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You’ve probably seen this warning on medicines you’ve taken.
The danger is real. Mixing alcohol with certain medications can
cause nausea and vomiting, headaches, drowsiness, fainting, or
loss of coordination. It also can put you at risk for internal
bleeding, heart problems, and difficulties in breathing. In addition
to these dangers, alcohol can make a medication less effective
or even useless, or it may make the medication harmful or
toxic to your body.
Some medicines that you might can result. The list gives the brand
never have suspected can react with name by which each medicine is
alcohol, including many medications commonly known (for example,
which can be purchased “over-the- Benadryl ® ) and its generic name or
counter”—that is, without a prescription. active ingredient (in Benadryl ® , this
Even some herbal remedies can is diphenhydramine). The list
have harmful effects when combined presented here does not include all
with alcohol. the medicines that may interact
This pamphlet lists medications harmfully with alcohol. Most im-
that can cause harm when taken with portant, the list does not include all
alcohol and describes the effects that the ingredients in every medication.

1
 Medications typically are safe and
effective when used appropriately.
Your pharmacist or other health care
provider can help you determine
which medications interact harmfully
with alcohol.

D I D YO U K N OW …

Mixing alcohol and medicines can

be harmful. Alcohol, like some medi-
cines, can make you sleepy, drowsy,
or lightheaded. Drinking alcohol
while taking medicines can intensify
these effects. You may have trouble
concentrating or performing me-
chanical skills. Small amounts of
alcohol can make it dangerous to
drive, and when you mix alcohol with
certain medicines you put yourself at
even greater risk. Combining alcohol
with some medicines can lead to falls
and serious injuries, especially among
older people.
MEDICINES MAY HAVE
MANY INGREDIENTS
Some medications—including many
popular painkillers and cough, cold,
and allergy remedies—contain more
than one ingredient that can react
with alcohol. Read the label on the
medication bottle to find out exactly
what ingredients a medicine contains.
Ask your pharmacist if you have any
questions about how alcohol might
interact with a drug you are taking.
SOME MEDICINES
CONTAIN ALCOHOL
Certain medicines contain up to 10
percent alcohol. Cough syrup and
laxatives may have some of the high-
est alcohol concentrations.
ALCOHOL AFFECTS
WOMEN DIFFERENTLY
Women, in general, have a higher
risk for problems than men. When a
woman drinks, the alcohol in her
bloodstream typically reaches a higher
level than a man’s even if both are
drinking the same amount. This is
because women’s bodies generally
have less water than men’s bodies. Be-
cause alcohol mixes with body water,
a given amount of alcohol is more
concentrated in a woman’s body than
in a man’s. As a result, women are
more susceptible to alcohol-related
damage to organs such as the liver.

2
OLDER PEOPLE FACE TIMING IS IMPORTANT
GREATER RISK Alcohol and medicines can interact
Older people are at particularly harmfully even if they are not taken
high risk for harmful alcohol– at the same time.
medication interactions. Aging slows
the body’s ability to break down REMEMBER...
alcohol, so alcohol remains in a Mixing alcohol and medicines puts
person’s system longer. Older people you at risk for dangerous reactions.
also are more likely to take a Protect yourself by avoiding alcohol if
medication that interacts with you are taking a medication and don’t
alcohol—in fact, they often need know its effect. To learn more about
to take more than one of these a medicine and whether it will inter-
medications. act with alcohol, talk to your phar-
macist or other health care provider.
Commonly Used Medicines (Both Prescription and Over-the-Counter)
That Interact With Alcohol
Symptoms/ Medication Medication Some possible
Disorders (Brand name) (Generic name) reactions with alcohol
Allergies/ • Alavert® Loratadine Drowsiness,
colds/flu • Atarax® Hydroxyzine dizziness;
• Benadryl® Diphenhydramine increased risk
• Clarinex® Desloratadine for overdose
• Claritin®, Loratadine
Claritin-D®
• Dimetapp® Brompheniramine
Cold & Allergy
• Sudafed® Chlorpheniramine
Sinus & Allergy
• Triaminic® Chlorpheniramine
Cold & Allergy
• Tylenol® Chlorpheniramine
Allergy Sinus
• Tylenol® Chlorpheniramine
Cold & Flu
• Zyrtec® Cetirizine
Angina • Isordil® Isosorbide Rapid heartbeat,
(chest pain), Nitroglycerin sudden changes
coronary in blood pressure,
heart disease dizziness, fainting
3
 Commonly Used Medicines (Both Prescription and
Symptoms/ Medication Medication Some possible
Disorders (Brand name) (Generic name) reactions with alcohol
Anxiety • Ativan® Lorazepam Drowsiness, dizziness;
and • BuSpar® Buspirone increased risk for
epilepsy • Klonopin® Clonazepam overdose; slowed or
• Librium® Chlordiazepoxide difficulty breathing;
• Paxil® Paroxetine impaired motor control;
• Valium® Diazepam unusual behavior;
• Xanax® Alprazolam memory problems

