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medication interactions with alcohol

Drug interactions: 1) antibiotics - metronidazole, grisiofulvin, furazalidone, quinacrine used concurrently with alcohol can cause nausea/vomiting, headache & possibly convulsions - chronic alcohol use may diminish effective of isoniazid (INH) & rifampin 2) anticoagulants - anticoagulant effect of warfarin is increased with acute alcohol consumption, but reduced by chronic alcohol consumption 3) antidepressants* - alcohol increases the sedative effect of tricyclic antidepressants - tyramine found in some beers & red wine interacts with monoamine oxidase inhibitors (MAO) to produce hyperadrenergic states 4) hypoglycemic agents - acute alchohol consumption prolongs & chronic alcohol diminishes elimination of tolbutamide (Orinase) - chlorpropamide & tolbutamide in combination with alcohol may result in a disulfiram-like reaction 5) antihistamines - alcohol may intensify the sedative effects of antihistamines, i.e. diphenhydramine (Benadryl) 6) antipsychotic medications - acute alcohol consumption increases the sedative effects of phenothiazines (thorazine) 7) anticonvulsants - acute alcohol consumption increases & chronic alcohol consumption may diminish availability of phenytoin 8) antiulcer agents - cimetidine & ranitidine increase availability of low dose alcohol 9) antihypertensives - acute alcohol consumption interacts with hydralazine, nitroglycerin, reserpine, methyldopa & guanethidine to cause orthostatic hypotension - chronic alcohol consumption decreases the availability of propranolol 10) narcotic analgesics - combination of opiates (morphine, codeine, propoxyphene (Darvon), meperidine ...) & alcohol enhances the sedative effect of both drugs, increasing the risk of death from overdose 11) analgesics (non-narcotic) - alcohol can increase risk of gastrointestinal hemorrhage associated with NSAID use - aspirin may increase the availability of alcohol (men) [2] - chronic alcoholism increases the risk of acetaminophen-induced hepatotoxicity (doses > 2.6 g/day) 12) sedative & hypnotics - low doses of flurazepam (Dalmane) interact with low doses of alcohol to impair driving - lorazepam (Ativan) when given to an alcohol-intoxicated person may result in cardiopulmonary suppression - acute alcohol consumption increases the availability of barbiturates & prolongs their sedative effect - chronic alcohol consumption decreases barbiturate availability - acute or chronic alcohol consumption enhances the sedative effects of barbiturates * alcoholism & depression are frequently associated

Related

alcoholic beverage alcoholism (includes binge drinking) ethanol; ethyl alcohol

Specific

wine

General

drug interaction

References

  1. Alison Moore, UCLA Multicampus Program in Geriatrics & Gerontology, 2002
  2. Geriatrics Review Syllabus, American Geriatrics Society, 5th edition, 2002-2004