Staying off alcohol when taking antibiotics has been hallowed advice from GPs, pharmacists and well-meaning relatives for decades.
The advice that you shouldn’t drink alcohol while taking antibiotics does hold true for a small group of anti-infective drugs including metronidazole , tinidazole and sulfamethoxazole/trimethoprim . These drugs block one of the major pathways that metabolize alcohol and cause a rapid build-up of nasties called acetaldehydes, which are responsible for many of the unpleasant physical effects of hangovers.
For nearly all other types of antibiotics there is no clear evidence of harm from modest alcohol intake. But this doesn’t mean it’s a good idea to drink to excess when you’re in the grip of an infection, as the sedative and nauseating effects of the alcohol are likely to increase if you are unwell. Some antibiotics such as isoniazid and flucloxacillin may inflame the liver in a small percentage of those treated. A boozy night out could further irritate the liver, which is already working hard to get rid of the extra alcohol. A similar mild hepatitis may occur with some infections such as glandular fever, which would have the same outcome.
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