Why can it be toxic to take certain medication with any type of alcoholic beverage?

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Why can it be toxic to take certain medication with any type of alcoholic beverage?

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Alcohol slows down the body, including the digestive system. When you take that medication, pharmacists only expect it to be in your body for a certain amount of time. It is dangerous because that now stays in your body longer.

Things like acetaminophen (Tylenol) hurt your liver.

Alcohol also hurts your liver.

But if you mix the two it doesn’t double the damage – it does worse than double because they play off each other.

Many reasons, but here are a few.

Alcohol is a central nervous system (CNS) depressant, so any drug that has an effect on the CNS could be affected by alcohol. Example: since Xanax is a benzodiazepine and also is a CNS depressant, using Xanax and alcohol together increases the CNS depression.

Alcohol is metabolized in the liver. The liver is responsible for metabolizing many, many other drugs. Drinking can effect the function of the liver which could increase the exposure you have to other drugs
. Example: Tylenol is metabolized by multiple enzymes in the liver. A couple of these enzymes turns Tylenol into a toxic byproduct called NAPQI. You liver needs another substance called glutathione to detoxify the NAPQI. However, your body also needs glutathione to detoxify the byproducts of alcohol metabolism. You only have a certain amount of glutathione available, so you risk liver injury or failure when combining Tylenol and alcohol.

There is also the “disulfiram reaction.” This is named after the drug disulfiram which inhibits the second step of alcohol breakdown. This causes a build up of toxic byproducts and can cause serious issues. Disulfiram is sold under the brand name Antabuse because it can be used to treat alcoholism. Basically, if you take Antabuse and then drink any amount of alcohol, you will get violently ill. They even recommend not using Listerine because that can be enough to cause uncomfortable effects.

There are many ways that alcohol can be toxic and I’m sure I’m missing some. The basic idea is that alcohol is a poison and alters the way your body naturally functions in many ways. This does not mean you absolutely cannot drink alcohol while taking any medications, but you should consult with your doctor or pharmacist about what you take and if you can safely drink while on your medications.

There are a number of mechanisms that make mixing alcoholic drinks with medications dangerous to the health.

Ethanol is a depressant to the central nervous system, so any medication that has the same effect — regardless of mechanism — will add to this effect. This *can* result in something like a loss of consciousness or stop someone from breathing in their sleep (when breath is controlled by the part of the nervous system that works without us telling it to). Sometimes, the depressant effects don’t “add” to one another but actually do something kind of like multiplying one another (technically called super-additive or synergistic).

Alcohol can also create new compounds in the body by reacting with medications chemically. A notable example of this is when someone has cocaine and ethanol (alcohol) in their blood at the same time. These can react to form a compound called cocaethylene, which is one insanely potent molecule. It produces an intoxicating effect stronger than either drug independently, is highly toxic to heart tissue, and interferes with multiple neurotransmitter systems.

Another mechanism of toxicity is when metabolism requires one organ system that is already taxed by another medication. This is commonly seen in combinations like acetaminophen (paracetamol/Tylenol) and ethanol, both of which are hard on the liver.

A final mechanism is when ethanol prevents a medication from having its primary therapeutic effect but not its side effects. This is less common because of the specificity of the interaction, but is known to occur with some medicines.