May cause DROWSINESS. 

ALCOHOL

may intensify this effect. 

USE CARE

when operating a car 

or dangerous machinery. 

Mixing Alcohol 

with Medicines 

Harmful 

Interactions: 

Harmful

Interactions:

Mixing Alcohol 

with Medicines
May cause DROWSINESS. 

ALCOHOL may intensify this effect. 

USE CARE when operating a car 

or dangerous machinery. 

You’ve probably seen this warning on medicines 

you’ve taken. The danger is real. Mixing alcohol with 

certain medications can cause nausea and vomiting, 

headaches, drowsiness, fainting, or loss of coordination. 

It also can put you at risk for internal bleeding, heart 

problems, and difficulties in breathing. In addition to 

these dangers, alcohol can make a medication 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 alcohol. 

This pamphlet lists medications that can cause harm 

when taken with alcohol and describes the effects that 

can result. The list gives the brand name by which each 

medicine is commonly known (for example, Benadryl®) 

and its generic name or active ingredient (in Benadryl®, 

this is diphenhydramine). The list presented here does 

not include all the medicines that may interact harmfully with alcohol. Most important, the list does not

include all the ingredients in every medication. 

Medications are safe and effective when used 

appropriately. Your pharmacist or other health care 

provider can help you determine which medications 

interact harmfully with alcohol. 

1 
Did You Know... 

Mixing alcohol and 

medicines can be harmful. 

Alcohol, like some medicines, 

can make you sleepy, drowsy, 

or lightheaded. Drinking 

alcohol while taking medicines can intensify these 

effects. You may have trouble 

concentrating or performing 

mechanical skills. Small 

amounts of alcohol can make it dangerous to drive, and 

when you mix alcohol with certain medicines you put 

yourself at even greater risk. Combining alcohol with 

some medicines can lead to falls and serious injuries, 

especially among older people. 

Medicines may have many ingredients 

Some medications—including many popular painkillers and 

cough, cold, and allergy remedies—contain more than 

one ingredient that can react with alcohol. Read the label 

on the medication bottle to find out exactly what ingredients a medicine contains. Ask your pharmacist if you 

have any questions about how alcohol might interact with 

a drug you are taking. 

Some medicines contain alcohol 

Certain medicines contain up to 10 percent alcohol. Cough 

syrup and laxatives may have some of the highest alcohol 

concentrations. 

2 
Alcohol affects women differently 

Women, in general, have a higher risk for problems than 

men. When a woman drinks, the alcohol in her bloodstream typically reaches a higher level than a man’s even 

if both are drinking the same amount. This is because 

women’s bodies generally have less water than men’s bodies. 

Because alcohol mixes with body water, a given amount 

of alcohol is more concentrated in a woman’s body than 

in a man’s. As a result, women are more susceptible to 

alcohol-related damage to organs such as the liver. 

Older people face greater risk 

Older people are at particularly high risk for harmful alcohol– 

medication interactions. Aging slows the body’s ability to 

break down alcohol, so alcohol remains in a person’s system 

longer. Older people also are more likely to take a medication that interacts with alcohol—in fact, they often 

need to take more than one of these medications. 

Timing is important 

Alcohol and medicines can interact harmfully even if they 

are not taken at the same time. 

Remember... 

Mixing alcohol and medicines puts you at risk for dangerous reactions. Protect yourself by avoiding alcohol if 

you are taking a medication and don’t know its effect. To 

learn more about a medicine and whether it will interact 

with alcohol, talk to your pharmacist or other health 

care provider. 

3 
4
 

Commonly Used Medicines (Both Prescription and 


Symptoms/ Medication Medication Some possible 

Disorders (Brand name) (Generic name) reactions with alcohol 

Allergies/ • Alavert® Loratadine Drowsiness, 

Colds/Flu • Allegra® , Fexofenadin dizziness; 

