Ethanol, or dehydrated alcohol, is a tissue toxin indicated for percutaneous transluminal septal myocardial ablation (PTSMA) in patients with hypertrophic obstructive cardiomyopathy and for neurolysis for the relief of intractable chronic pain. Injection for therapeutic use involves amounts too small to increase systemic concentrations of endogenous alcohol significantly. The most common adverse reactions encountered with therapeutic neurolysis include post-injection neuritis with persistent pain, hyperesthesia, and paresthesias. When used for PTSMA, heart block, excessive myocardial necrosis, and ventricular arrhythmias may occur. Alcohol is also used as a topical antiseptic to decrease bacteria on the nasal vestibule skin.
General Administration Information
For storage information, see the specific product information within the How Supplied section.
Route-Specific Administration
Injectable Administration
-Visually inspect parenteral products for particulate matter and discoloration prior to administration whenever solution and container permit. Dehydrated alcohol is a clear, colorless solution.
-Storage: Keep cool (at room temperature) and store away from any heat source; alcohol is a highly flammable liquid.
Other Injectable Administration
Intraneural and Subarachnoid Administration
-A 1 mL tuberculin syringe is desirable to facilitate accurate measurement of the dose.
-Use separate needles for injection of successive interspaces or other sites.
-Proper positioning of the patient is essential to control localization of injections.
-A trial injection of local anesthetic or x-ray visualization can confirm accurate needle placement.
-Inject slowly and only after all steps have been taken to ensure precise placement.
-When peripheral nerves are injected, take care that residual alcohol is not deposited along the needle track or in any location where tissue destruction is not wanted.
-When used for selective sensory block within the subarachnoid space, avoid contact with the anterior (motor) roots of the spinal nerve to be treated if motor paralysis is not desired.
Percutaneous Administration
-Administer under the supervision of a qualified interventional cardiologist experienced in the percutaneous transluminal septal myocardial ablation procedure.
-Inject small volumes over 1 to 2 minutes.
Topical Administration
Other Topical Formulations
Intranasal Administration
Avoid contact with eyes and mucous membranes outside the nasal area.
Ampules
Preparation
-Clean nostrils with tissue.
-Shake ampule well for 5 seconds.
-Remove ampule, flip and reinsert into sleeve to expose swab tip. Avoid touching swab tip.
-At dot on sleeve, squeeze firmly to crack inner ampule.
-Point swab tip down, squeeze sleeve repeatedly to saturate swab tip.
Application
-Insert swab tip into the right nostril. Do not go deeper than the tip of the swab.
-With moderate pressure, swab around the nostril 8 times clockwise.
-Cover all surfaces, including inside tip of the nostril.
-Squeeze to re-saturate swab tip.
-Insert ampule into the right nostril again and swab 8 times counterclockwise.
-Repeat steps these steps in the left nostril.
-Discard used ampule
For preoperative use, repeat all steps in both nostrils with second ampule, but do not re-wipe the nostrils with a tissue.
Multidose Bottle
Note: Do no use as a nose spray.
Preparation
-Clean nostrils with a tissue.
-Shake bottle well and remove the cap.
-Apply 2 to 4 drops of solution to the cotton swab.
Application
-Gently apply wetted cotton to skin inside the rim of the right nostril.
-Do not extend the swab into the nose beyond the swab tip (about 1 cm or 3/8 inches). Apply to skin only. The swab stem should never enter the nose.
-Swab around the right nostril rim 6 times in each direction.
-Reapply 2 to 4 drops of solution to cotton swab.
-Gently apply wetted cotton to skin inside the rim of the left nostril.
-Swab around the left nostril rim 6 times in each direction.
-Discard swab after use.
Transient heart block (i.e., AV block) is common upon injection of dehydrated alcohol into a septal artery for percutaneous transluminal septal myocardial ablation. Approximately 10% of complete heart block events become permanent and require permanent pacemaker placement. Although used to create a controlled myocardial infarction for therapeutic purposes, excessive myocardial necrosis and subsequent heart failure have been reported with injection of dehydrated alcohol. Ventricular tachycardia and ventricular fibrillation requiring electrocardioversion have occurred in approximately 1% of patients; perform continuous electrocardiographic monitoring for 48 hours after the procedure.
Inject dehydrated alcohol with care to avoid unwanted tissue necrosis. When used for therapeutic neurolysis, proper positioning of the patient is essential to control localization of injections of dehydrated alcohol, which is hypobaric, into the subarachnoid space. A trial injection of local anesthetic or x-ray visualization can confirm accurate needle placement. When used for selective sensory block within the subarachnoid space, avoid contact with the anterior (motor) roots of the spinal nerve to be treated if motor paralysis is not desired. When peripheral nerves are injected, take care that residual alcohol is not deposited along the needle track or in any location where tissue destruction is not wanted.
When used for therapeutic neurolysis, post-injection neuritis with persistent pain, hyperesthesia, and paresthesias are the most common adverse events. Subarachnoid neurolysis and lumbar sympathetic block may cause motor muscle paralysis, urinary incontinence, fecal incontinence, and impotence (erectile dysfunction). Severe hypotension may occur after celiac ganglion injection. If injected into gasserian ganglion, corneal anesthesia, meningitis, or cranial nerve palsies may occur.
Nasal bleeding or nasal irritation have been reported with the use of the alcohol topical nasal solution.
Alcohol is a highly flammable liquid; keep cool and away from fire, flame or any heat source.
Alcohol topical nasal solution should be avoided in patients with a history of nasal bleeding or irritation.
Subarachnoid injection of dehydrated alcohol is contraindicated in patients receiving anticoagulant therapy due the risk of bleeding.
Transient heart block is common upon injection of dehydrated alcohol into a septal artery for percutaneous transluminal septal myocardial ablation. Prior to injection, a temporary pacing wire is routinely inserted into the apex of the right ventricle, usually via the femoral vein, to treat transient heart block. If no episode of high-degree atrioventricular (AV) block occurs after several hours of observation, the pacing lead can be removed. Approximately 10% of complete heart block events become permanent and require permanent pacemaker placement. Risk factors for permanent pacemaker dependency include a baseline PQ interval more than 160 msec, bradycardia (heart rate less than 50 bpm), baseline left ventricular outflow gradient more than 70 mmHg, maximum QRS during the first 48 hours more than 155 msec, third-degree AV block occurring during the procedure, and no clinical recovery at 12 to 48 hours after the procedure. Although used to create a controlled myocardial infarction for therapeutic purposes, excessive myocardial necrosis and subsequent heart failure have been reported with injection of dehydrated alcohol. Risk factors for excessive myocardial necrosis include a higher volume of alcohol used and a higher number of septal branches injected to reduce the left ventricular outflow tract gradient. Due to the risk of arrhythmia, perform continuous electrocardiographic monitoring for 48 hours after the procedure.
Inject dehydrated alcohol with care to avoid unwanted tissue necrosis. When used for therapeutic neurolysis, proper positioning of the patient is essential to control localization of injections of dehydrated alcohol, which is hypobaric, into the subarachnoid space. A trial injection of local anesthetic or x-ray visualization can confirm accurate needle placement. When used for selective sensory block within the subarachnoid space, avoid contact with the anterior (motor) roots of the spinal nerve to be treated if motor paralysis is not desired. When peripheral nerves are injected, take care that residual alcohol is not deposited along the needle track or in any location where tissue destruction is not wanted. Excessive myocardial tissue necrosis and subsequent heart failure have been reported with injection of dehydrated alcohol for percutaneous transluminal septal myocardial ablation. Risk factors for excessive myocardial tissue necrosis include a higher volume of alcohol used and a higher number of septal branches injected to reduce the left ventricular outflow tract gradient.