• Herbal preparations Liver damage,

(Kava Kava) drowsiness

Arthritis • Celebrex® Celecoxib Ulcers, stomach

• Naprosyn® Naproxen bleeding, liver
• Voltaren® Diclofenac damage

Attention and • Adderall ® Amphetamine/ Dizziness, drowsiness,

concentration dextro-amphetamine impaired concentration
(Attention • Concerta ®, Methylphenidate (methylphenidate,
deficit/ Ritalin ® dexmethylphenidate);
hyperactivity • Dexedrine ® Dextroamphetamine possible increased risk
disorder) • Focalin ® Dexmethylphenidate for heart problems
• Strattera ® Atomoxetine (amphetamine, dex-
• Vyvanse ® Lisdexamfetamine troamphetamine, lis-
dexamfetamine); liver
damage (atomoxetine)
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®, Dextromethorpan Drowsiness, dizziness;
Robitussin Cough® increased risk
• Robitussin A–C® Guaifenesin + codeine for overdose

4
Over-the-Counter) That Interact With Alcohol
Symptoms/ Medication Medication Some possible
Disorders (Brand name) (Generic name) reactions with alcohol

Depression • Abilify® Aripriprazone Drowsiness, dizziness;

• Anafranil® Clomipramine increased risk for overdose;
• Celexa® Citalopram increased feelings of
• Clozaril® Clozapine depression or hopelessness
• Cymbalta® Duloxetine (all medications); impaired
• Desyrel® Trazodone motor control (quetiapine,
• Effexor® Venlafaxine mirtazapine); increased
• Elavil® Amitriptyline alcohol effect (bupropion);
• Geodon® Ziprasidone liver damage (duloxetine)
• Invega® Paliperidone
• Lexapro ® Escitalopram Monoamine oxidase
• Luvox® Fluvoxamine inhibitors (MAOIs),
• Nardil® Phenelzine such as tranylcypromine
• Norpramin® Desipramine and phenelzine, when
• Parnate ® Tranylcypromine combined with alcohol,
• Paxil® Paroxetine may result in serious heart-
• Pristiq® Desevenlafaxine related side effects. Risk for
• Prozac® Fluoxetine dangerously high blood
• Remeron® Mirtazapine pressure is increased when
• Risperdal® Risperidone MAOIs are mixed with
• Seroquel® Quetiapine tyramine, a byproduct
• Serzone® Nefazodone found in beer and red wine
• Symbyax® Fluoxetine/Olanzapine
• Wellbutrin® Bupropion
• Zoloft® Sertraline
• Zyprexa Olanzapine
• Herbal preparations
(St. John’s Wort)
Diabetes • Diabinese® Chlorpropamide Abnormally low blood sugar
• Glucotrol® Glipizide levels, flushing reaction
• Glucophage® Metformin (nausea, vomiting,
• Glynase®, Glyburide headache, rapid heartbeat,
DiaBeta®, sudden changes in blood
Micronase® pressure); symptoms of
• Orinase® Tolbutamide nausea and weakness may
• Tolinase® Tolazamide occur (metformin)
Enlarged • Cardura® Doxazosin Dizziness, light
prostate • Flomax® Tamsulosin headedness, fainting
• Hytrin® Terazosin
• Minipress® Prazosin
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 Commonly Used Medicines (Both Prescription and
Symptoms/ Medication Medication Some possible
Disorders (Brand name) (Generic name) reactions with alcohol
Heartburn, • Axid® Nizatidine Rapid heartbeat; increased
indigestion, • Reglan® Metoclopramide alcohol effect; sudden
sour stomach • Tagamet® Cimetidine changes in blood pressure
• Zantac® Ranitidine (metoclopramide)

High blood • Accupril® Quinapril Dizziness, fainting,

pressure • Calan® Verapamil drowsiness; heart
• Capozide® Hydrochlorothiazide problems such as changes
• Cardura® Doxazosin in the heart’s regular
• Catapres® Clonidine heartbeat (arrhythmia)
• Cozaar® Losartan
• Hytrin® Terazosin
• Lopressor® HCT Hydrochlorothiazide
• Lotensin® Benzapril
• Minipress® Prazosin
• Norvasc® Amlodipine mesylate
• Prinivil®, Lisinopril
Zestril®
• Vaseretic® Enalapril

High • Advicor® Lovastatin + Niacin Liver damage (all

cholesterol • Altocor® Lovastatin medications); increased
• Crestor® Rosuvastatin flushing and itching
• Lipitor® Atorvastatin (niacin), increased
• Mevacor® Lovastatin stomach bleeding
• Niaspan® Niacin (pravastatin + aspirin)
• Pravachol® Pravastatin
• Pravigard™ Pravastatin +
Aspirin
• Vytorin™ Ezetimibe +
Simvastatin
• Zocor® Simvastatin

