When Combined With Alcohol Some Over-The-Counter Drugs?

Timing is important – Alcohol and medicines can interact harmfully even if they are not taken at the same time. Mixing alcohol and medicines puts you at risk for dangerous reactions. Protect yourself by avoiding alcohol if you are taking a medication and don’t know its effect.

Commonly Used Medicines (Both Prescription and Over-the-Counter) That Interact With Alcohol

Symptom/Disorders	Medication (Brand name)	Medication (Generic name)	Some possible reactions with alcohol
Allergies/Colds/Flu	Alavert®	Loratadine	Drowsiness, dizziness; increased risk for overdose
Atarax®	Hydroxyzine
Benadryl®	Diphenhydramine
Clarinex®	Desloratadine
Claritin®, Claritin-D®	Loratadine
Dimetapp® Cold &Allergy	Brompheniramine
Sudafed® Sinus & Allergy	Chlorpheniramine
Triaminic® Cold & Allergy	Chlorpheniramine
Tylenol® Allergy Sinus	Chlorpheniramine
Tylenol® Cold & Flu	Chlorpheniramine
Zyrtec®	Cetirizine
Angina (chest pain), coronary heart disease	Isordil®	Isosorbide Nitroglycerin	Rapid heartbeat, sudden changes in blood pressure, dizziness, fainting
Anxiety and epilepsy	Ativan®	Lorazepam	Drowsiness, dizziness; increased risk for overdose; slowed or difficulty breathing; impaired motor control; unusual behavior; memory problems
BuSpar®	Buspirone
Klonopin®	Clonazepam
Librium®	Chlordiazepoxide
Paxil®	Paroxetine
Valium®	Diazepam
Xanax®	Alprazolam
Herbal preparations (Kava Kava)		Liver damage, drowsiness
Arthritis	Celebrex®	Celecoxib	Ulcers, stomach bleeding, liver damage
Naprosyn®	Naproxen
Voltaren®	Diclofenac
Attention and concentration (Attention deficit/hyperactivity disorder)	Adderall®	Amphetamine/dextro-amphetamine	Dizziness, drowsiness, impaired concentration (methylphenidate, dexmethylphenidate); possible increased risk for heart problems (amphetamine, dextroamphetamine, lisdexamfetamine); liver damage (atomoxetine)
Concerta®, Ritalin®	Methylphenidate
Dexedrine®	Dextroamphetamine
Focalin®	Dexmethylphenidate
Strattera®	Atomoxetine
Vyvanse®	Lisdexamfetamine
Blood clots	Coumadin®	Warfarin	Occasional drinking may lead to internal bleeding; heavier drinking also may cause bleeding or may have the opposite effect, resulting in possible blood clots, strokes, or heart attacks
Cough	Delsym®, Robitussin Cough®	Dextromethorpan	Drowsiness, dizziness; increased risk for overdose
Robitussin A–C®	Guaifenesin + codeine
Depression	Abilify®	Aripriprazone	Drowsiness, dizziness; increased risk for overdose; increased feelings of depression or hopelessness (all medications); impaired motor control (quetiapine, mirtazapine); increased alcohol effect (bupropion); liver damage (duloxetine) Monoamine oxidase inhibitors (MAOIs), such as tranylcypromine and phenelzine, when combined with alcohol, may result in serious heart-related side effects. Risk for dangerously high blood pressure is increased when MAOIs are mixed with tyramine, a byproduct found in beer and red wine
Anafranil®	Clomipramine
Celexa®	Citalopram
Clozaril®	Clozapine
Cymbalta®	Duloxetine
Desyrel®	Trazodone
Effexor®	Venlafaxine
Elavil®	Amitriptyline
Geodon®	Ziprasidone
Invega®	Paliperidone
Lexapro®	Escitalopram
Luvox®	Fluvoxamine
Nardil®	Phenelzine
Norpramin®	Desipramine
Pamate®	Tranylcypromine
Paxil®	Paroxetine
Pristiq®	Desevenlafaxine
Prozac®	Fluoxetine
Remeron®	Mirtazapine
Risperdal®	Risperidone
Seroquel®	Quetiapine
Serzone®	Nefazodone
Symbyax®	Fluoxetine/Olanzapine
Wellbutrin®	Bupropion
Zoloft®	Sertraline
Zyprexa®	Olanzapine
Herbal preparations (St. John’s Wort)
Diabetes	Diabinese®	Chlorpropamide	Abnormally low blood sugar levels, flushing reaction (nausea, vomiting, headache, rapid heartbeat, sudden changes in blood pressure); symptoms of nausea and weakness may occur (metformin)