Percutaneous administration of dehydrated alcohol requires an experienced clinician; administer only under the supervision of a qualified interventional cardiologist experienced in the percutaneous transluminal septal myocardial ablation procedure.
Avoid contact with the eyes, eyelids, lips, and other mucous membranes when using the alcohol topical nasal solution. If unintended mucus membrane or ocular exposure occurs, thoroughly rinse affected areas with water.
When possible, postpone the percutaneous transluminal septal myocardial ablation (PTSMA) procedure during pregnancy until the postpartum period. Dehydrated alcohol for PTSMA has not been evaluated for use and is not recommended during pregnancy. The concentrations of alcohol in blood after PTSMA were not measured, but dehydrated alcohol is not expected to increase significantly the systemic concentrations of endogenous alcohol after administration into a septal artery during PTSMA; maternal use is not expected to result in fetal exposure to the drug. Animal reproduction studies have shown an adverse effect on the fetus and chronic fetal alcohol exposure is known to cause developmental defects in humans. The developmental effects of acute ethanol exposure, such as from PTSMA, have not been studied when used during pregnancy. Use dehydrated alcohol for therapeutic neurolysis during pregnancy only if clearly needed. Data are not available for use of the topical nasal solution.
Dehydrated alcohol is not expected to significantly increase the systemic concentrations of endogenous alcohol after administration into a septal artery during percutaneous transluminal septal myocardial ablation (PTSMA) and breast-feeding is not expected to result in exposure of the child to the drug. The developmental effects of acute ethanol exposure, such as from PTSMA, have not been studied. Data are not available for use of the topical nasal solution.
This drug may also have activity against the following microorganisms: Staphylococcus aureus (MRSA), Staphylococcus aureus (MSSA)
NOTE: Some organisms may not have been adequately studied during clinical trials; therefore, exclusion from this list does not necessarily negate the drug's activity against the organism.
For the induction of controlled cardiac septal infarction to improve exercise capacity in adults with symptomatic hypertrophic obstructive cardiomyopathy who are not candidates for surgical myectomy:
Percutaneous dosage:
Adults: Inject small volumes percutaneously into septal arterial branches, guided by assessment of the gradient. Use the minimum dose necessary to achieve desired reduction in peak left ventricular outflow tract pressure gradient. Usual dose: 1 to 2 mL. Max: 5 mL.
For therapeutic neurolysis of nerves or ganglia for the relief of intractable chronic pain in conditions such as inoperable cancer and trigeminal neuralgia in patients for whom neurosurgical procedures are contraindicated:
Intraneural dosage:
Adults: 0.05 to 0.5 mL/interspace by intraneural injection. Usual Max: 1.5 mL.
Subarachnoid dosage:
Adults: 0.5 to 1 mL/interspace by subarachnoid injection. Usual Max: 1.5 mL.
For bacteria nasal carriage eradication, including methicillin-resistant S. aureus decolonization using methicillin-resistant S. aureus nasal carriage eradication to reduce the risk of infection among high-risk persons:
-for bacteria nasal carriage eradication, including methicillin-resistant S. aureus decolonization using methicillin-resistant S. aureus nasal carriage eradication to reduce the risk of infection among high-risk inpatients:
Intranasal dosage:
Adults: Apply a sufficient amount into each nostril. Twice daily dosing has been studied for MRSA decolonization. A duration of 5 days is suggested for nasal decolonization by guidelines. The product labeling frequency is up to 4 times daily. Consider using in combination with daily chlorhexidine baths.
Children and Adolescents 2 to 17 years: Apply a sufficient amount into each nostril. Twice daily dosing has been studied for MRSA decolonization. A duration of 5 days is suggested for nasal decolonization by guidelines. The product labeling frequency is up to 4 times daily. Consider using in combination with daily chlorhexidine baths.
-for bacteria nasal carriage eradication, including methicillin-resistant S. aureus decolonization using methicillin-resistant S. aureus nasal carriage eradication to prevent postoperative infections:
Intranasal dosage:
Adults: Apply a sufficient amount into each nostril preoperatively. Postoperative dosing given 1 to 3 times daily for up to 14 days has been studied for MRSA decolonization. The product labeling frequency is up to 4 times daily. Consider using in combination with chlorhexidine baths.
Children and Adolescents 2 to 17 years: Apply a sufficient amount into each nostril preoperatively. Postoperative dosing given 1 to 3 times daily for up to 14 days has been studied for MRSA decolonization. The product labeling frequency is up to 4 times daily. Consider using in combination with chlorhexidine baths.
Maximum Dosage Limits:
-Adults
5 mL/procedure by percutaneous injection; 1.5 mL/interspace by intraneural or subarachnoid injection; 4 applications/day for topical nasal product.
-Geriatric
5 mL/procedure by percutaneous injection; 1.5 mL/interspace by intraneural or subarachnoid injection; 4 applications/day for topical nasal product.
-Adolescents
4 applications/day for topical nasal product. Safety and efficacy have not been established for injectable products.
-Children
2 years and older: 4 applications/day for topical nasal product. Safety and efficacy have not been established for injectable products.
younger than 2 years: Safety and efficacy have not been established.
-Infants
Safety and efficacy have not been established.
-Neonates
Safety and efficacy have not been established.
Patients with Hepatic Impairment Dosing
Specific guidelines for dosage adjustments in hepatic impairment are not available; it appears that no dosage adjustments are needed.
Patients with Renal Impairment Dosing
Specific guidelines for dosage adjustments in renal impairment are not available; it appears that no dosage adjustments are needed.
*non-FDA-approved indication
Abacavir: (Major) Advise patients to avoid alcohol consumption while taking abacavir. Abacavir is metabolized via alcohol dehydrogenase. Alcohol decreases the elimination of abacavir causing an increase in overall exposure to abacavir. In a study involving HIV-infected men, coadministration of alcohol and abacavir resulted in a 41% increase in abacavir AUC and a 26% increase in abacavir half-life. In males, abacavir had no effect on the pharmacokinetic properties of alcohol; this interaction has not been studied in females. Abacavir has no effect on the pharmacokinetic properties of alcohol.
Abacavir; Dolutegravir; Lamivudine: (Major) Advise patients to avoid alcohol consumption while taking abacavir. Abacavir is metabolized via alcohol dehydrogenase. Alcohol decreases the elimination of abacavir causing an increase in overall exposure to abacavir. In a study involving HIV-infected men, coadministration of alcohol and abacavir resulted in a 41% increase in abacavir AUC and a 26% increase in abacavir half-life. In males, abacavir had no effect on the pharmacokinetic properties of alcohol; this interaction has not been studied in females. Abacavir has no effect on the pharmacokinetic properties of alcohol.
Abacavir; Lamivudine, 3TC: (Major) Advise patients to avoid alcohol consumption while taking abacavir. Abacavir is metabolized via alcohol dehydrogenase. Alcohol decreases the elimination of abacavir causing an increase in overall exposure to abacavir. In a study involving HIV-infected men, coadministration of alcohol and abacavir resulted in a 41% increase in abacavir AUC and a 26% increase in abacavir half-life. In males, abacavir had no effect on the pharmacokinetic properties of alcohol; this interaction has not been studied in females. Abacavir has no effect on the pharmacokinetic properties of alcohol.
Abacavir; Lamivudine, 3TC; Zidovudine, ZDV: (Major) Advise patients to avoid alcohol consumption while taking abacavir. Abacavir is metabolized via alcohol dehydrogenase. Alcohol decreases the elimination of abacavir causing an increase in overall exposure to abacavir. In a study involving HIV-infected men, coadministration of alcohol and abacavir resulted in a 41% increase in abacavir AUC and a 26% increase in abacavir half-life. In males, abacavir had no effect on the pharmacokinetic properties of alcohol; this interaction has not been studied in females. Abacavir has no effect on the pharmacokinetic properties of alcohol.
