When you receive a course of antibiotics, you are often warned against drinking alcohol. What happens if you have a glass of wine with it?
Joris Bartstra, journalist with medical diploma
Nothing. The following applies to almost all antibiotics: they are not made less effective by alcohol and you do not get sick from the combination either. There is one exception: metronidazole, also available under the name Flagyl. Alcohol is broken down in the liver into acetaldehyde, which is then further broken down into formic acid. An enzyme controls this last step. Metronidazole inhibits the action of this enzyme. This can create high concentrations of acetaldehyde and make you sick. You will experience flushing, headache, nausea and vomiting. These symptoms are the same as those of the ‘anti-alcohol medication’ disulfiram, a drug used to keep people with a drinking problem from using the bottle. The realization that it makes you bad prevents you from drinking at a weak moment.
Theoretical risks
Safety advice about medicines is often based on theoretical risks and not on experience that things actually go wrong. I once drank a glass of wine in addition to a course of metronidazole and I didn’t notice anything. Of course, based on my experiment, I cannot advise you to drink when you take metronidazole. It can do no harm with other antibiotics, although taking it firmly if you are not completely healthy is of course never a good idea.
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This article originally appeared in Plus Magazine September 2017. Not yet a Plus Magazine subscriber? Becoming a subscriber is done in no time!
