Combining Alcohol and Over-the-Counter Drugs

Combining Alcohol and Over-the-Counter Drugs

Around 86.3% of adults in the United States reported drinking alcohol at some point in their lifetime, with 70.0% reporting alcohol consumption in the past year.

Alcohol and Over-the-Counter Drugs

Alcohol and over-the-counter drugs are two substances that many people use without thinking twice. Many people don't realize the risks associated with combining alcohol and certain medications, including over-the-counter drugs. Unfortunately, there are over 100 legal drugs, both OTC and prescription, that interact badly with alcohol.

Drinking while taking these medications can lead to an overdose or poisoning, damage to internal organs, or uncomfortable side effects like nausea or dizziness.

According to a survey by the National Institutes of Health, 42 percent of respondents admitted to drinking while also taking drugs that could cause problems when mixed with alcohol.

While prescription anti-anxiety medicines or blood thinners may seem obviously risky, OTC medications are often assumed to be safe due to their availability on drugstore shelves.

However, not only do these drugs interact poorly with alcohol, they may even contain some alcohol themselves. In this article, we will explore why combining alcohol and over-the-counter drugs is such a dangerous mix and what steps you can take to protect yourself from harm.

Risks of Combining Alcohol and Over-the-Counter Drugs

There are many risks associated with combining alcohol and over-the-counter drugs.

Increased Effects and Dangerous Side Effects

One of the main concerns is that alcohol can increase the effects of these drugs, leading to dangerous side effects. For example, if you take a pain reliever like acetaminophen and then drink alcohol, you may experience liver damage or other serious health problems.

Similarly, combining alcohol with antihistamines can cause drowsiness, dizziness, and impaired coordination, which can increase your risk of accidents and injuries.

Interference with Medication Processing

Another concern is that alcohol can interfere with the way your body processes medications. This can lead to unpredictable effects and increase your risk of overdose or toxicity.

For example, if you take a sleeping pill and then drink alcohol, you may experience extreme drowsiness and respiratory depression, which can be life-threatening.

Harmful Interactions Combining Alcohol and Over-the-Counter Drugs

Combining medications with alcohol can have serious risks and side effects.

Certain drugs can intensify the effects of alcohol, leading to more severe impairment and potentially dangerous symptoms like:

  • Nausea
  • Vomiting
  • Headaches
  • Faintness or fainting
  • Drowsiness or excessive sleepiness
  • Fluctuations in blood pressure
  • Abnormal behaviors
  • Loss of coordination, or stumbling
  • Accidents

Mixing alcohol and medications can also lead to long-term health risks. Even over-the-counter medications can cause serious health problems when combined with alcohol abuse. People who abuse alcohol while taking drugs, whether prescription or over-the-counter, put themselves at increased risk for long-term harm. These risks may include:

  • Liver damage or failure
  • Heart problems
  • Impaired breathing, leading to oxygen deprivation
  • Internal bleeding
  • Depression or mental changes

In some cases, mixing alcohol with medication can even lead to an overdose or alcohol poisoning, which are both life-threatening medical emergencies.

The severity of these effects can vary based on individual factors such as metabolism, with women often experiencing more severe effects than men due to metabolic differences.

Older adults who take multiple medications may also be at higher risk due to reduced ability to clear both alcohol and drugs from their bodies.

How Alcohol Can Interact with Specific Drugs and Their Side Effects

Certain types of over-the-counter drugs can have dangerous interactions with alcohol. Here are some examples:

Nonsteroidal anti-inflammatory drugs (NSAIDs)

Drugs like ibuprofen or acetaminophen can cause stomach upset if taken with alcohol. Repeated use of these drugs with alcohol can lead to stomach ulcers, bleeding from the stomach lining or intestines, and liver damage. They may also raise heart rate, which is dangerous for those with heart conditions. Here are some common types of NSAIDs:

  • Ibuprofen (Advil, Motrin)
  • Naproxen (Aleve)
  • Aspirin
  • Acetaminophen (Tylenol)
  • Ketoprofen (Orudis)

Allergy, cold, and flu medications

Drugs in Sudafed, Tylenol Cold and Sinus, or similar medications can increase drowsiness or dizziness. When mixed with alcohol, the intoxicating drink may be more bioavailable, so it enters the bloodstream at higher volumes. This puts the person at risk of becoming drunker faster, potentially leading to unsafe driving or accidents. There is also an increased risk of overdose. Here are some common types of allergy, cold, and flu medications:

  • Pseudoephedrine (Sudafed)
  • Phenylephrine (Sudafed PE)
  • Diphenhydramine (Benadryl)
  • Loratadine (Claritin)
  • Acetaminophen + Dextromethorphan + Phenylephrine (Tylenol Cold and Sinus)