Acetaminophen: (Major) The risk of developing hepatotoxicity from acetaminophen appears to be increased in patients who regularly consume alcohol. Patients who drink more than 3 alcohol-containing drinks a day and take acetaminophen are at increased risk of developing hepatotoxicity. Acute or chronic alcohol use increases acetaminophen-induced hepatotoxicity by inducing CYP2E1 leading to increased formation of the hepatotoxic metabolite of acetaminophen. Also, chronic alcohol use can deplete liver glutathione stores. Administration of acetaminophen should be limited or avoided altogether in patients with alcoholism or patients who consume alcohol regularly.
Acetaminophen; Aspirin, ASA; Caffeine: (Major) Concomitant ingestion of alcohol with salicylates, especially aspirin, ASA, increases the risk of developing gastric irritation and GI mucosal bleeding. Alcohol and salicylates are mucosal irritants and aspirin decreases platelet aggregation. Routine ingestion of alcohol and aspirin can cause significant GI bleeding, which may or may not be overt. Even occasional concomitant use of salicylates and alcohol should be avoided. Chronic ingestion of alcohol is often associated with hypoprothrombinemia and this condition increases the risk of salicylate-induced bleeding. Patients should be warned regarding the potential for increased risk of GI bleeding if alcohol-containing beverages are taken concurrently with salicylates. (Major) The risk of developing hepatotoxicity from acetaminophen appears to be increased in patients who regularly consume alcohol. Patients who drink more than 3 alcohol-containing drinks a day and take acetaminophen are at increased risk of developing hepatotoxicity. Acute or chronic alcohol use increases acetaminophen-induced hepatotoxicity by inducing CYP2E1 leading to increased formation of the hepatotoxic metabolite of acetaminophen. Also, chronic alcohol use can deplete liver glutathione stores. Administration of acetaminophen should be limited or avoided altogether in patients with alcoholism or patients who consume alcohol regularly.
Acetaminophen; Aspirin: (Major) Concomitant ingestion of alcohol with salicylates, especially aspirin, ASA, increases the risk of developing gastric irritation and GI mucosal bleeding. Alcohol and salicylates are mucosal irritants and aspirin decreases platelet aggregation. Routine ingestion of alcohol and aspirin can cause significant GI bleeding, which may or may not be overt. Even occasional concomitant use of salicylates and alcohol should be avoided. Chronic ingestion of alcohol is often associated with hypoprothrombinemia and this condition increases the risk of salicylate-induced bleeding. Patients should be warned regarding the potential for increased risk of GI bleeding if alcohol-containing beverages are taken concurrently with salicylates. (Major) The risk of developing hepatotoxicity from acetaminophen appears to be increased in patients who regularly consume alcohol. Patients who drink more than 3 alcohol-containing drinks a day and take acetaminophen are at increased risk of developing hepatotoxicity. Acute or chronic alcohol use increases acetaminophen-induced hepatotoxicity by inducing CYP2E1 leading to increased formation of the hepatotoxic metabolite of acetaminophen. Also, chronic alcohol use can deplete liver glutathione stores. Administration of acetaminophen should be limited or avoided altogether in patients with alcoholism or patients who consume alcohol regularly.
Acetaminophen; Aspirin; Diphenhydramine: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression. (Major) Concomitant ingestion of alcohol with salicylates, especially aspirin, ASA, increases the risk of developing gastric irritation and GI mucosal bleeding. Alcohol and salicylates are mucosal irritants and aspirin decreases platelet aggregation. Routine ingestion of alcohol and aspirin can cause significant GI bleeding, which may or may not be overt. Even occasional concomitant use of salicylates and alcohol should be avoided. Chronic ingestion of alcohol is often associated with hypoprothrombinemia and this condition increases the risk of salicylate-induced bleeding. Patients should be warned regarding the potential for increased risk of GI bleeding if alcohol-containing beverages are taken concurrently with salicylates. (Major) The risk of developing hepatotoxicity from acetaminophen appears to be increased in patients who regularly consume alcohol. Patients who drink more than 3 alcohol-containing drinks a day and take acetaminophen are at increased risk of developing hepatotoxicity. Acute or chronic alcohol use increases acetaminophen-induced hepatotoxicity by inducing CYP2E1 leading to increased formation of the hepatotoxic metabolite of acetaminophen. Also, chronic alcohol use can deplete liver glutathione stores. Administration of acetaminophen should be limited or avoided altogether in patients with alcoholism or patients who consume alcohol regularly.
Acetaminophen; Caffeine: (Major) The risk of developing hepatotoxicity from acetaminophen appears to be increased in patients who regularly consume alcohol. Patients who drink more than 3 alcohol-containing drinks a day and take acetaminophen are at increased risk of developing hepatotoxicity. Acute or chronic alcohol use increases acetaminophen-induced hepatotoxicity by inducing CYP2E1 leading to increased formation of the hepatotoxic metabolite of acetaminophen. Also, chronic alcohol use can deplete liver glutathione stores. Administration of acetaminophen should be limited or avoided altogether in patients with alcoholism or patients who consume alcohol regularly.
Acetaminophen; Caffeine; Dihydrocodeine: (Major) Advise patients to avoid alcohol consumption while taking opioids. Alcohol consumption may result in additive CNS depression and may increase the risk for opioid overdose. Consider the patient's use of alcohol when prescribing opioid medications. If the patient is unlikely to be compliant with avoiding alcohol, consider prescribing naloxone especially if additional risk factors for opioid overdose are present. (Major) The risk of developing hepatotoxicity from acetaminophen appears to be increased in patients who regularly consume alcohol. Patients who drink more than 3 alcohol-containing drinks a day and take acetaminophen are at increased risk of developing hepatotoxicity. Acute or chronic alcohol use increases acetaminophen-induced hepatotoxicity by inducing CYP2E1 leading to increased formation of the hepatotoxic metabolite of acetaminophen. Also, chronic alcohol use can deplete liver glutathione stores. Administration of acetaminophen should be limited or avoided altogether in patients with alcoholism or patients who consume alcohol regularly.
Acetaminophen; Caffeine; Pyrilamine: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression. (Major) The risk of developing hepatotoxicity from acetaminophen appears to be increased in patients who regularly consume alcohol. Patients who drink more than 3 alcohol-containing drinks a day and take acetaminophen are at increased risk of developing hepatotoxicity. Acute or chronic alcohol use increases acetaminophen-induced hepatotoxicity by inducing CYP2E1 leading to increased formation of the hepatotoxic metabolite of acetaminophen. Also, chronic alcohol use can deplete liver glutathione stores. Administration of acetaminophen should be limited or avoided altogether in patients with alcoholism or patients who consume alcohol regularly.
Acetaminophen; Chlorpheniramine: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression. (Major) The risk of developing hepatotoxicity from acetaminophen appears to be increased in patients who regularly consume alcohol. Patients who drink more than 3 alcohol-containing drinks a day and take acetaminophen are at increased risk of developing hepatotoxicity. Acute or chronic alcohol use increases acetaminophen-induced hepatotoxicity by inducing CYP2E1 leading to increased formation of the hepatotoxic metabolite of acetaminophen. Also, chronic alcohol use can deplete liver glutathione stores. Administration of acetaminophen should be limited or avoided altogether in patients with alcoholism or patients who consume alcohol regularly.