Allegra-D® increased risk 

• Benadryl® Diphenhydramine for overdose 

• Clarinex® Desloratadine 

• Claritin® , Loratadine 

Claritin-D® 

• Dimetapp® Brompheniramine 

Cold & Allergy 

• Sudafed® Chlorpheniramine 

Sinus & Allergy 

• Triaminic® Chlorpheniramine 

Cold & Allergy 

• Tylenol® Chlorpheniramine 

Allergy Sinus 

• Tylenol® Chlorpheniramine 

Cold & Flu 

• Zyrtec® Cetirizine 

Angina • Isordil® Isosorbide Rapid heartbeat, 

(chest pain), Nitroglycerin sudden changes 

coronary in blood pressure, 

heart dizziness, fainting

disease 

Anxiety • Ativan® Lorazepam Drowsiness, 

and • Klonopin® Clonazepam dizziness; increased

epilepsy • Librium® Chlordiazepoxide risk for overdose; 

• Paxil® Paroxetine slowed or difficulty 

• Valium® Diazepam breathing; impaired 

• Xanax® Alprazolam motor control; 

unusual behavior; 

and memory 

problems 

• Herbal Liver damage,

preparations drowsiness 

(Kava Kava) 
Over-the-Counter) That Interact With Alcohol
 

Symptoms/ 

Disorders 

Medication 

(Brand name) 

Medication 

(Generic name) 

Some possible 

reactions with alcohol 

Arthritis • Celebrex® Celecoxib 

• Naprosyn® Naproxen 

• Voltaren® Diclofenac 

Blood clots • Coumadin® Warfarin 

Cough • Delsym® , Dextromethorpan 

Robitussin Cough® 

• Robitussin A–C® Guaifenesin + 

codeine 

Depression • Anafranil® Clomipramine 

• Celexa® Citalopram 

• Desyrel® Trazodone 

• Effexor® Venlafaxine 

• Elavil® Amitriptyline 

• Lexapro® Escitalopram 

• Luvox® Fluvoxamine 

• Norpramin® Desipramine 

• Paxil® Paroxetine 

• Prozac® Fluoxetine 

• Serzone® Nefazodone 

• Wellbutrin® Bupropion 

• Zoloft® Sertraline 

• Herbal 

preparations 

(St. John’s Wort) 

Ulcers, stomach 

bleeding, liver 

problems 

Occasional drinking may lead to 

internal bleeding; 

heavier drinking 

also may cause 

bleeding or may 

have the opposite 

effect, resulting in 

possible blood clots, 

strokes, or heart 

attacks 

Drowsiness, 

dizziness; 

increased risk 

for overdose 

Drowsiness, 

dizziness; increased 

risk for overdose; 

increased feelings 

of depression or 

hopelessness in 

adolescents (suicide) 

5 
6
 

Commonly Used Medicines (Both Prescription and 


Symptoms/ Medication Medication Some possible 

Disorders (Brand name) (Generic name) reactions with alcohol 

Diabetes • Glucophage® Metformin Abnormally low 

• Micronase® Glyburide blood sugar levels, 

• Orinase® Tolbutamide flushing reaction 

(nausea, vomiting, 

headache, rapid 

heartbeat, sudden 

changes in blood 

pressure) 

Enlarged • Cardura® Doxazosin Dizziness, 

prostate • Flomax® Tamsulosin light headedness, 

• Hytrin® Terazosin fainting 

• Minipress® Prazosin 

Heartburn, • Axid® Nizatidine Rapid heartbeat, 

indigestion,• Reglan® Metoclopramide sudden changes 

sour • Tagamet® Cimetidine in blood pressure 

stomach • Zantac® Ranitidine (metoclopramide); 

increased alcohol 

effect 

High blood • Accupril® Quinapril Dizziness, fainting, 

pressure • Capozide® Hydrochlorothiazide drowsiness; heart 

• Cardura® Doxazosin problems such as 

• Catapres® Clonidine changes in the 

• Cozaar® Losartan heart’s regular 

• Hytrin® Terazosin heartbeat 

• Lopressor® HCT Hydrochlorothiazide (arrhythmia) 

• Lotensin® Benzapril 

• Minipress® Prazosin 

• Vaseretic® Enalapril 
7
 

Over-the-Counter) That Interact With Alcohol
 

Symptoms/ Medication Medication Some possible 

Disorders (Brand name) (Generic name) reactions with alcohol 

High • Advicor® Lovastatin Liver damage 

cholesterol + Niacin (all medications); 