Cough syrup

Decongestants and cough suppressants in OTC cough syrups may contain up to 10 percent alcohol, so mixing these with even a casual drink or two increases the risk of intoxication. Some cough syrups also contain dextromethorphan (DXM), a cough suppressant that can be an intoxicating drug in high doses. Mixing DXM with alcohol increases its potency, putting the person at even greater risk of harm. Here are some common types of cough syrups:

  • Robitussin
  • NyQuil
  • Delsym
  • Mucinex DM
  • Triaminic

Acetaminophen and Ibuprofen

Acetaminophen by itself can lead to overdose, including liver damage and failure, if a person takes more than 4,000 mg of the drug. When mixed with alcohol, the risk of liver damage increases. Ibuprofen and naproxen do not harm the liver as much as acetaminophen can, but they may damage the stomach lining. The risks of this damage increase if a person consumes alcohol, leading to gastritis (inflammation of the stomach lining), which may lead to ulcers and bleeding. They may also damage the kidneys, especially when their potency is increased because of alcohol. Here are some common types of medications that contain acetaminophen or ibuprofen:

  • Tylenol (acetaminophen)
  • Advil (ibuprofen)
  • Motrin (ibuprofen)
  • Aleve (naproxen)
  • Excedrin (acetaminophen + aspirin + caffeine)

Mixing Mental Health Medications with Alcohol

Mental health medications are often prescribed to help manage symptoms of various mental health conditions, such as anxiety, depression, bipolar disorder, and schizophrenia. However, many of these medications can interact negatively with alcohol and cause harmful side effects.

Here are some common mental health medications that can interact with alcohol:


Mixing alcohol with antidepressants can lead to increased sedation and drowsiness. It can also increase the risk of suicidal thoughts or actions. Some antidepressants like monoamine oxidase inhibitors (MAOIs) should not be taken with alcohol at all due to the risk of a dangerous spike in blood pressure. Here are some common types of antidepressants:

  • Selective serotonin reuptake inhibitors (SSRIs)
  • Serotonin-norepinephrine reuptake inhibitors (SNRIs)
  • Tricyclic antidepressants (TCAs)
  • Monoamine oxidase inhibitors (MAOIs)
  • Atypical antidepressants

Anti-anxiety medications

Alcohol and anti-anxiety medications like benzodiazepines can both cause sedation and drowsiness. Combining them can lead to extreme drowsiness, breathing difficulties, coma, or even death. Here are some common types of anti-anxiety medications:

  • Alprazolam (Xanax)
  • Clonazepam (Klonopin)
  • Diazepam (Valium)
  • Lorazepam (Ativan)
  • Chlordiazepoxide (Librium)

Mood stabilizers

Lithium is a common mood stabilizer used to treat bipolar disorder. Drinking alcohol while taking lithium can interfere with its effectiveness and increase the risk of toxicity. Other mood stabilizers like valproic acid or carbamazepine may also increase the risk of liver damage when combined with alcohol. Here are some common types of mood stabilizers:

  • Lithium
  • Valproic acid (Depakote)
  • Carbamazepine (Tegretol)
  • Lamotrigine (Lamictal)
  • Oxcarbazepine (Trileptal)


Alcohol and antipsychotic medications like olanzapine or risperidone can both cause dizziness, drowsiness, and impaired coordination. Combining them can increase these effects and lead to falls or accidents. Here are some common types of antipsychotic medications:

  • Aripiprazole (Abilify)
  • Clozapine (Clozaril)
  • Olanzapine (Zyprexa)
  • Quetiapine (Seroquel)
  • Risperidone (Risperdal)

It's important to talk to your doctor before drinking alcohol while taking any medication for mental health conditions. They can advise you on whether it's safe to drink alcohol while taking your medication and what precautions you should take if you choose to drink.

Related: Cocaethylene – The Danger of Mixing Cocaine and Alcohol

Over-the-Counter Drugs Safe with Alcohol

Here's a list of some over-the-counter drugs that are often assumed to be safe when taken with alcohol:

  1. Acetaminophen (Tylenol)
  2. Ibuprofen (Advil, Motrin IB)
  3. Naproxen (Aleve)
  4. Aspirin
  5. Antacids (Tums, Rolaids)
  6. Cough and cold medicines (Robitussin, Nyquil)
  7. Allergy medications (Claritin, Zyrtec)

But don't be fooled - as we've discussed earlier in this article, mixing alcohol with any medication can lead to dangerous side effects or interfere with how your body processes the medication.

Tips for Recognizing Signs of Overdose or Toxicity

Combining alcohol and over-the-counter drugs can lead to an increased risk of overdose or toxicity. It's important to know the signs and symptoms of these conditions so that you can seek medical attention immediately if necessary.