Acetaminophen; Chlorpheniramine; Dextromethorphan: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression. (Major) The risk of developing hepatotoxicity from acetaminophen appears to be increased in patients who regularly consume alcohol. Patients who drink more than 3 alcohol-containing drinks a day and take acetaminophen are at increased risk of developing hepatotoxicity. Acute or chronic alcohol use increases acetaminophen-induced hepatotoxicity by inducing CYP2E1 leading to increased formation of the hepatotoxic metabolite of acetaminophen. Also, chronic alcohol use can deplete liver glutathione stores. Administration of acetaminophen should be limited or avoided altogether in patients with alcoholism or patients who consume alcohol regularly.
Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression. (Major) The risk of developing hepatotoxicity from acetaminophen appears to be increased in patients who regularly consume alcohol. Patients who drink more than 3 alcohol-containing drinks a day and take acetaminophen are at increased risk of developing hepatotoxicity. Acute or chronic alcohol use increases acetaminophen-induced hepatotoxicity by inducing CYP2E1 leading to increased formation of the hepatotoxic metabolite of acetaminophen. Also, chronic alcohol use can deplete liver glutathione stores. Administration of acetaminophen should be limited or avoided altogether in patients with alcoholism or patients who consume alcohol regularly.
Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression. (Major) The risk of developing hepatotoxicity from acetaminophen appears to be increased in patients who regularly consume alcohol. Patients who drink more than 3 alcohol-containing drinks a day and take acetaminophen are at increased risk of developing hepatotoxicity. Acute or chronic alcohol use increases acetaminophen-induced hepatotoxicity by inducing CYP2E1 leading to increased formation of the hepatotoxic metabolite of acetaminophen. Also, chronic alcohol use can deplete liver glutathione stores. Administration of acetaminophen should be limited or avoided altogether in patients with alcoholism or patients who consume alcohol regularly.
Acetaminophen; Chlorpheniramine; Phenylephrine : (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression. (Major) The risk of developing hepatotoxicity from acetaminophen appears to be increased in patients who regularly consume alcohol. Patients who drink more than 3 alcohol-containing drinks a day and take acetaminophen are at increased risk of developing hepatotoxicity. Acute or chronic alcohol use increases acetaminophen-induced hepatotoxicity by inducing CYP2E1 leading to increased formation of the hepatotoxic metabolite of acetaminophen. Also, chronic alcohol use can deplete liver glutathione stores. Administration of acetaminophen should be limited or avoided altogether in patients with alcoholism or patients who consume alcohol regularly.
Acetaminophen; Codeine: (Major) Advise patients to avoid alcohol consumption while taking opioids. Alcohol consumption may result in additive CNS depression and may increase the risk for opioid overdose. Consider the patient's use of alcohol when prescribing opioid medications. If the patient is unlikely to be compliant with avoiding alcohol, consider prescribing naloxone especially if additional risk factors for opioid overdose are present. (Major) The risk of developing hepatotoxicity from acetaminophen appears to be increased in patients who regularly consume alcohol. Patients who drink more than 3 alcohol-containing drinks a day and take acetaminophen are at increased risk of developing hepatotoxicity. Acute or chronic alcohol use increases acetaminophen-induced hepatotoxicity by inducing CYP2E1 leading to increased formation of the hepatotoxic metabolite of acetaminophen. Also, chronic alcohol use can deplete liver glutathione stores. Administration of acetaminophen should be limited or avoided altogether in patients with alcoholism or patients who consume alcohol regularly.
Acetaminophen; Dextromethorphan: (Major) The risk of developing hepatotoxicity from acetaminophen appears to be increased in patients who regularly consume alcohol. Patients who drink more than 3 alcohol-containing drinks a day and take acetaminophen are at increased risk of developing hepatotoxicity. Acute or chronic alcohol use increases acetaminophen-induced hepatotoxicity by inducing CYP2E1 leading to increased formation of the hepatotoxic metabolite of acetaminophen. Also, chronic alcohol use can deplete liver glutathione stores. Administration of acetaminophen should be limited or avoided altogether in patients with alcoholism or patients who consume alcohol regularly.
Acetaminophen; Dextromethorphan; Doxylamine: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression. (Major) The risk of developing hepatotoxicity from acetaminophen appears to be increased in patients who regularly consume alcohol. Patients who drink more than 3 alcohol-containing drinks a day and take acetaminophen are at increased risk of developing hepatotoxicity. Acute or chronic alcohol use increases acetaminophen-induced hepatotoxicity by inducing CYP2E1 leading to increased formation of the hepatotoxic metabolite of acetaminophen. Also, chronic alcohol use can deplete liver glutathione stores. Administration of acetaminophen should be limited or avoided altogether in patients with alcoholism or patients who consume alcohol regularly.
Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression. (Major) The risk of developing hepatotoxicity from acetaminophen appears to be increased in patients who regularly consume alcohol. Patients who drink more than 3 alcohol-containing drinks a day and take acetaminophen are at increased risk of developing hepatotoxicity. Acute or chronic alcohol use increases acetaminophen-induced hepatotoxicity by inducing CYP2E1 leading to increased formation of the hepatotoxic metabolite of acetaminophen. Also, chronic alcohol use can deplete liver glutathione stores. Administration of acetaminophen should be limited or avoided altogether in patients with alcoholism or patients who consume alcohol regularly.
Acetaminophen; Dextromethorphan; Guaifenesin; Pseudoephedrine: (Major) The risk of developing hepatotoxicity from acetaminophen appears to be increased in patients who regularly consume alcohol. Patients who drink more than 3 alcohol-containing drinks a day and take acetaminophen are at increased risk of developing hepatotoxicity. Acute or chronic alcohol use increases acetaminophen-induced hepatotoxicity by inducing CYP2E1 leading to increased formation of the hepatotoxic metabolite of acetaminophen. Also, chronic alcohol use can deplete liver glutathione stores. Administration of acetaminophen should be limited or avoided altogether in patients with alcoholism or patients who consume alcohol regularly.
Acetaminophen; Dextromethorphan; Phenylephrine: (Major) The risk of developing hepatotoxicity from acetaminophen appears to be increased in patients who regularly consume alcohol. Patients who drink more than 3 alcohol-containing drinks a day and take acetaminophen are at increased risk of developing hepatotoxicity. Acute or chronic alcohol use increases acetaminophen-induced hepatotoxicity by inducing CYP2E1 leading to increased formation of the hepatotoxic metabolite of acetaminophen. Also, chronic alcohol use can deplete liver glutathione stores. Administration of acetaminophen should be limited or avoided altogether in patients with alcoholism or patients who consume alcohol regularly.
Acetaminophen; Dextromethorphan; Pseudoephedrine: (Major) The risk of developing hepatotoxicity from acetaminophen appears to be increased in patients who regularly consume alcohol. Patients who drink more than 3 alcohol-containing drinks a day and take acetaminophen are at increased risk of developing hepatotoxicity. Acute or chronic alcohol use increases acetaminophen-induced hepatotoxicity by inducing CYP2E1 leading to increased formation of the hepatotoxic metabolite of acetaminophen. Also, chronic alcohol use can deplete liver glutathione stores. Administration of acetaminophen should be limited or avoided altogether in patients with alcoholism or patients who consume alcohol regularly.
Acetaminophen; Dichloralphenazone; Isometheptene: (Major) The risk of developing hepatotoxicity from acetaminophen appears to be increased in patients who regularly consume alcohol. Patients who drink more than 3 alcohol-containing drinks a day and take acetaminophen are at increased risk of developing hepatotoxicity. Acute or chronic alcohol use increases acetaminophen-induced hepatotoxicity by inducing CYP2E1 leading to increased formation of the hepatotoxic metabolite of acetaminophen. Also, chronic alcohol use can deplete liver glutathione stores. Administration of acetaminophen should be limited or avoided altogether in patients with alcoholism or patients who consume alcohol regularly.
