You should not drink alcohol while taking certain medications—and it’s important to know how long after taking medicine you can drink. You may have heard that mixing alcohol and medication can be a bad, even dangerous combination. Drinking combined with certain medications can cause symptoms like drowsiness, forgetfulness, lightheadedness, impaired judgment, trouble concentrating, or even liver damage or death.

But when healthcare providers say not to mix drinking with drugs, are they really talking about one beer or glass of wine?

Many factors influence whether or not—and when—it’s safe to drink alcohol with or after taking your medication, including the kind of medicine, the type and amount of alcohol, and your age and sex. Learn more about the risks of combining alcohol and medication, including how long to wait to drink after taking certain medications.

Determining whether you can take medicine before or after drinking alcohol can depend on several factors. For example, the type of medication, as well as the type and amount of alcohol, can make a difference in how safe or unsafe it is to combine them or how long after taking the medication you should wait before consuming alcohol.

Consult with a medical provider about how any alcohol use may interact with your medications, including any supplements, vitamins, or contraception. Each person’s metabolism, alcohol tolerance, and other individual health factors will determine specifically how long you need to wait before it’s safe to drink.

Timing is important. Alcohol and medicines can cause harmful effects even if they’re not taken simultaneously. Sometimes, you can drink a few hours after taking a medication, other times you’ll need to wait a few days or longer.

Age is another factor. As we get older, alcohol stays in our system longer. That’s because we metabolize alcohol more slowly as we age. In addition, the older we get, the more likely we are to be taking one or more medications that could interact with alcohol.

How well we metabolize alcohol is also determined by our sex. Since people assigned male and female at birth have differences in body chemistry, they may absorb and metabolize alcohol at different rates. After drinking the same amount, people assigned female at birth tend to have higher blood alcohol levels than their male counterparts.

Here’s a list of medications that can negatively interact with alcohol, along with descriptions of what those interactions may look like.

The following medications are all antihistamines. This class of drugs can cause excessive drowsiness and may put you at risk if you’re driving a car or operating machinery—and that’s without alcohol. When you combine these drugs with alcohol, you’re even more at risk of accidents. They also pose an increased risk of overdose.

• Brompheniramine (found in Dimetapp Cold & Allergy)
• Cetirizine (found in Zyrtec)
• Chlorpheniramine (found in Sudafed Sinus & Allergy, Triaminic Cold & Allergy, Tylenol Allergy Sinus, Tylenol Cold & Flu)
• Desloratadine (found in Clarinex)
• Diphenhydramine (found in Benadryl)
• Hydroxyzine (found in Vistaril)
• Loratadine (found in Alavert, Claritin, Claritin-D)

Bottom line: Don’t drink alcohol when taking antihistamines. However, if you do choose to have a drink, do so in a safe setting in which you don’t have to drive or otherwise put yourself at risk.

A healthcare provider will likely warn you about drinking when you’re prescribed certain medications for bacterial and fungal infections—and for a good reason. Alcohol can make some of the unpleasant side effects of these drugs worse.

Side effects of mixing antibiotics and antifungals with alcohol can range from fast heartbeat and sudden changes in blood pressure to stomach pain, upset stomach, vomiting, headache, or redness in the face. Mixing isoniazid and ketoconazole with alcohol can also cause liver damage.

Here are some common antibiotic and antifungal medications that can potentially have worse side effects when mixed with alcohol.

Antibiotics:

• Cycloserine
• Flagyl (metronidazole)
• Isoniazid
• Macrodantin (nitrofurantoin)
• Tindamax (tinidazole)
• Zithromax (azithromycin)

Antifungals:

Bottom line: Don’t drink if you’re taking one of the antibiotics or antifungals listed above. Ask a healthcare provider when it’s okay to start drinking again. Sometimes, you may need to wait 48 to 72 hours after your last dose before it’s safe to have an alcoholic beverage.

Remember, you’ll be taking the antibiotic or antifungal medication only for a matter of days or weeks. Abstaining from alcohol until you’re entirely done with your meds will also support your body as it heals.

Antidepressants can cause drowsiness and dizziness that can be made worse with alcohol. This can raise your risk for falls and car accidents. Mixing any of the antidepressants below with alcohol can also increase feelings of depression or hopelessness.

