According to an interview with Europa Press salud Infosalus, Ana Dora Bonilllo, vocal of Adjuntos, Sustitutos y Regentes of the College of Pharmacists of Almería and community pharmacist, explains that among the most common side effects are nausea and vomiting, and she mentions that alcohol can intensify stomach irritation caused by some antibiotics; as well as headaches, dizziness or imbalance, and heart problems.
Furthermore, this expert talks about liver damage, stating that «alcohol consumption can increase the burden on the liver, which also metabolizes antibiotics»; as well as weakening the immune system.
In the same line, Sandra Pérez, secretary of the College of Pharmacists of Cádiz and community pharmacist, mentioned in another interview with Europa Press Salud Infosalus that the most frequently observed side effects include dizziness, drowsiness, headache, gastrointestinal discomfort, and facial flushing. However, she warns that in certain circumstances, and depending on the antibiotic administered, more severe adverse reactions may also occur, such as increased blood pressure, tachycardia, liver failure, disulfiram-like effect (similar to that produced by a drug for alcohol detoxification), and reduced treatment efficacy.
Both agree that while undergoing antibiotic treatment, it is advisable to avoid alcohol consumption, as it is always better to avoid it to ensure optimal recovery without complications.
In fact, Ana Dora Bonillo, from the College of Pharmacists of Almería, argues that in these cases it is important to consider that if we are undergoing antibiotic treatment, regardless of the drug, it is because we are suffering from an infection: «Consuming alcohol in this situation is not advisable because it (regardless of the drug) will negatively affect the immune system, further weakening it, and hindering the fight against this pathogen, and the subsequent recovery of our body.»
She continues by stating that the significance of this event will obviously depend on the type and magnitude of the infection and the amount of alcohol ingested. «But as a general rule, it is best to say that it is not recommended,» insists this expert.
ESPECIALLY DANGEROUS ANTIBIOTICS
But that’s not all because both specialists point out that there are certain antibiotics that are especially dangerous when combined with alcohol. Sandra Pérez, secretary of the College of Pharmacists of Cádiz, specifically mentions that there are certain antibiotics for which alcohol consumption is completely contraindicated, mainly due to the high risk of severe adverse reactions: «These antibiotics can cause severe side effects, even with small amounts of alcohol, and in some cases, the restriction should be maintained for up to 72 hours after completing the treatment.»
In particular, Ana Dora Bonillo points out three types of antibiotics that have a «strong pharmacological interaction with alcohol»: some cephalosporins, chloramphenicol, and metronidazole. «This is known as a ‘Disulfiram-like reaction’, as mentioned earlier, and manifests with symptoms including cutaneous vasodilation, sweating, thirst, throbbing headache, shortness of breath, nausea, vomiting, vertigo, blurred vision, hypotension, tachycardia, mental confusion, or syncope,» details this pharmacist.
Furthermore, she warns that, in general, excessive and acute alcohol consumption can act as an enzymatic inhibitor of certain drugs, negatively affecting their clearance and subsequent elimination, leading to an increase in the drug’s plasma concentration and potential toxicity.
However, she points out that chronic consumption can have the opposite effect, increasing drug elimination, resulting in a decrease in pharmacological effect as alcohol acts as an enzymatic inducer in this case.
CAN INTERFERE WITH ITS EFFECT
Furthermore, Sandra Pérez, secretary of the College of Pharmacists of Cádiz and community pharmacist, maintains that alcohol consumption can interfere with the absorption and metabolism of antibiotics, which can reduce their blood concentration and, therefore, decrease their effectiveness in fighting infection: «This occurs because both alcohol and many antibiotics are metabolized by the liver, and by consuming both, this organ must work harder, which can slow down or speed up the absorption and elimination of the medication.»
She also argues that alcohol can alter antibiotic levels in the body, making it difficult to maintain constant levels, which are essential for treatment effectiveness. «If the levels drop too low, the antibiotic may not be sufficient to eliminate the infection, which also promotes the development of bacterial resistance,» she adds.
WHEN CAN ALCOHOL BE CONSUMED AGAIN
Finally, we asked these community pharmacists about when alcohol can be consumed again after taking an antibiotic because many continue to ‘work’ hours or days after ingestion. In this regard, Sandra Pérez from the College of Pharmacists of Cádiz emphasizes that for most common antibiotics (such as amoxicillin), it is advised to wait at least 24 to 48 hours after the last dose before consuming alcohol. «This allows the medication to be completely eliminated from the body and reduces the risk of side effects or interactions,» she points out.
For antibiotics with severe interactions with alcohol (such as those previously mentioned as contraindicated), it is recommended to wait at least 72 hours after completing the treatment before consuming alcohol, as these medications can remain in the body longer, increasing the risk of adverse reactions.
«In all cases, it is important to consider the overall recovery status: if symptoms of the infection or side effects of the antibiotic persist, it is ideal to wait until fully recovered before consuming alcohol,» asserts this expert.
On the other hand, Ana Dora Bonillo, vocal of Adjuntos, Sustitutos y Regentes of the College of Pharmacists of Almería, indicates that it all depends on the type of infection and, therefore, the duration of the antibiotic treatment, and how healthy our body is: «It is not the same to overcome a moderate urinary infection with a two-dose fosfomycin treatment as it is to have been in treatment for 14 days against Helycobacter Pylori, or 10 days with Amoxicillin Clavulanic Acid after overcoming the flu and having suffered diarrhea or other digestive adverse effects; to give another example.»
Therefore, after finishing the antibiotic treatment, it is advisable to recommend a dietary supplement to strengthen the immune system, thus aiding the body in total and complete recovery. «That’s when alcohol consumption can be resumed with each individual’s previous and personal routine,» concludes this pharmacist.