Glucotrol®	Glipizide
Glucophage®	Metformin
Glynase®, DiaBeta®, Micronase®	Glyburide
Orinase®	Tolbutamide
Tolinase®	Tolazamide
Enlarged prostate	Cardura®	Doxazosin	Dizziness, light headedness, fainting
Flomax®	Tamsulosin
Hytrin®	Terazosin
Minipress®	Prazosin
Heartburn, indigestion, sour stomach	Axid®	Nizatidine	Rapid heartbeat; increased alcohol effect; sudden changes in blood pressure (metoclopramide)
Reglan®	Metoclopramide
Tagamet®	Cimetidine
Zantac®	Ranitidine
High blood pressure	Accupril®	Quinapril	Dizziness, fainting, drowsiness; heart problems such as changes in the heart’s regular heartbeat (arrhythmia)
Calan®	Verapamil
Capozide®	Hydrochlorothiazide
Cardura®	Doxazosin
Catapres®	Clonidine
Cozaar®	Losartan
Hytrin®	Terazosin
Lopressor® HCT	Hydrochlorothiazide
Lotensin®	Benzapril
Minipress®	Prazosin
Norvasc®	Amlodipine mesylate
Prinivil®, Zestril®	Lisinopril
Vaseretic®	Enalapril
High cholesterol	Advicor®	Lovastatin + Niacin	Liver damage (all medications); increased flushing and itching (niacin), increased stomach bleeding (pravastatin + aspirin)
Altocor®	Lovastatin
Crestor®	Rosuvastatin
Lipitor®	Atorvastatin
Mevacor®	Lovastatin
Niaspan®	Niacin
Pravachol®	Pravastatin
Pravigard™	Pravastatin + Aspirin
Vytorin™	Ezetimibe + Simvastatin
Zocor®	Simvastatin
Infections	Acrodantin®	Nitrofurantoin	Fast heartbeat, sudden changes in blood pressure; stomach pain, upset stomach, vomiting, headache, or flushing or redness of the face; liver damage (isoniazid, ketoconazole)
Flagyl®	Metronidazole
Grisactin®	Griseofulvin
Nizoral®	Ketoconazole
Nydrazid®	Isoniazid
Seromycin®	Cycloserine
Tindamax®	Tinidazole
Zithromax®	Azithromycin
Mood stabilizers	Depakene®, Depakote®	Valproic acid	Drowsiness, dizziness; tremors; increased risk for side effects, such as restlessness, impaired motor control; loss of appetite; stomach upset; irregular bowel movement; joint or muscle pain; depression; liver damage (valproic acid)
Eskalith®, Eskalith®CR, Lithobid	Lithium
Muscle pain	Flexeril®	Cyclobenzaprine	Drowsiness, dizziness; increased risk of seizures; increased risk for overdose; slowed or difficulty breathing; impaired motor control; unusual behavior; memory problems
Soma®	Carisoprodol
Nausea, motion sickness	Antivert®	Meclizine	Drowsiness, dizziness; increased risk for overdose
Dramamine®	Dimenhydrinate
Phenergan®	Promethazine
Pain (such as muscle ache, minor arthritis pain), fever, inflammation	Advil®	Ibuprofen	Stomach upset, bleeding and ulcers; liver damage (acetaminophen); rapid heartbeat
Aleve®	Naproxen
Excedrin®	Aspirin, Acetaminophen
Motrin®	Ibuprofen
Tylenol®	Acetaminophen
Seizures	Dilantin®	Phenytoin	Drowsiness, dizziness; increased risk of seizures (levetiracetam, phenytoin); unusual behavior and changes in mental health (such as thoughts of suicide) (topiramate)
Horizant®, Neurontin®	Gabapentin
Keppra®	Levetiracetam
Klonopin®	Clonazepam
	Phenobarbital
Lamictal®	Lamotrigine
Lyrica®	Pregabalin
Tegretol®	Carbamazepine
Topamax®	Topiramate
Trileptal®	Oxcarbazepine
	Barbiturates
Severe pain from injury, postsurgical care, oral surgery, migraines	Darvocet–N®	Propoxyphene	Drowsiness, dizziness; increased risk for overdose; slowed or difficulty breathing; impaired motor control; unusual behavior; memory problems
Demerol®	Merepidine
Fiorinal® with codeine	Butalbital + codeine
Percocet®	Oxycodone
Vicodin®	Hydrocodone
Sleep problems	Ambien®	Zolpidem	Drowsiness, sleepiness, dizziness; slowed or difficulty breathing; impaired motor control; unusual behavior; memory problems
Lunesta™	Eszopiclone
Prosom™	Estazolam
Restoril®	Temazepam
Sominex®	Diphenhydramine
Unisom®	Doxylamine
Herbal preparations (chamomile, valerian, lavender)		Increased drowsiness

