Amoxicillin is a widely used antibiotic, basically because of its broad spectrum of activity, its known efficacy, and of course, its cost–effectiveness. Though it is readily available, it is a prescription medication that ideally requires a doctor’s diagnosis and prescription before use.
In the United States, amoxicillin ranked in the top five of commonly prescribed antibiotics from 2013 to 2015. It is more likely than not that a prescription for amoxicillin would fall in your hands at some point in life.
Needless to say, alcohol is more than just a drink. It is a way of life, with wide acceptance in many cultures. It is fermented liquor, such as wine, beer, or distilled spirit, that contains ethyl alcohol, or ethanol. Alcohol is legally accepted in most countries of the world with just a few exceptions.
So, is it safe to take both alcohol and amoxicillin together? First of all, let’s bust some myths about alcohol and amoxicillin combination.
Myths About Amoxicillin And Alcohol Combination
1. Alcohol Renders Amoxicillin Ineffective
While this may look or sound logical, the evidence against this myth has been long-standing. A 1988 study shows that, although alcohol may reduce the rate of absorption of amoxicillin in the body, it does not reduce its overall eventual concentration. This implies that you would still have the expected quantity of amoxicillin in your blood required to fight infection, only that it would take longer to arrive at this quantity.
2. Alcohol Inhibits The Treatment of Ulcer
On its own, amoxicillin is used to treat a wide range of bacterial infections, and in combination with Clavulanic acid, it is used to combat bacteria that have developed resistance against amoxicillin alone. Amoxicillin is also used as an adjunct in the treatment of duodenal ulcers and Helicobacter pylori infections.
Helicobacter pylori is a bacteria cell that weakens the mucus coating protecting the stomach and duodenum, and thereby allows acid to get through the sensitive lining underneath. The acid in the stomach and the bacteria itself irritate the lining, causing a sore which is referred to as an ulcer.
This myth is a bit hard to bust, and here is why. A study looked at the effect of cigarette smoking and alcohol consumption on the eradication of Helicobacter pylori by a combination of drugs which includes Amoxicillin. It was discovered that the drug was more effective in people who drank alcohol compared to people who did not drink alcohol. Surprised? That’s not all! Another study conducted two years later showed that the drug used in ulcer treatment had a higher probability of eradicating Helicobacter pylori in people who consumed alcohol daily.
Now, here is the hard part. A more recent study showed that alcohol consumption actually increased the failure rate in the eradication of Helicobacter pylori. So there is evidence for both sides. More evidence may be needed to draw a definite conclusion.
Now that the myths are off the table, let’s consider some critical points.
Is Drinking Alcohol While Taking Amoxicillin Safe?
1. Not Good For A Recovering Body
The mere fact that you need amoxicillin to fight infection is an indication that your body is not functioning at optimal levels and definitely needs a boost. While amoxicillin kills bacteria in your body by inhibiting the formation of their cell wall which is needed to protect the bacteria, your body needs to eliminate the toxins (harmful substances) that the bacteria had produced, and recover from the illness.
This is why multivitamins (and a balanced diet) are sometimes prescribed after completing an antibiotic dosage regimen to help improve the body’s functionality. Alcohol, on the other hand, is great at causing the body to be weak and is evidently not good for a recovering body. Weakening the body with alcohol may have a prolonging effect on recovery time, and may complicate treatment of other health problems.
Getting enough rest and having a good sleep pattern is also essential for recovery from an infection. Drinking alcohol can disrupt sleep patterns and reduce energy levels, thereby countering the efforts of a recuperating body.
2. Confusing Side Effects
Amoxicillin belongs to a class of antibiotics known as penicillin. The penicillins are popular for their efficacy and broad spectrum and have also been subject to a high rate of abuse leading to resistance over the years. The most common side effects of penicillin antibiotics are nausea (feeling of wanting to puke), vomiting, and diarrhea, all of which may also occur when you take too much alcohol.
