How do alcoholic drinks affect the body?
The basis of any such drink is ethanol. The difference lies in its content. For example, there is 10 times more of it in vodka than in beer. Drinking alcohol in large quantities has a negative effect on the body. No more than a tenth of the volume of ingested ethanol is excreted in the urine and then, the remaining 90% is broken down and absorbed.
Ethanol harms cell membrane lipids. Their viscosity decreases, and the receptors become insufficiently sensitive to the necessary mediators. To prevent this effect, the stomach tries to neutralize ethanol. To do this, the mucous membrane produces much more mucus than in normal digestive mode. On the one hand, this slows down the absorption of the unwanted substance, on the other hand, it causes irritation of the mucous membrane and inhibits the absorption of nutrients and other drugs.
A complex of pathologies called alcoholic liver disease cannot be excluded. When ethanol is abused, cellular degeneration develops, interfering with the normal functioning of the organ.
How do antibiotics affect the body?
It is not without reason that drugs in this group are taken only as prescribed by a doctor. The principle of their action is to destroy or suppress the growth of bacteria, all of them (both beneficial and harmful).
They attack:
• Cellular synthesis apparatus. This prevents bacteria from building protective peptide walls.
• DNA gyrase. This prevents the replication of genetic information and inhibits the proliferation of pathogenic microorganisms.
• Protein biosynthesis apparatus (ribosomes) - without it, bacteria die.
Modern pharmacology is trying to make antibiotics more selective. But their use leads to an imbalance of microflora. Beneficial bacteria, which form a kind of shield in the intestines, also suffer. Therefore, only a specialist can compare the effect of treatment with possible losses. Also, a number of antibacterial drugs have the property of hepatotoxicity. They damage liver cells, causing cholestasis (impaired bile flow) or necrosis (tissue death).
Can I drink alcohol while taking antibiotics?
We have found that alcohol and antibiotics have a hepatotoxic effect. It turns out that if you combine them, the attack on liver cells will intensify many times over. This is the first reason why you should not drink alcohol during antibacterial therapy. But there are others.
A small portion of beer or wine will not destroy the liver. However, it is sufficient to activate the protective reaction of the gastric mucosa. Medicines will not be properly absorbed under such conditions. When antibiotics interact even with weak alcohol, the effect of antibacterial therapy will be minimal, if not zero. Therefore, it is better not to allow such a combination.
Consequences of taking antibiotics and alcohol at the same time
In most cases, alcohol does not affect the effectiveness of antibiotics. However, some combinations may cause unpleasant side effects. Ethyl alcohol is broken down in the liver by special enzymes. Some antibacterial drugs are metabolized by similar enzymes. The liver of people who drink alcohol too often cannot metabolize antibiotics. At best, the drug becomes ineffective, at worst, the liver cells are destroyed.
Disulfiram-like reaction is one of the most common side effects of simultaneous use of alcohol and antibiotics. The patient complains of the following complications:
- nausea and vomiting;
- skin redness;
- stomach cramps;
- colic;
- headache;
- cardiopalmus;
- labored breathing;
- tremor.
Symptoms of the antabuse effect (the second name of the pathology) occur within 15-30 minutes after ethanol and medications enter the body. The intensity of the pain increases over several hours and reaches its peak after 8-12 hours. The danger of a disulfiram-like reaction is that unpleasant symptoms can occur even 1.5-2 weeks after quitting alcohol. The antabuse effect can be fatal. It is extremely important to seek professional medical help when the first symptoms develop. Even weak alcohol can cause complications.
Ethanol depresses the central nervous system. Medicines containing metronidazole also impair nerve conduction. The combination of the two components leads to:
- drowsiness;
- depression and confusion;
- dizziness;
- motor retardation.
The additive effect is especially dangerous for older people, drivers, and knowledge workers.
The consequences of mixing alcohol with antibacterial drugs directly depend on individual factors. For example, women experience side effects much more often than men. Due to metabolic rate disturbances, older people do not tolerate disulfiram-like reactions well and suffer from complications longer. Patients who take antidepressants, opioid painkillers, muscle relaxants, and anticonvulsants do not tolerate the simultaneous use of antibiotics and alcoholic beverages.
Which antibiotics are best not to combine with alcohol?
Antibacterial drugs form a fairly large pharmacological group. The drugs included in it have varying degrees of activity. Therefore, the use of some together with alcohol is undesirable, while others are not prohibited.
The first include antibiotics that have a high hepatotoxic effect:
• amoxicillin;
• flucloxacillin;
• erythromycin;
• sulfamethoxazole;
• gatifloxacin.
There are different points of view on the interaction of ethanol with tetracyclines. Some believe that with this combination the medicine is neutralized, others believe that it enhances the negative effect on the liver.
Some antibacterial drugs should not be taken with alcohol due to possible side effects. This is especially true for metronidazole.