What are common drug interactions with alcohol?

Nonnarcotic Pain Medications and Anti-Inflammatory Agents – Many people frequently use nonnarcotic pain medications and anti-inflammatory agents (e.g., aspirin, acetaminophen, or ibuprofen) for headaches and other minor aches and pains. In addition, arthritis and other disorders of the muscles and bones are among the most common problems for which older people consult physicians ( Adams 1995 ).

NSAIDs have been implicated in an increased risk of ulcers and gastrointestinal bleeding in elderly people. Alcohol may exacerbate that risk by enhancing the ability of these medications to damage the stomach mucosa ( Adams 1995 ).6 Aspirin, indomethacin, and ibuprofen cause prolonged bleeding by inhibiting the function of certain blood cells involved in blood clot formation. This effect also appears to be enhanced by concurrent alcohol use ( Deykin et al.1982 ). Aspirin has been shown to increase BALs after small alcohol doses, possibly by inhibiting first-pass metabolism ( Roine et al.1990 ).

An important pharmacokinetic interaction between alcohol and acetaminophen can increase the risk of acetaminophen-related toxic effects on the liver. Acetaminophen breakdown by CYP2E1 (and possibly CYP3A) results in the formation of a toxic product that can cause potentially life-threatening liver damage.

As mentioned earlier, heavy alcohol use enhances CYP2E1 activity. In turn, enhanced CYP2E1 activity increases the formation of the toxic acetaminophen product. To prevent liver damage, patients generally should not exceed the maximum doses recommended by the manufacturers (i.e., 4 grams, or up to eight extra-strength tablets of acetaminophen per day).

In people who drink heavily or who are fasting (which also increases CYP2E1 activity), however, liver injury may occur at doses as low as 2 to 4 grams per day. The specific drinking levels at which acetaminophen toxicity is enhanced are still unknown.

What happens when a person drinks alcohol and takes another depressant drug?

Combining medications (prescribed or not prescribed) with alcohol can have unpredictable and unwanted consequences. We can help ourselves, our friends and our community by understanding the dangers and taking steps to prevent harm. How Do You Know What Happens? | Josh Levine PSA from Scott Wasserman on Vimeo,

• See also Transcription below ) Depressants (Xanax, Valium) combined with alcohol have a synergistic effect, with potential for dangerous and even lethal consequences, with rapid onset of dizziness, stumbling, loss of sphincter control, memory loss and potential death.
• Stimulants (e.g., Ritalin, Adderall, Concerta) combined with alcohol conceal alcohol’s effects, so people cannot gauge their level of intoxication, which can result in over-consumption, e.g.

significant impairment of coordination and judgment, black out, pass out and potential death. Prescription opiates (e.g., Vicodin, OxyContin, Tylenol 3 with codeine, Percocet) combined with alcohol can result in slowed or arrested breathing, lowered pulse and blood pressure, unconsciousness, coma, and potential death.