Acetaminophen; Diphenhydramine: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression. (Major) The risk of developing hepatotoxicity from acetaminophen appears to be increased in patients who regularly consume alcohol. Patients who drink more than 3 alcohol-containing drinks a day and take acetaminophen are at increased risk of developing hepatotoxicity. Acute or chronic alcohol use increases acetaminophen-induced hepatotoxicity by inducing CYP2E1 leading to increased formation of the hepatotoxic metabolite of acetaminophen. Also, chronic alcohol use can deplete liver glutathione stores. Administration of acetaminophen should be limited or avoided altogether in patients with alcoholism or patients who consume alcohol regularly.
Acetaminophen; Guaifenesin; Phenylephrine: (Major) The risk of developing hepatotoxicity from acetaminophen appears to be increased in patients who regularly consume alcohol. Patients who drink more than 3 alcohol-containing drinks a day and take acetaminophen are at increased risk of developing hepatotoxicity. Acute or chronic alcohol use increases acetaminophen-induced hepatotoxicity by inducing CYP2E1 leading to increased formation of the hepatotoxic metabolite of acetaminophen. Also, chronic alcohol use can deplete liver glutathione stores. Administration of acetaminophen should be limited or avoided altogether in patients with alcoholism or patients who consume alcohol regularly.
Acetaminophen; Hydrocodone: (Major) Advise patients to avoid alcohol consumption while taking opioids. Alcohol consumption may result in additive CNS depression and may increase the risk for opioid overdose. Alcohol may also increase opioid drug exposure and the risk for fatal overdose by disrupting extended- or delayed-release opioid formulations. Consider the patient's use of alcohol when prescribing opioid medications. If the patient is unlikely to be compliant with avoiding alcohol, consider prescribing naloxone especially if additional risk factors for opioid overdose are present. (Major) The risk of developing hepatotoxicity from acetaminophen appears to be increased in patients who regularly consume alcohol. Patients who drink more than 3 alcohol-containing drinks a day and take acetaminophen are at increased risk of developing hepatotoxicity. Acute or chronic alcohol use increases acetaminophen-induced hepatotoxicity by inducing CYP2E1 leading to increased formation of the hepatotoxic metabolite of acetaminophen. Also, chronic alcohol use can deplete liver glutathione stores. Administration of acetaminophen should be limited or avoided altogether in patients with alcoholism or patients who consume alcohol regularly.
Acetaminophen; Ibuprofen: (Major) Advise patients to avoid alcohol and alcohol-containing products while taking NSAIDs. Concomitant ingestion of alcohol with NSAIDs increases the risk of developing gastric irritation and GI mucosal bleeding. Alcohol is a mucosal irritant and NSAIDs decrease platelet aggregation. Routine ingestion of alcohol and NSAIDs can cause significant GI bleeding, which may or may not be overt. Even occasional concomitant use of NSAIDs and alcohol should be avoided. Chronic alcohol ingestion is often associated with hypoprothrombinemia and this condition increases the risk of bleeding. (Major) The risk of developing hepatotoxicity from acetaminophen appears to be increased in patients who regularly consume alcohol. Patients who drink more than 3 alcohol-containing drinks a day and take acetaminophen are at increased risk of developing hepatotoxicity. Acute or chronic alcohol use increases acetaminophen-induced hepatotoxicity by inducing CYP2E1 leading to increased formation of the hepatotoxic metabolite of acetaminophen. Also, chronic alcohol use can deplete liver glutathione stores. Administration of acetaminophen should be limited or avoided altogether in patients with alcoholism or patients who consume alcohol regularly.
Acetaminophen; Oxycodone: (Major) Advise patients to avoid alcohol consumption while taking opioids. Alcohol consumption may result in additive CNS depression and may increase the risk for opioid overdose. Consider the patient's use of alcohol when prescribing opioid medications. If the patient is unlikely to be compliant with avoiding alcohol, consider prescribing naloxone especially if additional risk factors for opioid overdose are present. (Major) The risk of developing hepatotoxicity from acetaminophen appears to be increased in patients who regularly consume alcohol. Patients who drink more than 3 alcohol-containing drinks a day and take acetaminophen are at increased risk of developing hepatotoxicity. Acute or chronic alcohol use increases acetaminophen-induced hepatotoxicity by inducing CYP2E1 leading to increased formation of the hepatotoxic metabolite of acetaminophen. Also, chronic alcohol use can deplete liver glutathione stores. Administration of acetaminophen should be limited or avoided altogether in patients with alcoholism or patients who consume alcohol regularly.
Acetaminophen; Pamabrom; Pyrilamine: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression. (Major) The risk of developing hepatotoxicity from acetaminophen appears to be increased in patients who regularly consume alcohol. Patients who drink more than 3 alcohol-containing drinks a day and take acetaminophen are at increased risk of developing hepatotoxicity. Acute or chronic alcohol use increases acetaminophen-induced hepatotoxicity by inducing CYP2E1 leading to increased formation of the hepatotoxic metabolite of acetaminophen. Also, chronic alcohol use can deplete liver glutathione stores. Administration of acetaminophen should be limited or avoided altogether in patients with alcoholism or patients who consume alcohol regularly.
Acetaminophen; Phenylephrine: (Major) The risk of developing hepatotoxicity from acetaminophen appears to be increased in patients who regularly consume alcohol. Patients who drink more than 3 alcohol-containing drinks a day and take acetaminophen are at increased risk of developing hepatotoxicity. Acute or chronic alcohol use increases acetaminophen-induced hepatotoxicity by inducing CYP2E1 leading to increased formation of the hepatotoxic metabolite of acetaminophen. Also, chronic alcohol use can deplete liver glutathione stores. Administration of acetaminophen should be limited or avoided altogether in patients with alcoholism or patients who consume alcohol regularly.
Acetaminophen; Pseudoephedrine: (Major) The risk of developing hepatotoxicity from acetaminophen appears to be increased in patients who regularly consume alcohol. Patients who drink more than 3 alcohol-containing drinks a day and take acetaminophen are at increased risk of developing hepatotoxicity. Acute or chronic alcohol use increases acetaminophen-induced hepatotoxicity by inducing CYP2E1 leading to increased formation of the hepatotoxic metabolite of acetaminophen. Also, chronic alcohol use can deplete liver glutathione stores. Administration of acetaminophen should be limited or avoided altogether in patients with alcoholism or patients who consume alcohol regularly.
Acetohydroxamic Acid: (Major) Advise patients to avoid alcohol-containing beverages while taking acetohydroxamic acid. Concomitant use of acetohydroxamic acid and alcohol can cause a flushing reaction and a nonpruritic, macular rash on the upper extremities and face. The rash typically occurs within 30 to 45 minutes of alcohol ingestion and disappears 30 to 60 minutes later.
Acitretin: (Contraindicated) Advise patients who may become pregnant to avoid alcohol-containing beverages and medicines, including over-the-counter products, during and for 2 months after stopping therapy with acitretin. Concurrent ingestion of alcohol and acitretin results in the conversion of acitretin to etretinate. Etretinate has a significantly longer elimination half-life than acitretin and extends the duration of teratogenic potential for patients who may become pregnant beyond 3 years.
Acrivastine; Pseudoephedrine: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Alfentanil: (Major) Advise patients to avoid alcohol consumption while taking opioids. Alcohol consumption may result in additive CNS depression and may increase the risk for opioid overdose. Consider the patient's use of alcohol when prescribing opioid medications. If the patient is unlikely to be compliant with avoiding alcohol, consider prescribing naloxone especially if additional risk factors for opioid overdose are present.
Aliskiren; Hydrochlorothiazide, HCTZ: (Major) Advise patients to avoid alcohol while taking thiazide diuretics. Ingesting alcohol can increase the risk for orthostatic hypotension when taking a thiazide diuretic.
