Antibiotic treatment and alcohol use

There is a generally held belief that alcohol should not be consumed while on a course of oral antibiotics. This advice is correct if a patient is taking metronidazole, tinadazole (may cause a disulfiram-like reaction), and possibly oral ketoconazole (may cause facial flushing). However there is no contraindication to the consumption of alcohol with other antibiotics.

Patient Advice (3)

When to avoid drinking alcohol completely

• completely avoid drinking alcohol when taking:
  • metronidazole - an antibiotic sometimes used to clear dental, or vaginal, infections, or to clear infected leg ulcers, or pressure sores
  • tinidazole - an antibiotic sometimes used to treat many of the same infections as metronidazole, as well as to help clear bacteria called Helicobacter pylori (H pylori) from the gut.

Other antibiotics that can interact with alcohol

There are some antibiotics that can sometimes interact with alcohol, so you should be wary of drinking alcohol if you are taking:

• co-trimoxazole - drinking alcohol while taking co-trimoxazole can occasionally cause a similar reaction to that of metronidazole or tinidazole, although this is very rare. Drinking alcohol in moderation does not normally cause a problem
• linezolid - linezolid can interact with un-distilled (fermented) alcoholic drinks, such as wine, beer, sherry and lager
• doxycycline - this is known to interact with alcohol and in people with a history of chronic alcohol consumption the effectiveness of doxyclycline may be reduced. It should not be taken by people with liver problems
• erythromycin - there is some evidence or a minor interaction with alcohol that may slightly reduce or delay the effect of erythromycin

Reference:

• Drugs and Therapeutics Bulletin (1996), Drugs and alcohol: harmful cocktails?, 34 (5), 36-8.
• Penwarden J, Raynor DK (1996), Can I drink alcohol with this? Pharmacy in Practice, 6, 111.
• NHS Choices (Accessed 4/5/14). Can I drink alcohol while taking antibiotics?