What are the Risks of Taking Amoxicillin and Alcohol?

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Are there risks attached to taking the antibiotic known as Amoxicillin and Alcohol together?

This article explores this question and takes a look at how the body reacts to both substances.

And if drinking alcohol will prohibit the efficacy of the Amoxicillin antibiotic.

Arming those taking both together with knowledge in the area to make an informed decision.

There are many contraindications to using alcohol on top of prescribed medicines and understanding the risks, if any, allows the patient to make and informed decision prior to use.

As always those using alcohol in excess should inform their medical practitioner before prescribing begins to allow an informed decision to be made. To protect the patient from any unnecessary harms,  a alcohol rehab should be considered. 

What are the Risks of Taking Amoxicillin and Alcohol_

Combining Alcohol and Amoxicillin together

There are no medical instructions to say that amoxicillin will stop working if alcohol is consumed.

Amoxicillin will still work with alcohol.

Caution is encouraged though as there are two main side effects common with both alcohol and amoxicillin such as:

  • Nausea
  • Elevated heart rate

Even though taking both together does not cause contraindications these symptoms amongst others may be present with alcohol on its own or amoxicillin on its own.

So, it may be hard to differentiate why these side effects are occurring.

If using alcohol, it is recommended to drink in moderation.

It is important not to skip doses due to alcohol use and still use even if drinking. If possibly take the dose before beginning drinking to give the tablet time to start working properly.

What effects can Amoxicillin have on the body?

Amoxicillin is an antibiotic from the penicillin family and is used on a large scale world-wide to treat bacterial infections.

Such as urinary tract infections, infections of the skin, lung infections such as pneumonia, middle ear infections and strep throat.

On the sign of adverse conditions such as confusion, change in presentation, anxiety, sensitivity to light etc the patient is encouraged to seek medical intervention immediately.

As Amoxicillin includes penicillin it is important to check that the patient is not allergic to this. As in severe reactions anaphylaxis may occur.

It is important to finish the course prescribed by the medical practitioner and follow the directions for use.

Not finishing the course may allow the infection to return or not clear completely.

Fluids are encouraged to avoid dehydration the most effective fluid when using antibiotics is water.

One of the most common side effects is a rash although nausea, vomiting and diarrhoea may also occur.

What are Amoxicillin side effects?

  • Skin rash
  • Itching
  • Swelling of tongue, face and lips
  • Blistering
  • Peeling of skin (external and internal in the mouth)
  • Darkness in urine
  • Diarrhoea
  • Upset stomachs

Amoxicillin forms:

  • Tablets
  • Liquid
  • Injection

Amoxicillin more information:

  • Start to feel better within days
  • Can stain the teeth – removed by brushing
  • Nausea or diarrhoea can occur
  • Safe to use alcohol
  • Can be prescribed for children
  • Pregnant and breast-feeding woman may be prescribed this antibiotic

What effects can alcohol have on the body?

Alcohol works as a sedative slowing down the bodies response rates. In the short term the inhibitions are lowered, concentration levels reduce, vision may become impaired, the mood may be altered, blood pressure can rise, core body temperature may rise, and nausea may occur.

In the worst case an individual may pass out. This is particularly dangerous if vomiting occurs.

Chronic physical health problems such as heart disease, liver problems and some cancers can occur. In the long term, pressure is placed on the heart and blood pressure can remain high.

Conditions such as stroke, loss of memory, irregular heart rate, alcoholic hepatitis and cardiomyopathy may also occur due to long term use.

As alcohol is mood- and mind-altering drug mental health conditions can occur over time such as anxiety, depression and stress to name a few. Or can exacerbate conditions that already exist.

Damage to the immune system:

Drinking alcohol excessively can damage the immune system as it reduces the amount of white blood cells the body produces. White blood cells are the bodies defence system. They defend against infection, cancers and cellular debris.

A reduction in white blood cells due to alcohol intake increases the chance of infection.

If the chance of infection increases the need for antibiotics may also increase.

Long term alcohol use can cause:

Confusion:

Those consuming alcohol over the long term may be prescribed Thiamine to counteract the effects of confusion and/or memory loss a contraindication of excessive drinking.

Alcohol is mood and mind altering hence no machinery should be driven whilst intoxicated at any level, alcohol can cause confusion.

It is important that antibiotics are taken as prescribed and forgetfulness due to alcohol may interfere with correct usage.

Low mood:

Over time the use of alcohol can cause low mood. This may appear conflicting as alcohol can create feelings of well-being and happiness. Which is true. But over the long-term these feelings may be fleeting as the overuse of alcohol creates feelings of anxiety, depression, stress and sadness.

Many have described a melancholy feeling as memories of the past are never far away.

Low mood can create low motivation these feelings can promote a disinterest in health and taking antibiotics may seem pointless.

If this occurs the infection may get worse or return.

Dissociation:

Due to alcohol overuse dissociation may occur. The loss of time or date and day may occur.

If admitted to hospital those with alcohol over user symptoms may be asked the FAST - Fast Alcohol use Screening Test. One of the questions on this test is about memory.

The question asks how many times have you been unable to remember what happened the night before due to your alcohol use?

A high score to this answer may indicate the presence of dissociation and loss of memory.

The medical team may also ask questions like: who is the Prime Minister of the UK? What day is it? Etc.

Again dissociation may promote memory loss and the patient may forget to take tablets or when they took the last tablet.

Weight loss or weight gain:

If dependant on alcohol many may choose alcohol before food and nutrition. This is harmful and may cause digestion problems.

These digestion problems in combination with large amounts of alcohol can cause abdominal discomfort, nausea, diarrhoea and stomach ulcers.

It is recommended Amoxicillin is taken on an empty stomach and before alcohol is consumed.

Liver Damage:

The body can digest one unit of alcohol per hour approximately. When consuming large amounts of alcohol. Pressure is placed on the liver to continuously break down the alcohol enzymes in safety.

Over time the liver can be damaged by the additional stress placed upon it and liver disease can occur.

Examples of Liver Disease is:

Liver Cirrhosis – liver scarring due to the liver trying to repair itself after damage, the more scar tissue the harder it is to repair itself.

Alcoholic Hepatitis – inflammation of the liver after years of excessive drinking, may appear jaundice, have swelling, fatigue and brain dysfunction.

Amoxicillin can still be taken however medical practitioners may alter the does and time between doses accordingly.

Amoxicillin can be taken with alcohol; it is recommended alcohol use is moderate. For best results take the antibiotic before commencing alcohol use.

If the patient feels unwell they should seek medical attention.

It is not recommended to take alcohol with some antibiotics, but this bacterial curing antibiotic should be taken as directed by the medical practitioner prescribing.

The dose as always should be finished to ensure the infection does not return or become worse.


About the author

Peter Szczepanski

Peter has been on the GPhC register for 29 years. He holds a Clinical Diploma in Advanced Clinical Practice and he is a Clinical Lead in Alcohol and Substance Misuse for Abbeycare Gloucester and works as the Clinical Lead in Alcohol and Substance Use in Worcestershire. Find Peter on Respiratory Academy, Aston University graduates, University of Birmingham, Q, Pharmaceutical Journal, the Dudley Pharmaceutical Committee, Dudley Council, Twitter, and LinkedIn.