Continue to use medication when the prescription is no longer valid Use prescribed drugs contrary to the prescription Use prescription drugs not prescribed to you Give or sell prescribed drugs to another person

Misusing prescription drugs can result in conviction with jail time. Potential harm can happen in three ways:

When people do not know that there are significant drug interactions and are caught by surprise when they inadvertently drink while using prescription medication When people knowingly combine alcohol with other drugs because they mistakenly believe it will be a “better” or “enriched” intoxication As a tool to facilitate a crime (sexual assault, robbery, etc) by making a victim incapacitated

If you choose to drink:

Make your own drink whenever possible, and don’t leave your drink unattended If you don’t see your drink being made, don’t drink it Avoid drinks that come from a common source (e.g. punch bowl, igloo container, jug)

Stay safe, Go Blue, and Stay in the Blue. For more information, see:

Harmful Interactions: Mixing Alcohol with Medicines from the National Institute on Alcohol Abuse and Alcoholism Commonly Abused Prescription Drugs Chart from the National Institute on Drug Abuse Alcohol Abuse Makes Prescription Drug Abuse More Likely, from the National Institute on Drug Abuse

Video transcription: Narrator: What do you get when mixing red and blue paint? How about Coca-Cola and Mentos from science class? Then there’s alcohol mixed with prescription drugs. What happens when you mix them together? How do you know what happens? Josh’s mom: I lost my son Josh Levine because he didn’t know what would happen when he mixed Adderall with alcohol.

What is it called when two drugs are mixed?

Polysubstance Use Facts The use of more than one drug, also known as polysubstance use, is common. This includes when two or more are taken together or within a short time period, either intentionally or unintentionally.

• Intentional polysubstance use occurs when a person takes a drug to increase or decrease the effects of a different drug or wants to experience the effects of the combination.
• Unintentional polysubstance use occurs when a person takes drugs that have been mixed or cut with other substances, like fentanyl, without their knowledge.
• Whether intentional or not, mixing drugs is never safe because the effects from combining drugs may be stronger and more unpredictable than one drug alone, and even deadly.

The dangers of polysubstance use also apply to prescription drugs. Always let your doctor know what drugs you are taking to prevent any adverse reactions with newly prescribed medications. Never take pills that did not come from a pharmacy and weren’t prescribed to you.250+ —The number of American lives lost to drugs every day.1 50% — In 2019, nearly half of drug overdose deaths involved multiple drugs.2 Examples of stimulants: ecstasy (MDMA), cocaine, methamphetamines, amphetamines (speed) Stimulants (also known as uppers) can increase your heart rate and blood pressure to dangerous levels and increase your risk of several serious health problems. Combining stimulants may even directly or indirectly increase your risk of:

• Brain injury
• Liver damage
• Heart attack
• Stroke

Signs of use/overdose 3,4 that may occur when mixing stimulants:

• Fast/troubled breathing
• Increased body temperature
• Nausea or vomiting
• Chest pain
• Seizures or tremors

Examples of depressants: opioids (heroin, morphine, oxycodone, hydrocodone, fentanyl), benzodiazepines Depressants (also known as downers) can slow down your breathing and increase your risk of several adverse health outcomes. Combining depressants can also directly or indirectly increase your risk of:

• Damage to the brain and other organs
• Overdose
• Death

Signs of use/overdose 5,6 when mixing depressants:

• Slow breathing
• Weak pulse
• Altered mental status or confusion
• Passing out

Mixing stimulants and depressants Mixing stimulants and depressants doesn’t balance or cancel them out. In fact, the results of combining drugs are unpredictable, often modifying or even masking the effects of one or both drugs. This may trick you into thinking that the drugs are not affecting you, making it easier to overdose. Drinking alcohol while using other drugs Drinking alcohol while using other drugs isn’t safe. Alcohol is a depressant with similar effects to other downers. Mixing alcohol with other drugs can increase your risk of overdose and serious damage to the brain, heart, and other organs.

