Can You Drink Alcohol While Taking Amoxicillin?

Nero asked

Can I drink alcohol after taking amoxicillin? I want to be sure they are OK together.

Answer

It is not recommended to drink alcohol while recovering from an infection. Alcohol can decrease immune function and worsen 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. With that being said, there is no direct drug interaction between alcohol and amoxicillin.

It is important to note that when we refer to alcohol, that includes all alcoholic beverages including, wine, beer and spirits.

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. Amoxicillin does not cause a disulfiram-like reaction.  

Information On Amoxicillin

Amoxicillin is a beta-lactam antibiotic that is used for treatment of respiratory, sinus, and ear infections, among others. Because amoxicillin is a type of penicillin, it should not be taken in patients with a penicillin allergy. Reported allergies to penicillins are thought to be higher than the rate of true penicillin allergies. It is important to let your doctor and pharmacist know your allergies or other adverse reactions before taking any medication.

Amoxicillin is well absorbed in the GI tract and is metabolized and eliminated primarily through the kidney. It is not extensively metabolized by CYP enzymes so will not impact metabolism of alcohol. Amoxicillin can cause rash, nausea, vomiting, and diarrhea.

In healthy patients, amoxicillin has a half-life around 1-2 hours, meaning the drug should be completely cleared within 12 hours. In patients with declined kidney function, the half-life may be significantly increased up to 13 hours (could take several days to be completely cleared). Assuming you have good kidney function, waiting at least 12 hours after your last dose of amoxicillin to drink alcohol will reduce the risk of worsened side effects.