Alcohol can speed up the rate of bowel movement, and reduce the amount of water absorbed in the colon, causing diarrhea. In more serious cases, vomiting (or other signs such as slow breathing, loss of consciousness) can be a sign of alcohol overdose, which is a serious problem.
If you throw up while on amoxicillin and alcohol, it can be difficult to know which is the cause, and hence may affect the decision of whether you should stay calm or get immediate medical help. For your own safety, it may just be better to stay off alcohol for the few days of amoxicillin treatment.
3. Beware Of Dehydration
As already mentioned, alcohol consumption by itself can cause a loss of fluid through diarrhea. Alcohol also decreases the production of the anti-diuretic hormone in the body. This hormone helps the body to reabsorb water and by reducing its production, alcohol causes passage of more water in the urine. This is why you pee more often when you drink.
The danger is that excessive loss of body fluids can cause dehydration with its attendant consequences, such as headaches, dizziness and in serious cases, low blood pressure, increased heart rate, fever, and loss of consciousness. Amoxicillin also causes loss of body fluids through diarrhea, and a combination of alcohol and amoxicillin may worsen diarrhea and loss of body fluids.
If you take plenty of water while on amoxicillin medication, this should not be a problem, but if you do not take enough water, this can be a potential danger. A good way to tell if you are taking enough water is the color of your urine. Urine is usually pale yellow or ‘straw-colored’.
Darker colors may be a sign of concentrated urine which may be a sign of dehydration. Some medications and some conditions such as liver problems can also affect urine color). The clearer your urine the more likely you are well hydrated.
With severe dehydration, confusion, weakness, impairment of cognitive performance such as attention, and motor coordination problems may occur as the brain and other body organs receive less blood flow. If dehydration remains unattended to for a long time, it can result in coma, organ failure, and death.
Okay, chances that you would get severely dehydrated from taking amoxicillin with alcohol are very low, it is, however helpful to keep this fact in mind.
4. You Just Might Be Addicted
Amoxicillin is available in oral forms; as 250mg, 500mg tablets and capsules, and as a powder for oral reconstitution. Usually, the dosage regimen lasts between 5 to 10 days. If it is quite difficult to stay away from alcohol for a few days in order to complete your amoxicillin regimen, addiction to alcohol might be an underlying culprit here, which is a cause for concern and enough reason to see a health professional immediately.
Side Effects Of Amoxicillin
Amoxicillin has side effects of its own, some of which may be aggravated by the use of alcohol, as mentioned earlier. Here are some of the side effects of amoxicillin –
- Gastrointestinal effects such as abdominal pain, diarrhea, nausea, and vomiting
- Chest pain due to difficulty in breathing
- Flushed skin
- Increased heart rate
Other Medications That Interact With Alcohol
Generally speaking, taking alcohol while on medication is best avoided. That is why the patient information leaflets on many drugs come with the warning not to take the drug with alcohol.
When it comes to antibiotics though, some drugs like amoxicillin may not cause considerable harm especially with small quantities of alcohol. However, there are some antibiotics that can lead to very critical side effects when taken in combination with alcohol.
Metronidazole is reported to cause severe nausea, vomiting, diarrhea, rapid heart rate, hypotension (low blood pressure), thirst, chest pain and some other effects in what is known as Disulfiram-like reaction. While this is disputed by some researchers based on results of animal experiments, these are very uncomfortable effects and it is best to avoid them altogether by not taking alcohol in combination with the implicated drugs.
Other drugs that can cause Disulfiram-like reaction include, tinidazole, benznidazole, and Septrin (Trimethoprim-Sulfamethoxazole combination). Erythromycin, when taken with alcohol, may lead to heightened intoxication which can cause serious alcohol poisoning.
So, Here Is The Conclusion
Taking Alcohol while on amoxicillin may be considered safe, especially at low levels of alcohol, however, this combination is not entirely risk-proof. It is safe therefore to avoid alcohol for at least 72 hours after completing amoxicillin dosage, otherwise, please consult a health professional for personalized advice.