• Call 911 Immediately.*
• Administer, if available. **
• Try to keep the person awake and breathing.
• Lay the person on their side to prevent choking.
• Stay with the person until emergency assistance arrives.

*Most states have laws that may protect a person who is overdosing or the person who called for help from legal trouble. **Naloxone is a life-saving medication that can reverse the effects of opioid overdose and save lives. It is available in all 50 states and can be purchased from a local pharmacy without a prescription in most states.

1. NCHS, National Vital Statistics System. Estimates for 2020 are based on provisional data. Estimates for 2015-2019 are based on final data (available from: ).
2. O’Donnell J, Gladden RM, Mattson CL, Hunter CT, Davis NL. Vital Signs: Characteristics of Drug Overdose Deaths Involving Opioids and Stimulants — 24 States and the District of Columbia, January–June 2019. MMWR Morb Mortal Wkly Rep 2020; 69:1189–1197. DOI:
3. NIDA.2020, October 7. Cocaine. Retrieved from on 2021, March 11
4. NIDA.2019, May 16. Methamphetamine DrugFacts. Retrieved from on 2021, March 11
5. SAMHSA.2020, August 19. Opioid Overdose. Retrieved from
6. National Institute on Drug Abuse. (n.d.). Heroin (smack, junk) facts. Easy-to-Read Drug Facts. Retrieved from

: Polysubstance Use Facts

What is it called when you take multiple drugs?

Medicines are meant to help, not harm. But sometimes taking too many drugs can be dangerous, especially for older adults. The use of multiple drugs to treat diseases and other health conditions is known as polypharmacy. This is a growing concern for older adults.

Polypharmacy is more common among older adults, many of whom have multiple chronic conditions (MCC), defined as two or more chronic conditions such as arthritis, asthma, chronic obstructive pulmonary disease, coronary heart disease, depression, diabetes, and hypertension. But taking too many drugs can lead to safety concerns.

Read on to learn about NIA’s support for polypharmacy research and how our work in this area can help ensure older adults take only those medicines they need to help them live full, healthy lives. Adults age 65 and older tend to take more medicines than any other age group because they may have several diseases or other health problems at the same time. Managing multiple medications can be expensive, difficult to track, and hard to manage, especially for those who are homebound or who live in rural areas.

In addition, the use of many medications can increase the risk for adverse reactions (problems or side effects caused by a drug) and drug interactions (meaning two or more drugs don’t work well together, causing unintended problems). According to a report by the Centers for Disease Control and Prevention, 83% of U.S.

adults in their 60s and 70s had used at least one prescription drug in the previous 30 days and about one-third used five or more prescription drugs. The most commonly used drugs were cholesterol, high blood pressure, and diabetes medications. Inappropriate polypharmacy — the use of excessive or unnecessary medications — increases the risk of adverse drug effects, including falls and cognitive impairment, harmful drug interactions, and drug-disease interactions, in which a medication prescribed to treat one condition worsens another or causes a new one.

Patients may be prescribed medicines that are unlikely to help, potentially harmful, or misaligned with the person’s health goals. Polypharmacy also creates a tremendous burden for patients and their families, who need to understand the purpose of the many prescriptions written by multiple providers, get refills, take each medication at the correct time of day, and recognize side effects.

Researchers are studying deprescribing to reduce these risks and to improve outcomes in older adults with MCC. The goal is to reduce or stop medications that are potentially inappropriate or unnecessary, which can also make the management of medications less of a strain for patients and their families.

What are major drug interactions?