Infections • Acrodantin® Nitrofurantoin Fast heartbeat, sudden

• Flagyl® Metronidazole changes in blood
• Grisactin® Griseofulvin pressure; stomach pain,
• Nizoral® Ketoconazole upset stomach, vomiting,
• Nydrazid® Isoniazid headache, or flushing or
• Seromycin® Cycloserine redness of the face; liver
• Tindamax® Tinidazole damage (isoniazid,
• Zithromax® Azithromycin ketoconazole)
6
Over-the-Counter) That Interact With Alcohol
Symptoms/ Medication Medication Some possible
Disorders (Brand name) (Generic name) reactions with alcohol

Mood • Depakene®, Valproic acid Drowsiness, dizziness;

stabilizers Depakote® tremors; increased risk for
• Eskalith®, Lithium side effects, such as rest-
Eskalith®CR, lessness, impaired motor
Lithobid control; loss of appetite;
stomach upset; irregular
bowel movement; joint or
muscle pain; depression;
liver damage (valproic acid)

Muscle pain • Flexeril® Cyclobenzaprine Drowsiness, dizziness;

• Soma® Carisoprodol increased risk of seizures;
increased risk for overdose;
slowed or difficulty
breathing; impaired motor
control; unusual behavior;
memory problems

Nausea, • Antivert® Meclizine Drowsiness, dizziness;

motion • Dramamine® Dimenhydrinate increased risk for overdose
sickness • Phenergan® Promethazine

Pain • Advil® Ibuprofen Stomach upset, bleeding

(such as • Aleve® Naproxen and ulcers; liver damage
muscle ache, • Excedrin® Aspirin, (acetaminophen); rapid
minor arthritis Acetaminophen heartbeat
pain), fever, • Motrin® Ibuprofen
inflammation • Tylenol® Acetaminophen

Seizures • Dilantin® Phenytoin Drowsiness, dizziness;

• Horizant®, Gabapentin increased risk of seizures
Neurontin® (levetiracetam, phenytoin);
• Keppra® Levetiracetam unusual behavior and
• Klonopin® Clonazepam changes in mental health
(such as thoughts of
Phenobarbital suicide) (topiramate)
• Lamictal® Lamotrigine
• Lyrica® Pregabalin
• Tegretol® Carbamazepine
• Topamax® Topiramate
• Trileptal® Oxcarbazepine
Barbiturates
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 Commonly Used Medicines (Both Prescription and Over-the-Counter)
That Interact With Alcohol
Symptoms/ Medication Medication Some possible
Disorders (Brand name) (Generic name) reactions with alcohol

Severe pain • Darvocet–N® Propoxyphene Drowsiness, dizziness;

from injury, • Demerol® Merepidine increased risk for overdose;
postsurgical • Fiorinal® Butalbital + codeine slowed or difficulty
care, oral with codeine breathing; impaired motor
surgery, • Percocet® Oxycodone control; unusual behavior;
migraines • Vicodin® Hydrocodone memory problems

Sleep • Ambien® Zolpidem Drowsiness, sleepiness,

problems • Lunesta™ Eszopiclone dizziness; slowed or
• Prosom™ Estazolam difficulty breathing; impaired
• Restoril ® Temazepam motor control; unusual
• Sominex® Diphenhydramine behavior; memory problems
• Unisom® Doxylamine
• Herbal Increased drowsiness
preparations
(chamomile,
valerian, lavender)

8
Additional 
resources
Additional 
Resources

MedlinePlus U.S. Food and Drug Administration
A service of the U.S. National Library  Center for Drug Evaluation and Research:
of Medicine and the National Institutes  http://www.fda.gov/cder 
of Health.
http://www.nlm.nih.gov/medlineplus/ Drug Interactions: 
druginformation.html http://www.fda.gov/drugs/resourcesfor
you/ucm163354.htm
Provides information on prescription and
over­the­counter medications. Phone numbers: 
• Main FDA for general inquiries: 
National Institute on Alcohol Abuse  1–888–INFO–FDA (1–888–463–6332)
and Alcoholism • To submit a report about Adverse
http://www.niaaa.nih.gov Drug Reaction: Medwatch: 
Phone number: 301–443–3860  1–800–FDA–1088
Makes available free informational  Provides information on prescription 
materials on alcohol use, alcohol abuse, and over­the­counter medications, 
and alcoholism. consumer drug information, and reports
and publications.

9
NATIONAL INSTITUTE ON ALCOHOL ABUSE AND ALCOHOLISM
NIH . . . Turning Discovery Into Health

NIH Publication No. 13–5329

Published 2003
Revised 2014