John asked
I was just put on 5 day course of Cipro. I have a wedding to go to and wondered if it OK to have one or two drinks.
Answer
While there is no direct interaction between ciprofloxacin
(Cipro) and alcohol, it is not recommended to drink while recovering from an
infection. Alcohol can decrease immune function and exacerbate antibiotic side
effects like nausea, diarrhea, and upset stomach. While recovering from an
infection, it is important to stay well hydrated and get plenty of rest.
How Alcohol Is Metabolized
Alcohol is primarily metabolized via alcohol dehydrogenase, aldehyde dehydrogenase, cytochrome P450 (CYP2E1), and catalase. The byproducts of alcohol include acetaldehyde and acetate and contribute to many of the negative effects. Genetic variation of these enzymes causes varying degrees of alcohol metabolism—which is why everyone tolerates alcohol differently. This metabolism takes place mostly in the liver. CYP enzymes play a particularly important role in drug metabolism and drug interactions occur via the inhibition or induction of these enzymes. Alcohol does impact CYP enzymes, especially CYP2E1.
Some drugs may cause a “disulfiram-like reaction” when taken
with alcohol. This can cause flushing, nausea, vomiting, and general “hangover
effects”. These drugs inhibit aldehyde dehydrogenase which is crucial in
metabolism of alcohol. Some of these drugs include disulfiram and
chloramphenicol. Disulfiram is actually used clinically to treat alcohol dependence
since it makes drinking alcohol much less desirable. Ciprofloxacin is not one of these drugs.
Information On Ciprofloxacin
Ciprofloxacin is a commonly used antibiotic in the fluoroquinolone class and can be used to treat a variety of infections. It is considered to be broad-spectrum antibiotic. Ciprofloxacin is absorbed via the GI tract and is metabolized and eliminated via the liver and kidney. Ciprofloxacin does inhibit CYP1A2 and CYP3A4, but neither of these impact alcohol metabolism.
Ciprofloxacin can cause abdominal pain, nausea, and diarrhea similar to other antibiotics. Unique side effects for fluoroquinolones include tendon rupture (especially in the elderly population, burning/tingling in extremities, and CNS effects.
Ciprofloxacin has a half-life of around 4 hours (half-life refers to the time it takes your body to reduce the concentration of the drug by 50%) meaning it would about a day (24 hours) for the entire drug to be metabolized and out of your system. If you want to avoid alcohol and ciprofloxacin being in your system at the same time, wait at least 24 hours. Waiting this period of time will greatly reduce the risk of any type of adverse side effects.