What is a drug interaction? – Medicines help us feel better and stay healthy. But sometimes drug interactions can cause problems. There are three types of drug interactions:

Drug-drug interaction : A reaction between two (or more) drugs. Drug-food interaction : A reaction between a drug and a food or beverage. Drug-condition interaction: A reaction that occurs when taking a drug while having a certain medical condition. For example, taking a nasal decongestant if you have high blood pressure may cause an unwanted reaction.

A drug interaction can affect how a drug works or cause unwanted side effects.

What is a barbiturate?

Indications – Barbiturates are a group of sedative-hypnotic medications used for treating seizure disorder, neonatal withdrawal, insomnia, preoperative anxiety, and induction of coma for increased intracranial pressure. They are also useful for inducing anesthesia.

• Thiopental was introduced in 1934 for induction of anesthesia for general anesthesia.
• Thiopental was the predominant IV anesthetic induction agent until its replacement by propofol.
• In refractory status epilepticus, a Cochrane Review found that thiopental was equally effective as propofol for controlling seizure activity.

Because of its use in lethal injection protocols, the major supplier of thiopental in the US elected to discontinue production in 2011, and it is unavailable in the USA. FDA-approved barbiturates in clinical use are as below.

Phenobarbital: Phenobarbitone has extensive use as an antiepileptic drug in the neonatal and pediatric population. It is the most cost-effective drug treatment for epilepsy in adults in low-resource countries. Intravenous barbiturates have been used for neurosurgery due to reduced cerebral metabolic rate of oxygen consumption. For individuals with severe traumatic brain injury (TBI), high-dose barbiturates may be a consideration but are not indicated for prophylactic administration. In a review of practice in five European countries, about 20% of patients received barbiturates. In refractory status epilepticus, a Cochrane Review found that thiopental was equally effective as propofol for controlling seizure activity.

Methohexital: Methohexital has demonstrated safety and efficacy for procedural sedation of short duration for cardioversion and pediatric outpatient surgery. Methohexital can be used for fracture reduction in the emergency department and sedation for elective intubation in neonates. Methohexital has preferential use in electroconvulsive therapy due to its longer seizure duration.

Butalbital: Butalbital is used primarily for the treatment of headache disorders.

Pentobarbital: Pentobarbital is used as a pre-anesthetic medication and status epilepticus. Pentobarbital is used off-label for traumatic brain injury associated with refractory elevated intracranial pressure.

Primidone: Primidone is used for seizure disorders. According to the American academy of neurology, depending on comorbidities and potential ADR, primidone(barbiturate) or propranolol can be used for essential tremors.

Amobarbital: Amobarbital has a labeled indication for insomnia, but the American Association of Sleep Medicine does not endorse its use.

What happens when you mix antidepressants with alcohol reddit?

Drowsiness, Confusion, Loss of Coordination Alcohol and antidepressants can impair a person’s coordination, and cause confusion and severe drowsiness.

What should not be taken after alcohol?

Get plenty of rest. Even if you feel good the morning after heavy drinking, the lasting effects of alcohol reduce your ability to perform at your best. Avoid taking any medicines for your hangover that contain acetaminophen (such as Tylenol). Acetaminophen may cause liver damage when combined with alcohol.

What is it called when 2 drugs don’t work together?

A contraindication is a specific situation in which a drug, procedure, or surgery should not be used because it may be harmful to the person. There are two types of contraindications:

Relative contraindication means that caution should be used when two drugs or procedures are used together. (It is acceptable to do so if the benefits outweigh the risk.)Absolute contraindication means that event or substance could cause a life-threatening situation. A procedure or medicine that falls under this category must be avoided.

Some treatments may cause unwanted or dangerous reactions in people with allergies, high blood pressure, or pregnancy. For example, isotretinoin, a drug used to treat acne, is absolutely contraindicated in pregnancy due to the risk of birth defects. Certain decongestants are contraindicated in people with high blood pressure and should be avoided.

• Many medicines should not be used together by the same person.
• For instance, a person who takes warfarin to thin the blood should not take aspirin, which is also a blood thinner.
• This is an example of a relative contraindication.
• Updated by: Linda J.
• Vorvick, MD, Clinical Associate Professor, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA.

Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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