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