Alogliptin; Metformin: (Major) Patients taking metformin should be advised to avoid alcohol use. Blood lactate concentrations and the lactate to pyruvate ratio are increased during excessive (acute or chronic) intake of alcohol with metformin.
Alprazolam: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Amantadine: (Major) Advise patients to avoid alcohol while taking amantadine. Concomitant use with alcohol may increase the potential for CNS effects such as dizziness, confusion, lightheadedness, and orthostatic hypotension. In addition, if the patient is using amantadine extended-release (ER), alcohol use may result in amantadine dose-dumping and toxicity.
Amiloride; Hydrochlorothiazide, HCTZ: (Major) Advise patients to avoid alcohol while taking thiazide diuretics. Ingesting alcohol can increase the risk for orthostatic hypotension when taking a thiazide diuretic.
Aminosalicylate sodium, Aminosalicylic acid: (Major) Concomitant ingestion of alcohol with salicylates, especially aspirin, ASA, increases the risk of developing gastric irritation and GI mucosal bleeding. Alcohol and salicylates are mucosal irritants and aspirin decreases platelet aggregation. Routine ingestion of alcohol and aspirin can cause significant GI bleeding, which may or may not be overt. Even occasional concomitant use of salicylates and alcohol should be avoided. Chronic ingestion of alcohol is often associated with hypoprothrombinemia and this condition increases the risk of salicylate-induced bleeding. Patients should be warned regarding the potential for increased risk of GI bleeding if alcohol-containing beverages are taken concurrently with salicylates.
Amitriptyline: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants such as tricyclic antidepressants (TCAs). TCAs may exaggerate the CNS depressant response to alcohol, leading to an increase in sedation or psychomotor impairment. In some studies, alcohol has increased the unbound form of the TCA in the blood, which might be related to exaggerated clinical effect.
Amlodipine; Celecoxib: (Major) Advise patients to avoid alcohol and alcohol-containing products while taking NSAIDs. Concomitant ingestion of alcohol with NSAIDs increases the risk of developing gastric irritation and GI mucosal bleeding. Alcohol is a mucosal irritant and NSAIDs decrease platelet aggregation. Routine ingestion of alcohol and NSAIDs can cause significant GI bleeding, which may or may not be overt. Even occasional concomitant use of NSAIDs and alcohol should be avoided. Chronic alcohol ingestion is often associated with hypoprothrombinemia and this condition increases the risk of bleeding.
Amlodipine; Valsartan; Hydrochlorothiazide, HCTZ: (Major) Advise patients to avoid alcohol while taking thiazide diuretics. Ingesting alcohol can increase the risk for orthostatic hypotension when taking a thiazide diuretic.
Amobarbital: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Amoxapine: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Amphetamine: (Major) Advise patients to avoid alcohol while taking some dosage forms (e.g., Mydayis extended-release capsules) of amphetamine/dextroamphetamine salts. Consumption of alcohol while taking such dosage forms may result in a more rapid release of the dose of mixed amphetamine salts. Such effects may potentially lead to serious side effects such as acute anxiety, problems with sleep, or increases in heart rate or blood pressure that may lead to heart problems or stroke.
Amphetamine; Dextroamphetamine Salts: (Major) Alcohol should not be consumed with some dosage forms (e.g., Mydayis extended-release capsules) of amphetamine/dextroamphetamine salts. Consumption of alcohol while taking such dosage forms may result in a more rapid release of the dose of mixed amphetamine salts. Such effects may potentially lead to serious side effects such as acute anxiety, problems with sleep, or increases in heart rate or blood pressure that may lead to heart problems or stroke. Also, the use of amphetamine/dextroamphetamine salts may impair the ability of the patient to engage in potentially hazardous activities such as operating machinery or vehicles; the patient should therefore be cautioned accordingly.
Amphetamine; Dextroamphetamine: (Major) Advise patients to avoid alcohol while taking some dosage forms (e.g., Mydayis extended-release capsules) of amphetamine/dextroamphetamine salts. Consumption of alcohol while taking such dosage forms may result in a more rapid release of the dose of mixed amphetamine salts. Such effects may potentially lead to serious side effects such as acute anxiety, problems with sleep, or increases in heart rate or blood pressure that may lead to heart problems or stroke.
Apomorphine: (Major) Advise patients to avoid alcohol-containing beverages during apomorphine therapy. Concurrent use of alcohol and apomorphine has resulted in significantly worse orthostatic hypotension compared to apomorphine alone. Coadministration of low dose ethanol (0.3 grams/kg) with subcutaneous apomorphine in healthy subjects did not have a significant effect on the pharmacokinetics of apomorphine; however, high dose alcohol (0.6 grams/kg), equivalent to about 3 standardized alcohol-containing beverages, increased the maximum concentration of apomorphine by about 63%. A similar study with sublingual apomorphine has not been conducted.
Apraclonidine: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Aripiprazole: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Armodafinil: (Major) Advise patients to avoid alcohol-containing beverages while taking armodafinil. Per the manufacturer, there is no information on the effect of alcohol on armodafinil and alcohol use should be avoided.
Asenapine: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Aspirin, ASA: (Major) Concomitant ingestion of alcohol with salicylates, especially aspirin, ASA, increases the risk of developing gastric irritation and GI mucosal bleeding. Alcohol and salicylates are mucosal irritants and aspirin decreases platelet aggregation. Routine ingestion of alcohol and aspirin can cause significant GI bleeding, which may or may not be overt. Even occasional concomitant use of salicylates and alcohol should be avoided. Chronic ingestion of alcohol is often associated with hypoprothrombinemia and this condition increases the risk of salicylate-induced bleeding. Patients should be warned regarding the potential for increased risk of GI bleeding if alcohol-containing beverages are taken concurrently with salicylates.
Aspirin, ASA; Butalbital; Caffeine: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression. (Major) Concomitant ingestion of alcohol with salicylates, especially aspirin, ASA, increases the risk of developing gastric irritation and GI mucosal bleeding. Alcohol and salicylates are mucosal irritants and aspirin decreases platelet aggregation. Routine ingestion of alcohol and aspirin can cause significant GI bleeding, which may or may not be overt. Even occasional concomitant use of salicylates and alcohol should be avoided. Chronic ingestion of alcohol is often associated with hypoprothrombinemia and this condition increases the risk of salicylate-induced bleeding. Patients should be warned regarding the potential for increased risk of GI bleeding if alcohol-containing beverages are taken concurrently with salicylates.
Aspirin, ASA; Caffeine: (Major) Concomitant ingestion of alcohol with salicylates, especially aspirin, ASA, increases the risk of developing gastric irritation and GI mucosal bleeding. Alcohol and salicylates are mucosal irritants and aspirin decreases platelet aggregation. Routine ingestion of alcohol and aspirin can cause significant GI bleeding, which may or may not be overt. Even occasional concomitant use of salicylates and alcohol should be avoided. Chronic ingestion of alcohol is often associated with hypoprothrombinemia and this condition increases the risk of salicylate-induced bleeding. Patients should be warned regarding the potential for increased risk of GI bleeding if alcohol-containing beverages are taken concurrently with salicylates. (Major) The risk of developing hepatotoxicity from acetaminophen appears to be increased in patients who regularly consume alcohol. Patients who drink more than 3 alcohol-containing drinks a day and take acetaminophen are at increased risk of developing hepatotoxicity. Acute or chronic alcohol use increases acetaminophen-induced hepatotoxicity by inducing CYP2E1 leading to increased formation of the hepatotoxic metabolite of acetaminophen. Also, chronic alcohol use can deplete liver glutathione stores. Administration of acetaminophen should be limited or avoided altogether in patients with alcoholism or patients who consume alcohol regularly.
