On Sint Maarten, social gatherings, beach days, holidays, and carnival celebrations are an important part of life. Alcohol is often consumed at these events. Alcohol itself can cause problems with your health, but what many people don’t realize is that alcohol can also have a significant effect on how medications work in your body. The effects depend on the type and amount of alcohol and medication; how close together they are taken; and individual factors, such as your body and health.
Even a few drinks can change how medicine works – sometimes with serious consequences. For example, a person who takes medication for anxiety or sleep might feel extremely drowsy after a few drinks, more than expected, which can make everyday activities like walking home from the beach dangerous.
In your body, the liver is responsible for breaking down alcohol, but the liver also plays an important role in processing many medications. Some medicines do not work right away. The liver may need to activate the medicine before it can have an effect in the body. These medicines are called prodrugs. There are also medicines that work immediately, but the liver needs to break them down, so they can be removed safely from your body. This prevents medicines from building up to unsafe or toxic levels.
When alcohol and medicine are taken at the same time, the liver has to process both. This puts extra workload on the liver, because the liver must process the alcohol and the medication at the same time. In simple terms, they are competing. As a result, the medicine may stay longer than intended in the body, causing more side effects; or the medicine may not be activated properly, making it less effective.
One medication that deserves special attention regarding the liver is paracetamol (acetaminophen). It is commonly used to treat pain and fever and is widely available without a prescription. Although paracetamol is generally safe when used as directed, drinking alcohol while taking it can put extra stress on the liver, and increase the risk of liver damage. This risk is higher if you take high doses, use the medicine for a long time, or drink alcohol regularly or heavily.
When paracetamol is broken down, a small amount of toxic byproduct is formed. Normally, the body neutralizes this toxic byproduct safely, but in high doses or when the liver is stressed (for example by chronic alcohol use), this product can build up and damage the liver.
Another important mechanism involves the central nervous system, which includes the brain and nerves that control how your body feels and moves. Alcohol has a sedating effect, which means it slows down brain activity and can make you feel drowsy or less alert. When combined with medicines that also cause drowsiness – such as sleeping pills, anti-anxiety drugs, antidepressants, strong painkillers (opioids), allergy medications, and some cough syrups – these sedating effects can be increased. This may result in extreme drowsiness, dizziness, confusion, impaired judgment, slowed breathing, or loss of coordination. Because of these effects, it is dangerous to drive, swim, or operate machinery. Even walking on uneven ground, such as the beach or stairs, can become risky.
Alcohol can also interfere with medications used to treat chronic conditions, including high blood pressure, diabetes, heart disease, and gastrointestinal disorders. For example, alcohol can cause a sudden drop in blood pressure in someone taking blood pressure medication, or unexpected spikes or drops in blood sugar in someone using insulin. It can also irritate the stomach or increase the risk of bleeding, particularly when combined with blood thinners or anti-inflammatory medicines. Even a small amount of alcohol can cause these effects in some people, which is why it is important to be cautious.
There is a common misconception that over-the-counter (OTC) medications are always safe to combine with alcohol. In reality, many cold- and flu-medications, motion sickness tablets, and pain relievers can interact with alcohol and worsen side effects. For example, some cold medicines contain ingredients that cause drowsiness. If these medicines are combined with alcohol, you may feel extremely sleepy or dizzy.
Because these interactions are not always predictable, it is important to read medication labels carefully and consult a pharmacist about using your medication in combination with alcohol. Simple precautions, such as spacing apart alcohol and medicine, reducing alcohol intake, or checking with a pharmacist, can make a big difference in avoiding side effects or more serious problems.
The mechanism described above is explained in simplified terms to make it accessible to the public. For personal questions and/or advice, please speak with a qualified healthcare professional.
This information is provided by the Pharmacy Association of Sint Maarten (PAS). PAS is dedicated to improving the quality of pharmaceutical care on the island. All pharmacies on the Dutch side of Sint Maarten are proud members of PAS.
