The dangers of mixing drugs and alcohol


Many people, especially those over age 65, may be incurring a risk by using alcohol when taking prescription drugs, according to research from the National Institute on Alcohol Abuse and Alcoholism. Alcohol, itself a drug, becomes more intoxicating when it is consumed at the same time as a drug that blocks the stomach’s ability to metabolize alcohol. Drugs for treating gastrointestinal ulcers like ranitidine (found in Zantac and Tagamet) and drugs to help smoking cessation, such as Chantix, have this effect.  

People who combine alcohol and sedatives—including benzodiazepines such as Valium or Ativan and sleeping pills—can experience increased sedation, impaired breathing and a higher likelihood of falling or having a serious accident. Respiratory arrest can occur. Alcohol can also impair the metabolism of drugs, creating a risk of drug overdose. Using blood thinners like the drug warfarin with alcohol increases the risk of bleeding. Conversely, longterm heavy drinking could also enhance the metabolism of warfarin, raising the risk of blood clots. People on Warfarin should be aware of their levels of the blood thinner and not drink heavily.

Alcohol can interact with antibiotics, anti-fungal drugs, antidepressants, antihistamines, diabetes drugs, opioids and nonsteroidal anti-inflammatory drugs, such as Ibuprofen, naproxen (found in Advil and Aleve) and Tylenol.  

People who are used to having a glass of wine with dinner may not experience problems with medications; however, heavier drinking can cause serious problems. Therefore, the following advice is very important: check with your pharmacist and your health care provider before using alcohol with any prescription or over-the-counter drug. Read the warning labels on the bottle or package. If it says not to drink alcohol—don’t drink it! 

Information in this column is based on a newsletter called “Worst Pills, Best Pills.” I suggest subscribing to this newsletter by calling (800) 289.3787 if you or members of your family take prescription or over-the-counter drugs. You do not need medical knowledge to understand the content of this newsletter, and it can be lifesaving.


Sadja Greenwood, a longtime Bolinas resident now living in Portland, is a retired physician formerly active at the University of California, San Francisco.