• Altocor® Lovastatin increased flushing 

• Crestor® Rosuvastatin and itching (niacin), 

• Lipitor® Atorvastatin increased stomach 

• Mevacor® Lovastatin bleeding (pravas­

• Niaspan® Niacin tatin + aspirin) 

• Pravachol® Pravastatin 

• PravigardTM Pravastatin + 

Aspirin 

• VytorinTM Ezetimibe + 

Simvastatin 

• Zocor® Simvastatin 

Infections • Acrodantin® Nitrofurantoin Fast heartbeat, 

• Flagyl® Metronidazole sudden changes in 

• Grisactin® Griseofulvin blood pressure; 

• Nizoral® Ketokonazole stomach pain, upset 

• Nydrazid® Isoniazid stomach, vomiting, 

• Seromycin® Cycloserine headache, or flushing 

• Tindamax® Tinidazole or redness of the 

face; liver damage 

(isoniazid, 

ketokonazole) 

Muscle • Flexeril® Cyclobenzaprine Drowsiness, 

pain • Soma® Carisoprodol dizziness; 

increased risk 

of seizures; 

increased risk 

for overdose; 

slowed or difficulty 

breathing; 

impaired motor 

control; unusual 

behavior; memory 

problems 
8
 

Commonly Used Medicines (Both Prescription and

Over-the-Counter) That Interact With Alcohol 

Symptoms/ Medication Medication Some possible 

Disorders (Brand name) (Generic name) reactions with alcohol 

Nausea, • Antivert® Meclizine Drowsiness, 

motion • Atarax® Hydroxyzine dizziness; increased

sickness • Dramamine® Dimenhydrinate risk for overdose 

• Phenergan® Promethazine 

Pain • Advil® Ibuprofen Stomach upset, 

(such as • Aleve® Naproxen bleeding and 

headache, • Excedrin® Aspirin, ulcers; liver damage 

muscle Acetaminophen (acetaminophen); 

ache, • Motrin® Ibuprofen rapid heartbeat 

minor • Tylenol® Acetaminophen 

arthritis 

pain), fever, 

inflammation 

Seizures • Dilantin® Phenytoin Drowsiness, 

• Klonopin® Clonazepam dizziness; increased 

Phenobarbital risk of seizures 

Severe • Darvocet–N® Propoxyphene Drowsiness, 

pain from • Demerol® Merepidine dizziness; increased 

injury, • Fiorinal® with Butalbital + risk for overdose; 

postsurgical codeine codeine slowed or difficulty 

care, oral • Percocet® Oxycodone breathing; impaired 

surgery, • Vicodin® Hydrocodone motor control; 

migraines unusual behavior; 

memory problems 

Sleep • Ambien® Zolpidem Drowsiness, sleepiproblems • LunestaTM Eszopiclone ness, dizziness; 

• ProsomTM Estazolam slowed or difficulty 

• Restoril® Temazepam breathing; impaired 

• Sominex® Diphenhydramine motor control; 

• Unisom® Doxylamine unusual behavior; 

memory problems 

• Herbal preparations Increased 

(chamomile, drowsiness

valerian, lavender) 
Resources
 

MedlinePlus 

A service of the U.S. National Library of Medicine and the 

National Institutes of Health. 

http://www.nlm.nih.gov/medlineplus/druginformation.html 

Provides information on prescription and over-the-counter 

medications. 

U.S. Food and Drug Administration 

Center for Drug Evaluation and Research 

http://www.fda.gov/cder 

Phone numbers: 

Main FDA for general inquiries: 1–888–INFO–FDA

(1–888–463–6332) 

Drug Information: 301–827–4570

To submit a report about Adverse Drug Reaction: 

Medwatch: 1–800–FDA–1088

Provides information on prescription and over-the-counter 

medications, consumer drug information, and reports and 

publications. 

National Institute on Alcohol Abuse 

and Alcoholism 

http://www.niaaa.nih.gov 

Phone number: 301–443–3860

Makes available free informational materials on alcohol use, 

alcohol abuse, and alcoholism. 

9 
NIH Publication No. 03–5329
 

Revised 2007