that drives us toward that late-night slice of pizza (or three). It also suppresses the satiety hormone, leptin — a double whammy, as far as our diet plans are concerned.
• Hitting the metabolism brakes. Because the body sees alcohol as a poison, it prioritizes its metabolism above everything else. The result? The liver puts other metabolic processes on hold, making it more likely that anything else we eat will get stored as fat. This shift leads to an initial drop in blood sugar levels, followed by a rebound spike as the body struggles to process sugar. In the long term, heavy drinking can even lead to alcohol-related diabetes.

Want more information? Check out “The Link Between Alcohol and Unwanted Weight Gain.”

Potential for Dependence: Phentermine and Alcohol Misuse

Finally, there’s a slippery slope when relying on substances for mood regulation or weight loss, leading to potential dependence or misuse. Remember dopamine, the reward neurotransmitter? Both alcohol and phentermine boost dopamine levels in a way that leads to a higher surge of motivation and pleasure than our brain is naturally designed for. 

This is another reason why phentermine shouldn’t be used on a long-term basis: the brain gets used to a “free” boost of dopamine on demand and starts “demanding” more, sometimes with devastating effects such as dependence, overdose, and the possibility of transfer addictions. We’re likely to start using the substance that’s causing the dopamine rush just to feel normal, and we might even increase our dose over time. This potential for dependence is something to keep in mind when considering phentermine as a treatment option, especially if we have a history of substance misuse, including alcohol. It’s crucial to be honest with our healthcare provider about this part of our history to avoid serious problems down the road.

While both phentermine and alcohol alone can lead to dependence, combining the two ups our risk even more. With dopamine flooding our brain from two sources, it can be that much easier to get stuck in a dangerous cycle of potential addiction and misuse.

How Long Should I Wait To Drink After Taking Phentermine?

If drinking on phentermine isn’t recommended, when is it safe? For example, you might be wondering, “If I take phentermine in the morning, can I drink at night?” 

It’s not a good idea. 

Phentermine has a half life of about 20 hours, but stays in your system for as long as 4 days. So it’s better to wait at least a few days.

Tips for a Safe Alcohol and Weight Loss Journey

Finally, here are some tips to help you along the way.

1. Steer clear of the combo. Avoid drinking while taking phentermine. In addition to preventing potentially dangerous effects, cutting back on booze will also help you on your weight loss journey!
2. Always check with your doctor. Follow the advice of your physician about how to take phentermine and what other interactions to avoid. Make sure they have a full picture of everything you’re taking, including any supplements or herbal drugs. When it comes to phentermine, it might make a difference, so it’s always best to be as thorough as possible!
3. Ask for help when you need to. If you’re having trouble with alcohol, phentermine, or the combination of both, don’t hesitate to ask for help. There are plenty of folks who’ve been in your shoes and are ready to help, as well as professionals who’ve seen it all before and know what to do. Even if you find yourself starting to misuse either substance, don’t be afraid to admit it — asking for help is a sign of strength!
4. Don’t think of phentermine as a “forever” solution. While it might help in the short term when you most need it, phentermine isn’t “forever,” so don’t get too attached. The potential side effects and risk of dependency aren’t worth it in the long run, so stick with your doctor’s recommendations when it comes to the time limit of using the medication as part of your weight management plan.
5. Nourish your body. If you can, work with a nutritionist to carve out a customized meal plan for your weight loss goals. If it’s not an option, use the many resources available online to create your plan. Make sure to include plenty of nutrient-rich fruits and vegetables, lean proteins, and omega-3 fatty acids. The goal is to lose weight slowly and consistently, creating sustainable habits.
6. Watch your sugar intake. In addition to potentially derailing your weight loss efforts, sugar increases alcohol cravings. In the long run, lowering your sugar intake is a great overall step in a healthier direction.
7. Stay active. And, of course, let’s not forget physical activity! These days there are plenty of options beyond riding the exercise bike at the gym or running laps around the track — unless that’s your thing! Don’t want to leave the house? No problem! There are lots of great exercise routines for every level on YouTube. Try Popsugar Fitness or Fitness Blender to start with — they have a bit of everything.
8. Try mindfulness. Mindfulness can work wonders for both alcohol and food cravings alike, so it can be a great tool to take your journey to the next level.
9. Get support. Finally, everything is easier with a great support team at your side, and the same is true for the alcohol and weight loss journeys alike!

With these tips, you can stay on track in your weight loss journey and make sure that alcohol doesn’t derail your efforts.

Summing Up

While changing our eating habits (with or without phentermine) and our alcohol habits alike can feel challenging, it’s important to keep the long-term goal in mind: you’re on the way to a happier and healthier version of yourself! There are bound to be ups and downs along the way, but it will be worth it. 

In the end, it’s all about perspective. Looking at weight loss (and alcohol reduction) as an active choice we’re making to improve our lives can make the road that much easier. As Linda Spangle writes in 100 Days of Weight Loss: The Secret to Being Successful on Any Diet Plan, “Starting today, instead of saying ‘I have to’ when discussing your actions or goals, substitute the words ‘I choose to’ … ‘I have to lose weight’ becomes ‘I choose to lose weight.’ Saying ‘I choose to’ puts you in charge and affirms that you want to see results.”