• Abilify (aripriprazone)
• Amitriptyline
• Anafranil (clomipramine)
• Celexa (citalopram)
• Clozaril (clozapine)
• Cymbalta (duloxetine)
• Effexor XR (venlafaxine)
• Fluvoxamine
• Geodon (ziprasidone)
• Invega (paliperidone)
• Lexapro (escitalopram)
• Nardil (phenelzine)
• Nefazodone
• Norpramin (desipramine)
• Parnate (tranylcypromine)
• Paxil (paroxetine)
• Pristiq (desvenlafaxine)
• Prozac (fluoxetine)
• Remeron (mirtazapine)
• Risperdal (risperidone)
• Seroquel (quetiapine)
• St. John’s Wort herbal preparation
• Symbyax (fluoxetine/olanzapine)
• Trazodone
• Wellbutrin (bupropion)
• Zoloft (sertraline)
• Zyprexa (olanzapine)

Some of these antidepressants come with additional side effects when mixed with alcohol. Seroquel and Remeron can impair motor control. Wellbutrin can intensify the effect of alcohol. Cymbalta can cause liver damage.

Antidepressants called monoamine oxidase inhibitors (MAOIs), like Parnate and Nardil, can cause serious heart problems when combined with alcohol. When mixed with beer or wine, they can also cause dangerously high blood pressure due to an alcohol byproduct called tyramine.

Bottom line: If you’re on MAOIs, avoid alcohol completely. If you’re on another antidepressant and your depression is well managed, having an occasional alcoholic beverage may not be a problem. Before you indulge in that happy hour drink, however, talk to a healthcare provider about the risks of drinking with your antidepressant.

Drowsiness, dizziness, and slowed or labored breathing can all be side effects of mixing certain anxiety and epilepsy drugs with alcohol. A person may also have problems with motor functions, behavior, and memory. Plus, mixing these meds with alcohol increases the risk of overdose.

• Ativan (lorazepam)
• Buspirone
• Chlordiazepoxide
• Klonopin (clonazepam)
• Paxil (paroxetine)
• Valium (diazepam)
• Xanax (alprazolam)

Kava Kava, an herbal preparation, is sometimes used to treat these conditions. It, too, should not be used with alcohol due to liver damage and drowsiness risk.

Bottom line: Don’t drink on these meds. This mixture can be dangerous and even deadly.

Some arthritis medicines, when combined with alcohol, can cause ulcers, stomach bleeding, and liver damage.

• Aleve/Naprosyn (naproxen)
• Celebrex (celecoxib)
• Voltaren (diclofenac)

Bottom line: Drinking on these meds should be done in moderation, if at all.

When combined with alcohol, medications for attention and concentration disorders can make a person dizzy and sleepy.

• Adderall (amphetamine/dextroamphetamine)
• Concerta, Ritalin (methylphenidate)
• Dexedrine (dextroamphetamine)
• Focalin (dexmethylphenidate)
• Strattera (atomoxetine)
• Vyvanse (lisdexamfetamine)

Combining alcohol with Concerta, Ritalin, or Focalin can worsen concentration. Adderall, Dexedrine, and Vyvanse can increase a person’s risk for heart problems. Liver damage can occur with Strattera.

Bottom line: It’s best to talk to your healthcare provider to learn if there are side effects to mixing your medication with alcohol.

The effectiveness of oral contraceptives (and other forms of hormonal birth control) isn’t affected by alcohol, so it’s OK to enjoy a drink here and there when taking the pill.

An important note: The Centers for Disease Control and Prevention (CDC) advises people trying to get pregnant (and, therefore, not using birth control) to steer clear of alcohol due to the dangers of drinking in the early stages of pregnancy.

Bottom line: With most contraceptives, you can enjoy alcohol in moderation. Be cautious about imbibing too much, however. Any intoxication can make you likely to forget or be off track with your pills, which would make them less effective. For women, the recommendation is to have no more than one drink a day, and for men, no more than two drinks a day. However, discuss alcohol intake with your healthcare provider when you’re deciding on the right form of contraception for you.

When mixed with alcohol, these blood pressure medications can cause dizziness, fainting, and drowsiness. Heart problems can also occur, including irregular heartbeats (arrhythmia).

• Accupril (quinapril)
• Calan SR (verapamil)
• Cardura (doxazosin)
• Catapres (clonidine)
• Cozaar (losartan)
• Hydrochlorothiazide (found in Lopressor HCT among other products)
• Lotensin (benazepril)
• Minipress (prazosin)
• Norvasc (amlodipine)
• Terazosin
• Vasotec (enalapril)
• Zestril (lisinopril)

Bottom line: It’s best not to combine alcohol and blood pressure meds. Plus, limiting alcohol consumption can help manage and prevent high blood pressure. Talk to your healthcare provider about the risks of drinking based on the specific drugs you’re taking.

