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Can You Drink On Antibiotics? The Answer Is Probably Yes

Not that we're recommending it.

07/07/2017 7:38 AM AEST | Updated 07/07/2017 7:47 AM AEST

Antibiotics and alcohol have long been thought to be like toothpaste and OJ: in other words, they should never mix.

But according to Dr Ian Musgrave, senior lecturer of medical sciences at The University of Adelaide, the widely held belief that you mustn't drink any alcohol if you are taking antibiotics isn't necessarily true.

"For the vast majority of antibiotics, you don't have to worry," Musgrave told HuffPost Australia. "Seriously, for most antibiotics, it doesn't matter. Outside of -- if you drink too much and then you won't remember to take your antibiotics -- which can then be a problem."

So if there's nothing to worry about, why is the alcohol/antibiotic discussion even a thing?

The origin of the alcohol/antibiotic debate isn't exactly known, though Karl S. Kruszelnicki (Dr Karl) has said it could be traced back as early as the 1950s when drugs like penicillin first came into use to treat STDs like gonorrhoea and syphilis.

As reported in an article in The Conversation, doctors were apparently concerned patients would be more likely to have sex under the influence of alcohol and therefore spread the STD further or, worse, undo the effects of the new (expensive) medication.

John Firth via Getty Images
Apparently '50s doctors were concerned alcohol would increase friskiness in patients taking antibiotics for STDs.

However, in terms of actual side effects that would result from mixing antibiotics and alcohol, Musgrave states this only holds true for a select group which aren't commonly prescribed.

"There are specific groups [of antibiotics] which, when mixed with alcohol, can cause side effects," Musgrave says. "Generally they will have big warnings on them saying 'do not take with alcohol'. Some are quite restrictive in use.

"So for example, there is one class of antibiotics which interferes with how alcohol is broken down, or more specifically, how the product of alcohol is broken down and can cause side effects such as nausea, vomiting, a fall in blood pressure and headaches.

"These include cefotetan, metronidazole (trade name Flagyl) and trimethoprim-sulfamethoxazol (trade name Bactrim)."

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To be honest, you're probably better off having juice.

Musgrave also lists erythromycin as a drug that shouldn't be mixed with alcohol, mainly because it will increase its effects.

"Erythromycin causes faster gastric emptying, leading to more alcohol absorption and thus greater intoxication," he says. "So you are more likely to get drunker than usual."

Another problematic drug is isoniazid, which is commonly used for treating tuberculosis -- though we're betting anyone with TB isn't really feeling up to a night on the margaritas.

"The problem here is it has a risk of causing liver damage, and the presence of alcohol makes that risk higher," Musgrave says.

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While you might not suffer any adverse reactions from mixing alcohol with antibiotics, it's still not advised to drink while you're sick.

However, with the exception of these particular groups, Musgrave says there's no real pharmaceutical reason not to enjoy a glass of vino if you are taking antibiotics.

"I think the advice surrounding [these specific antibiotics] has been taken into the general population, whereas in reality there's not much to worry about," he says. "Of course this depends on how much alcohol you drink, making sure you remember to take your antibiotics, and the specific antibiotics you are taking."

However it's important to note while there strictly might not be a particular issue with mixing alcohol and antibiotics, that's not to say it's a good idea to be drinking when you're under the weather.

Firstly, if you have a fever, you need all the hydration you can get, and alcohol is well known for causing dehydration (anyone who has woken up the morning after a big night with 'desert mouth' will know what we're talking about).

Furthermore, alcohol can have a short-term negative effect on your immune system, making it more difficult for you to fight off the infection.

But as for suffering from the antibiotic/alcohol mix in itself? It would appear not. But just to be safe, make sure you consult your doctor before indulging in that beverage... even if it is a hot toddy.

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