Alexey Paramonov, a gastroenterologist, PhD, medical director of the Dobromed Family Clinic Network, explains in detail what happens if you decide to combine something with a drug.
- Can I drink pills with alcohol? By default, no. Alcohol, especially strong, entering into a pharmaceutical interaction with the active substances that make up a particular drug, changes its structure. Here we are talking about the so-called pharmacokinetic interaction - alcohol, affecting the absorption of drugs, most often accelerates it. The conclusion is simple: there is an interaction between alcohol and drugs, but it is very difficult to predict the consequences.
So what happens if you decide to drink pills with something alcoholic? If we discard some drugs, which will be discussed below, then most likely nothing. Human blood contains thousands of unique substances, and if you add one more to them, little will change. But there is one fundamental point, namely, the quality and quantity of drunk. In other words, a glass of wine and a bucket of vodka are two fundamentally different things. And if we are talking about a bucket of vodka, then we must understand that in such a situation the body is already in a state of severe intoxication, and any additional drug can unpredictably (!) Aggravate an already difficult situation.
It is worth noting that most of these interactions are simply not yet understood.
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Generally speaking about the effect of alcohol on the body, alcohol primarily affects the absorption of substances in the intestine - most often enhances it - and on the processing of the drug itself in the liver. Competition is possible here - alcohol can both weaken the effect of the drug (the liver will suffer from this), and change the binding of the drug to proteins plasma blood .
If we talk about the interaction of a particular group of drugs with alcohol, then the so-called antabuse effect, or disulfiram reaction should be separately noted.
The fact is that some drugs tend to block the metabolism of alcohol during the transition phase of acetaldehyde (the substance into which alcohol is converted, once in the liver) into acetate. Acetaldehyde is a moderate poison, with intoxication it causes general malaise, increased heart rate, shortness of breath, redness of the face and fever. Previously, this effect was used to treat alcoholism (although not very successfully) - the patient was simultaneously given alcohol and disulfiram so that he suffered and remembered that alcohol is bad. But alas, for the most part, patients remembered that disulfiram is bad, and drank themselves calmly further. Substances such as metronidazole, tinidazole, cephalosporins, fluoroquinolones, and sulfonamides have an effect similar to disulfiram.
That is, in combination with even a small amount of alcohol, the consequences will not be most pleasant.
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Next consider the effects of the interaction of the main groups of drugs with alcohol.
The action of such psychotropic drugs, as tranquilizers, antidepressants, antipsychotics, normotimics, antihistamines of the past generation, which have the properties of atypical tranquilizers and antipsychotics, in combination with alcohol is significantly enhanced. As a result, you get a fairly wide range of side effects - from harmless mild drowsiness to pathological intoxication and twilight consciousness.
But truly serious consequences await people with endogenous mental illness, dementia or epilepsy. Let's just say: a conditionally healthy people a glass of wine, drunk with an antidepressant, most likely will not bring such harm (or maybe even vice versa - will contribute to a speedy recovery and socialization). But keep in mind: if you are first combining a psychotropic drug with alcohol, the effect of this combination can be unpredictably strong. I repeat - for most healthy people, such experiments are painless, which can not be said about patients with depression. Most often, they use alcohol as a means of controlling anxiety and deliberately combine it with the use of psychotropic drugs to increase intoxication.
This behavior is called substance abuse and must be treated.
Monoamine oxidase inhibitors (MAOs) are worth mentioning separately. The instructions for almost every drug say that it does not combine with an MAO inhibitor. And this is true - in principle, little is combined with it, including alcohol. In fairness, it should be noted that MAO inhibitors themselves are now not used more often than nuclear warheads, and if they are still used, it is mainly in hospitals.
If you drank a little and your head ached, you can safely take a painkiller pill (paracetamol or ibuprofen - at your discretion) - nothing will happen. But if you regularly abuse alcoholic beverages, your risks are already so great that it is very difficult to predict how much they add up to the risks of pain medication.
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A popular statement that while taking antibiotics, the patient must completely exclude alcohol, more likely cunning than absolute truth. Let's put it this way: such an indication is true, but only by half.
In fact, alcohol should not be combined with drugs that are characterized by "antabuse effect" , but for all other antibiotics, the word "limit" is quite suitable.
In popular literature you can often find information that vasoconstrictor drops in combined with alcohol can greatly increase pressure. But in practice, the effect of such a combination would be rather the opposite. It is very difficult for an adult to get poisoned with drops, but uncontrolled hypotension (low blood pressure) in pediatricians is regularly seen in infants. Why? Despite the fact that vasoconstrictive drops, alpha blockers, directly affecting the vessels, increase pressure, they also have a strong effect on the vascular center, which reduces pressure.
Alcohol in this situation can enhance the hypotensive effect of drops, which means that the pressure will drop even lower.
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Can alcohol cause allergies? Can. By binding to proteins, it plays the role of a hapten provocateur. But it is worth noting that cases of allergic reactions caused directly by the use of alcoholic beverages occur infrequently.
But with the development of allergies, alcohol may well enhance its manifestations. But it does not interact with modern antihistamines (yes, drowsiness is the main and frequent result of this interaction).
Alcohol use in diabetes mellitus, as well as when taking insulin-containing and antidiabetic drugs, significantly increases the risk of hypoglycemia (lowering the concentration of glucose in the blood). Experienced diabetics can calculate the doses of drugs, food and alcohol to reduce potential risks, but beginners should be very careful.
Thus, we can safely say that with the exception of the drugs described above , the combination of one or two glasses of weak alcohol with taking medications will not bring any noticeable harm to your body.
But nevertheless, do not forget: alcohol abuse is dangerous in itself, and when combined with drugs, it is doubly dangerous.
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