Here are some common signs of overdose or toxicity from combining alcohol and OTC drugs:

Acetaminophen (Tylenol)

  • Nausea
  • Vomiting
  • Abdominal pain
  • Loss of appetite
  • Sweating
  • Confusion

Ibuprofen (Advil, Motrin IB) and Naproxen (Aleve)

  • Stomach pain
  • Nausea
  • Vomiting blood or material that looks like coffee grounds
  • Black, tarry stools
  • Diarrhea


  • Rapid breathing
  • Lethargy or confusion
  • Seizures
  • Coma

Antacids (Tums, Rolaids)

  • Constipation or diarrhea
  • Stomach cramps
  • Dry mouth
  • Increased thirst

Cough and cold medicines (Robitussin, Nyquil)

Symptoms of overdose from cough and cold medicines containing dextromethorphan include:

  • Disorientation
  • Hallucinations
  • Confusion
  • Drowsiness
  • Nausea or vomiting

Allergy medications (Claritin, Zyrtec)

Symptoms of allergy medication overdose can vary depending on the specific medication but may include:

  • Dizziness
  • Blurred vision
  • Dry mouth
  • Difficulty urinating

If you experience any of these symptoms after combining alcohol with an OTC drug, seek emergency medical attention immediately. It's important to be honest with medical professionals about what medications and alcohol you have consumed, as this information can help them provide the most effective treatment.

How Long It Takes for the Body to Metabolize Alcohol and Medication

The time it takes for the body to metabolize alcohol and medication can vary depending on several factors, including age, weight, sex, and overall health. In general, the liver is responsible for processing both alcohol and medication in the body.

The liver processes alcohol at a rate of approximately one standard drink per hour. A standard drink is defined as 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of liquor.

However, this rate can be affected by several factors such as:

  • Gender: Women tend to process alcohol more slowly than men due to differences in body composition.
  • Age: As we age, our bodies become less efficient at metabolizing alcohol.
  • Weight: People who weigh more may be able to process alcohol faster than those who weigh less.
  • Genetics: Some people may have genetic variations that affect how quickly they can metabolize alcohol.

When it comes to medication processing, the liver also plays a crucial role in breaking down drugs and removing them from the body. The time it takes for medication to be metabolized can vary widely depending on several factors such as:

  • Type of drug: Some drugs are processed more quickly than others.
  • Dosage: Higher doses of medication will take longer to be metabolized.
  • Frequency: Frequent use of medication can slow down metabolism over time.
  • Other medications: Taking multiple medications at once can interfere with each other's metabolism.

It's important to note that combining alcohol with medication can slow down the metabolism of both substances. This means that it can take even longer for your body to process these substances when they're taken together.

In some cases, this slow metabolism can lead to dangerous interactions and side effects. For example, if you drink alcohol while taking a pain reliever like acetaminophen, it can take longer for your body to process both substances, which can increase the risk of liver damage or other serious health problems.

It's always a good idea to talk to your doctor or pharmacist if you have questions about how long it takes for your body to metabolize alcohol or medication. They can help you understand the risks and potential side effects of combining these substances and provide guidance on safe consumption.

Safe Ways to Drink While Taking Medication

It's important to remember that the safest way to drink while taking medication is to avoid alcohol altogether. However, if you do choose to drink, there are some steps you can take to reduce your risk of harmful interactions.

Strategies to reduce risk

  • Wait after taking medication: Wait a certain amount of time after taking medication before drinking. This can give your body enough time to metabolize the medication and reduce the risk of dangerous interactions.
  • Consult with your doctor or pharmacist: Talk with your doctor or pharmacist about whether it's safe for you to drink while taking your medication. They may be able to recommend specific guidelines based on your individual health status and medication regimen.

Pay attention to your body

It's also important to pay attention to how your body responds when you combine alcohol and medication. If you experience any unusual symptoms or side effects, stop drinking immediately and seek medical attention if necessary.

Read labels carefully

Finally, it's always a good idea to read the labels on both your medication and any over-the-counter drugs or supplements you're taking. Some medications may have specific warnings against drinking alcohol while taking them, so be sure to follow these guidelines carefully.

By taking these precautions, you can help reduce your risk of harmful interactions between alcohol and medication, and enjoy a safe and responsible drinking experience.


In conclusion, it's important to be aware of the potential risks and dangers of mixing alcohol with medication, including over-the-counter drugs. While some medications may be safe when taken with alcohol in moderation, many can lead to serious side effects or dangerous interactions.

To stay safe while taking medication and drinking alcohol, it's best to avoid alcohol altogether or wait a certain amount of time after taking medication before drinking. Always talk to your doctor or pharmacist about the risks and potential side effects of combining alcohol and medication.

Remember to pay attention to how your body responds when you combine alcohol and medication, and seek medical attention immediately if you experience any unusual symptoms or side effects.


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