Blood thinners increase the risk of bleeding, which may cause blood loss, minor trauma, brain bleeds, or even death. Since alcohol consumption makes falling (or getting another injury that includes bleeding) more likely, drinking should be avoided while taking blood thinners.

Warfarin is a commonly used medication to prevent blood clots, sold under the name Coumadin. Alcohol can especially affect the metabolism of warfarin. People who drink occasionally may have internal bleeding while taking this medication. People who drink heavily may also experience internal bleeding (such as in the stomach or intestines) or bleeding disorders. There is also a risk of blood clots, strokes, or heart attacks.

Bottom line: Don’t drink if you’re taking this med. Mixing Coumadin (warfarin) with alcohol—whether it’s an occasional or daily drink—poses serious health risks. If you are on a blood thinner, discuss any alcohol use with a medical provider.

Drinking large amounts of alcohol with cholesterol-lowering drugs may increase your risk of liver damage. Niacor can cause increased flushing and itching, and Pravigard can cause increased stomach bleeding.

• Altoprev (lovastatin)
• Crestor (rosuvastatin)
• Lipitor (atorvastatin)
• Niacor (niacin)
• Pravastatin
• Pravigard (pravastatin + aspirin)
• Vytorin (ezetimibe + simvastatin)
• Zocor (simvastatin)

Bottom line: Due to the risk of liver damage and other negative health and side effects, it’s best to avoid heavy drinking while taking many cholesterol-lowering medications.

Alcohol and diabetes medications can cause a person’s blood sugar to go too low. Some people may experience nausea, vomiting, headache, rapid heartbeat, and sudden changes in blood pressure. Glumetza, in particular, may cause nausea and weakness.

• Glucotrol XL (glipizide)
• Glumetza (metformin)
• Glynase (glyburide)

Bottom line: Avoid alcohol when possible. If you do have a drink, make sure to keep an eye on your blood sugar.

Medications used to manage pain can also interact with alcohol. The effects vary depending on the type of pain pill.

For General Pain, Aches, Fever, Inflammation

Combining medicines for managing general pain, muscle ache, fever, and inflammation with alcohol can cause stomach upset, bleeding, ulcers in your stomach, and rapid heartbeat. When mixed with alcohol, Excedrin and Tylenol can also cause liver damage.

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

Bottom line: If you’re taking these medications regularly to manage pain, it’s best to avoid alcohol or drink only occasionally. If you use these meds for a random headache or after a dentist appointment, your risk isn’t going to increase that much from going to a happy hour later that day. However, avoid taking these medications at the same time as drinking.

For Muscle Pain

When paired with alcohol, muscle relaxers can also cause drowsiness and dizziness. A person’s risk of seizures and risk for overdose goes up. Breathing can become difficult or slowed. Impaired motor control, unusual behavior, and memory problems are also observed.

• Fexmid (cyclobenzaprine)
• Soma (carisoprodol)

Bottom line: Avoid alcohol if you’re taking these meds.

For Severe Pain

Pain from injuries, surgery, and migraines is usually severe. The meds used to treat it need to be equally strong. Combining them with alcohol can make a person sleepy and dizzy. People may have problems breathing or breathe more slowly. The risk of overdose is increased. Motor control, behavior, and memory can all be affected as well.

• Ascomp-Codeine (butalbital, aspirin, caffeine, codeine)
• ConZip (tramadol)
• Demerol (meperidine)
• Dilaudid (hydromorphone)
• Fentora, Duragesic (fentanyl)
• Hydrocodone (found in Lortab)
• Methadose (methadone)
• MS Contin (morphine)
• Oxycodone (found in Percocet, OxyContin)

Bottom line: Don’t drink alcohol if you’re taking these meds.

When combined with alcohol, sleeping pills can have the same effect as many other meds on this list. Side effects include drowsiness and dizziness. Breathing may slow or become difficult. People can also have problems with motor control, memory, and behavior.

• Ambien (zolpidem)
• Estazolam
• Lunesta (eszopiclone)
• Restoril (temazepam)
• Sominex (diphenhydramine)
• Unisom (doxylamine)

In addition, herbal sleep remedies, like chamomile, valerian, and lavender, can cause increased drowsiness when mixed with alcohol.

Bottom line: Don’t risk it—not even with one or two drinks. Not only can this combination be dangerous, but it can also be deadly.

It’s worth being cautious when it comes to mixing alcohol and medications. Some medications pose more serious risks than others, with symptoms ranging from drowsiness and dizziness to liver damage, slowed breathing, and possibly death.

If you’re not sure about the safety of combining alcohol and any medications you’re taking, talk with a healthcare provider to get answers specific to your health and medical history.