Long-term use of antibiotics and alcohol
At the same time, it is important to understand that with long-term use, many antibiotics, including erythromycin, rifampicin, tetracyclines, sulfonamides, nitrofurans and lincomycin accumulate in high concentrations in the bile and over time can lead to toxic damage to the liver. Being the main detoxifying organ, it itself is the first to suffer from the side effects of medications. And although such phenomena as cholestatic hepatitis and even fatty infiltration of liver cells are usually temporary, you should not add extremes to this important organ, which will have to work with double load if you need to metabilize both drugs and alcohol.
Quitting alcohol is the best option for most drugs.
Another argument in favor of avoiding alcohol during antibiotic treatment is the ability of ethanol to cause dehydration and slow down the overall healing process.
Consequences of drinking alcohol with antibiotics
If a person does not abuse alcohol, he will not feel any effect on the liver from a single combination of an antibiotic and ethanol. However, reactions may follow from other systems:
• Digestive. Stomach pain is due to irritation of the mucous membrane, and excess mucus secretion can cause diarrhea.
• Nervous. Antibiotics themselves have a detrimental effect on neurons. When interacting with ethanol, which excites the nervous system, convulsions are possible.
• Cardiovascular. Fluoroquinolones increase the risk of impaired blood flow, which increases stress on the heart. And every additional portion of beer or wine (not to mention stronger drinks) multiplies this load.
Allergy sufferers are generally prohibited from mixing any medications with alcohol, as the body's reaction can be unpredictable. Even a doctor cannot always predict the outcome.
Why shouldn't you drink alcohol while taking antibiotics?
We found that the main reasons are the danger to the liver and the possibility of side effects. But patients often ask the question: does the intensity of the drug’s action change under the influence of ethanol?
Overall it is decreasing. While the body resists the absorption of alcohol components, it unconsciously protects itself from medications. The stronger the alcoholic drink, the less likely it is that the medicine will be completely absorbed.
If you combine ethanol with metronidazole, a synergistic effect occurs. However, it concerns not the effect of the drug itself, but its side effects:
• drowsiness;
• concentration disorders;
• heart rhythm disturbances;
• nausea;
• headache.
There are also questions about a possible overdose. There is no need to be afraid of it - there is no alcohol in antibacterial drugs. Such assumptions arise due to inattentive study of the composition of drugs.
When can you drink alcohol after taking antibiotics?
A person who does not suffer from chronic diseases and has not undergone radiation or chemical therapy within the last year can drink a small portion of alcohol one day after completing antibiotic therapy. Patients taking metronidazole should avoid drinking alcohol for 48 hours after the last tablet or injection. After tinidazole therapy, alcohol is prohibited for 72 hours. Patients who suffer from cirrhosis and hepatitis are advised to avoid alcoholic beverages for at least two weeks.
Important! Dietary supplements, natural medicines, sprays and mouth rinses may also contain ethanol. It is worth consulting with your doctor regarding the advisability of simultaneously taking antibiotics and using ethanol-containing drugs.
How to avoid unwanted consequences?
The simplest solution is not to mix the substances. The course of antibacterial therapy does not last long, so you can be patient and not touch alcoholic beverages. However, a bacterial infection can strike at the most unexpected moment, for example, on the eve of a wedding or anniversary. In such a situation it is important:
• Consult your doctor about the compatibility of the prescribed drug with alcohol.
• Even in the absence of contraindications, do not abuse it - limit yourself to 1-2 glasses of a weak drink.
• If there are restrictions, do not violate them.
• Wait between the last dose of the medicine and drinking alcohol for at least two days (preferably three).
There is no need to interrupt your course of antibiotics for an alcoholic party. This will negate all achieved results and you will have to start treatment again. It turns out that during the first course of therapy the microflora suffered in vain, and with the second course it will be exposed to an unnecessary threat.
What else are antibiotics not compatible with?
However, the matter is not limited to just abstaining from alcohol while taking antibiotics. An important role is also played by what other medications a person takes and even what to wash down the medicine taken with.
So, for example, drinking a glass of milk along with an antibiotic tablet or eating a piece of cottage cheese casserole can negate all the benefits of the drug. The worst combinations with dairy products are penicillins and tetracyclines, which form stable chelate complexes with calcium. But taking erythromycin with milk is quite acceptable.
Antibiotics should not be combined with tea, coffee, lemonade, fruits and fruit juices, as well as dishes that contain vinegar.
You need to take the antibiotic strictly according to the instructions at regular intervals. If the matter is not limited to taking one drug, it is important to make sure that the drugs do not conflict with each other. A qualified doctor, of course, will not prescribe incompatible drugs, but he may not know that you are currently being treated by another specialist and are taking the pills prescribed by him.
For example, cholestyramine and enterosorbents taken simultaneously with antibiotics reduce the absorption of the latter. Taking erythromycin while taking oral contraceptives can lead to intrahepatic cholestasis, and some antibiotics can reduce the effectiveness of oral contraceptives.
Cephalosporins are dangerous to combine with thrombolytics due to the risk of bleeding, and macrolides and fluoroquinolones can enhance the toxic effect of theophylline.
Combining alcohol and a number of drugs can be fatal