Aspirin, ASA; Caffeine; Orphenadrine: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression. (Major) Concomitant ingestion of alcohol with salicylates, especially aspirin, ASA, increases the risk of developing gastric irritation and GI mucosal bleeding. Alcohol and salicylates are mucosal irritants and aspirin decreases platelet aggregation. Routine ingestion of alcohol and aspirin can cause significant GI bleeding, which may or may not be overt. Even occasional concomitant use of salicylates and alcohol should be avoided. Chronic ingestion of alcohol is often associated with hypoprothrombinemia and this condition increases the risk of salicylate-induced bleeding. Patients should be warned regarding the potential for increased risk of GI bleeding if alcohol-containing beverages are taken concurrently with salicylates.
Aspirin, ASA; Carisoprodol; Codeine: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression. (Major) Advise patients to avoid alcohol consumption while taking opioids. Alcohol consumption may result in additive CNS depression and may increase the risk for opioid overdose. Consider the patient's use of alcohol when prescribing opioid medications. If the patient is unlikely to be compliant with avoiding alcohol, consider prescribing naloxone especially if additional risk factors for opioid overdose are present. (Major) Concomitant ingestion of alcohol with salicylates, especially aspirin, ASA, increases the risk of developing gastric irritation and GI mucosal bleeding. Alcohol and salicylates are mucosal irritants and aspirin decreases platelet aggregation. Routine ingestion of alcohol and aspirin can cause significant GI bleeding, which may or may not be overt. Even occasional concomitant use of salicylates and alcohol should be avoided. Chronic ingestion of alcohol is often associated with hypoprothrombinemia and this condition increases the risk of salicylate-induced bleeding. Patients should be warned regarding the potential for increased risk of GI bleeding if alcohol-containing beverages are taken concurrently with salicylates.
Aspirin, ASA; Citric Acid; Sodium Bicarbonate: (Major) Concomitant ingestion of alcohol with salicylates, especially aspirin, ASA, increases the risk of developing gastric irritation and GI mucosal bleeding. Alcohol and salicylates are mucosal irritants and aspirin decreases platelet aggregation. Routine ingestion of alcohol and aspirin can cause significant GI bleeding, which may or may not be overt. Even occasional concomitant use of salicylates and alcohol should be avoided. Chronic ingestion of alcohol is often associated with hypoprothrombinemia and this condition increases the risk of salicylate-induced bleeding. Patients should be warned regarding the potential for increased risk of GI bleeding if alcohol-containing beverages are taken concurrently with salicylates.
Aspirin, ASA; Dipyridamole: (Major) Concomitant ingestion of alcohol with salicylates, especially aspirin, ASA, increases the risk of developing gastric irritation and GI mucosal bleeding. Alcohol and salicylates are mucosal irritants and aspirin decreases platelet aggregation. Routine ingestion of alcohol and aspirin can cause significant GI bleeding, which may or may not be overt. Even occasional concomitant use of salicylates and alcohol should be avoided. Chronic ingestion of alcohol is often associated with hypoprothrombinemia and this condition increases the risk of salicylate-induced bleeding. Patients should be warned regarding the potential for increased risk of GI bleeding if alcohol-containing beverages are taken concurrently with salicylates.
Aspirin, ASA; Omeprazole: (Major) Concomitant ingestion of alcohol with salicylates, especially aspirin, ASA, increases the risk of developing gastric irritation and GI mucosal bleeding. Alcohol and salicylates are mucosal irritants and aspirin decreases platelet aggregation. Routine ingestion of alcohol and aspirin can cause significant GI bleeding, which may or may not be overt. Even occasional concomitant use of salicylates and alcohol should be avoided. Chronic ingestion of alcohol is often associated with hypoprothrombinemia and this condition increases the risk of salicylate-induced bleeding. Patients should be warned regarding the potential for increased risk of GI bleeding if alcohol-containing beverages are taken concurrently with salicylates.
Aspirin, ASA; Oxycodone: (Major) Advise patients to avoid alcohol consumption while taking opioids. Alcohol consumption may result in additive CNS depression and may increase the risk for opioid overdose. Consider the patient's use of alcohol when prescribing opioid medications. If the patient is unlikely to be compliant with avoiding alcohol, consider prescribing naloxone especially if additional risk factors for opioid overdose are present. (Major) Concomitant ingestion of alcohol with salicylates, especially aspirin, ASA, increases the risk of developing gastric irritation and GI mucosal bleeding. Alcohol and salicylates are mucosal irritants and aspirin decreases platelet aggregation. Routine ingestion of alcohol and aspirin can cause significant GI bleeding, which may or may not be overt. Even occasional concomitant use of salicylates and alcohol should be avoided. Chronic ingestion of alcohol is often associated with hypoprothrombinemia and this condition increases the risk of salicylate-induced bleeding. Patients should be warned regarding the potential for increased risk of GI bleeding if alcohol-containing beverages are taken concurrently with salicylates.
Atenolol; Chlorthalidone: (Major) Advise patients to avoid alcohol while taking thiazide diuretics. Ingesting alcohol can increase the risk for orthostatic hypotension when taking a thiazide diuretic.
Atropine; Difenoxin: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Avanafil: (Major) Inform patients that substantial consumption of alcohol (e.g., greater than 3 units) in combination with avanafil may increase the potential for orthostatic signs and symptoms, including increase in heart rate, decrease in standing blood pressure, dizziness, and headache. Both alcohol and PDE5 inhibitors including avanafil act as vasodilators. Concomitant use may attenuate the blood-pressure-lowering effects of each individual compound.
Azelastine: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Azelastine; Fluticasone: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Azilsartan; Chlorthalidone: (Major) Advise patients to avoid alcohol while taking thiazide diuretics. Ingesting alcohol can increase the risk for orthostatic hypotension when taking a thiazide diuretic.
Baclofen: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Bedaquiline: (Major) Alcohol and other hepatotoxic drugs should be avoided while on bedaquiline, especially in patients with impaired hepatic function, due to a risk for hepatotoxicity.
Belladonna; Opium: (Major) Advise patients to avoid alcohol consumption while taking opioids. Alcohol consumption may result in additive CNS depression and may increase the risk for opioid overdose. Consider the patient's use of alcohol when prescribing opioid medications. If the patient is unlikely to be compliant with avoiding alcohol, consider prescribing naloxone especially if additional risk factors for opioid overdose are present.
Benazepril; Hydrochlorothiazide, HCTZ: (Major) Advise patients to avoid alcohol while taking thiazide diuretics. Ingesting alcohol can increase the risk for orthostatic hypotension when taking a thiazide diuretic.
Benzhydrocodone; Acetaminophen: (Major) Advise patients to avoid alcohol consumption while taking opioids. Alcohol consumption may result in additive CNS depression and may increase the risk for opioid overdose. Consider the patient's use of alcohol when prescribing opioid medications. If the patient is unlikely to be compliant with avoiding alcohol, consider prescribing naloxone especially if additional risk factors for opioid overdose are present. (Major) The risk of developing hepatotoxicity from acetaminophen appears to be increased in patients who regularly consume alcohol. Patients who drink more than 3 alcohol-containing drinks a day and take acetaminophen are at increased risk of developing hepatotoxicity. Acute or chronic alcohol use increases acetaminophen-induced hepatotoxicity by inducing CYP2E1 leading to increased formation of the hepatotoxic metabolite of acetaminophen. Also, chronic alcohol use can deplete liver glutathione stores. Administration of acetaminophen should be limited or avoided altogether in patients with alcoholism or patients who consume alcohol regularly.
Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate: (Major) Concomitant ingestion of alcohol with salicylates, especially aspirin, ASA, increases the risk of developing gastric irritation and GI mucosal bleeding. Alcohol and salicylates are mucosal irritants and aspirin decreases platelet aggregation. Routine ingestion of alcohol and aspirin can cause significant GI bleeding, which may or may not be overt. Even occasional concomitant use of salicylates and alcohol should be avoided. Chronic ingestion of alcohol is often associated with hypoprothrombinemia and this condition increases the risk of salicylate-induced bleeding. Patients should be warned regarding the potential for increased risk of GI bleeding if alcohol-containing beverages are taken concurrently with salicylates.
Bismuth Subcitrate Potassium; Metronidazole; Tetracycline: (Major) Advise patients to discontinue alcohol-containing beverages and other forms of alcohol (including medicines with significant alcohol content and any products containing propylene glycol) before, during, and up to 3 days after therapy with systemic metronidazole. Disulfiram-like side effects including nausea, vomiting, tachycardia, headache, flushing, and abdominal cramps may occur if used together.
Bismuth Subsalicylate: (Major) Concomitant ingestion of alcohol with salicylates, especially aspirin, ASA, increases the risk of developing gastric irritation and GI mucosal bleeding. Alcohol and salicylates are mucosal irritants and aspirin decreases platelet aggregation. Routine ingestion of alcohol and aspirin can cause significant GI bleeding, which may or may not be overt. Even occasional concomitant use of salicylates and alcohol should be avoided. Chronic ingestion of alcohol is often associated with hypoprothrombinemia and this condition increases the risk of salicylate-induced bleeding. Patients should be warned regarding the potential for increased risk of GI bleeding if alcohol-containing beverages are taken concurrently with salicylates.
Bismuth Subsalicylate; Metronidazole; Tetracycline: (Major) Advise patients to discontinue alcohol-containing beverages and other forms of alcohol (including medicines with significant alcohol content and any products containing propylene glycol) before, during, and up to 3 days after therapy with systemic metronidazole. Disulfiram-like side effects including nausea, vomiting, tachycardia, headache, flushing, and abdominal cramps may occur if used together. (Major) Concomitant ingestion of alcohol with salicylates, especially aspirin, ASA, increases the risk of developing gastric irritation and GI mucosal bleeding. Alcohol and salicylates are mucosal irritants and aspirin decreases platelet aggregation. Routine ingestion of alcohol and aspirin can cause significant GI bleeding, which may or may not be overt. Even occasional concomitant use of salicylates and alcohol should be avoided. Chronic ingestion of alcohol is often associated with hypoprothrombinemia and this condition increases the risk of salicylate-induced bleeding. Patients should be warned regarding the potential for increased risk of GI bleeding if alcohol-containing beverages are taken concurrently with salicylates.
Bisoprolol; Hydrochlorothiazide, HCTZ: (Major) Advise patients to avoid alcohol while taking thiazide diuretics. Ingesting alcohol can increase the risk for orthostatic hypotension when taking a thiazide diuretic.
Brexanolone: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Brexpiprazole: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Brimonidine: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Brimonidine; Brinzolamide: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Brimonidine; Timolol: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Brivaracetam: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants such as brivaracetam. Alcohol consumption may result in additive CNS depression. During a study in healthy subjects, a single brivaracetam dose of 200 mg and an ethanol continuous IV infusion (target blood alcohol concentration of 60 mg/100 mL during 5 hours) increased the effects of alcohol on psychomotor function, alertness, attention span, body sway, saccadic reaction time, and memory.
Bromocriptine: (Major) Alcohol may potentiate some of the side effects of bromocriptine, including hypotension and somnolence. Patients should be advised to avoid alcohol and not to drive or engage in activities where impaired alertness may put themselves or others at risk of serious injury (e.g., operating machines) until the effects of bromocriptine are known.
Brompheniramine: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Brompheniramine; Dextromethorphan; Phenylephrine: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Brompheniramine; Phenylephrine: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Brompheniramine; Pseudoephedrine: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Brompheniramine; Pseudoephedrine; Dextromethorphan: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Bupivacaine; Meloxicam: (Major) Advise patients to avoid alcohol and alcohol-containing products while taking NSAIDs. Concomitant ingestion of alcohol with NSAIDs increases the risk of developing gastric irritation and GI mucosal bleeding. Alcohol is a mucosal irritant and NSAIDs decrease platelet aggregation. Routine ingestion of alcohol and NSAIDs can cause significant GI bleeding, which may or may not be overt. Even occasional concomitant use of NSAIDs and alcohol should be avoided. Chronic alcohol ingestion is often associated with hypoprothrombinemia and this condition increases the risk of bleeding.
Buprenorphine: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Buprenorphine; Naloxone: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Bupropion: (Major) Advise patients to avoid alcohol consumption while taking bupropion. Bupropion is associated with a dose-related risk of seizures. Alcohol abuse and abrupt discontinuation of alcohol have also been associated with seizures. Neuropsychiatric events and reduced alcohol tolerance have also been described in postmarketing reports.
Bupropion; Naltrexone: (Major) Advise patients to avoid alcohol consumption while taking bupropion. Bupropion is associated with a dose-related risk of seizures. Alcohol abuse and abrupt discontinuation of alcohol have also been associated with seizures. Neuropsychiatric events and reduced alcohol tolerance have also been described in postmarketing reports.
Butalbital; Acetaminophen: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression. (Major) The risk of developing hepatotoxicity from acetaminophen appears to be increased in patients who regularly consume alcohol. Patients who drink more than 3 alcohol-containing drinks a day and take acetaminophen are at increased risk of developing hepatotoxicity. Acute or chronic alcohol use increases acetaminophen-induced hepatotoxicity by inducing CYP2E1 leading to increased formation of the hepatotoxic metabolite of acetaminophen. Also, chronic alcohol use can deplete liver glutathione stores. Administration of acetaminophen should be limited or avoided altogether in patients with alcoholism or patients who consume alcohol regularly.
Butalbital; Acetaminophen; Caffeine: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression. (Major) The risk of developing hepatotoxicity from acetaminophen appears to be increased in patients who regularly consume alcohol. Patients who drink more than 3 alcohol-containing drinks a day and take acetaminophen are at increased risk of developing hepatotoxicity. Acute or chronic alcohol use increases acetaminophen-induced hepatotoxicity by inducing CYP2E1 leading to increased formation of the hepatotoxic metabolite of acetaminophen. Also, chronic alcohol use can deplete liver glutathione stores. Administration of acetaminophen should be limited or avoided altogether in patients with alcoholism or patients who consume alcohol regularly.
Butalbital; Acetaminophen; Caffeine; Codeine: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression. (Major) Advise patients to avoid alcohol consumption while taking opioids. Alcohol consumption may result in additive CNS depression and may increase the risk for opioid overdose. Consider the patient's use of alcohol when prescribing opioid medications. If the patient is unlikely to be compliant with avoiding alcohol, consider prescribing naloxone especially if additional risk factors for opioid overdose are present. (Major) The risk of developing hepatotoxicity from acetaminophen appears to be increased in patients who regularly consume alcohol. Patients who drink more than 3 alcohol-containing drinks a day and take acetaminophen are at increased risk of developing hepatotoxicity. Acute or chronic alcohol use increases acetaminophen-induced hepatotoxicity by inducing CYP2E1 leading to increased formation of the hepatotoxic metabolite of acetaminophen. Also, chronic alcohol use can deplete liver glutathione stores. Administration of acetaminophen should be limited or avoided altogether in patients with alcoholism or patients who consume alcohol regularly.
Butalbital; Aspirin; Caffeine; Codeine: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression. (Major) Advise patients to avoid alcohol consumption while taking opioids. Alcohol consumption may result in additive CNS depression and may increase the risk for opioid overdose. Consider the patient's use of alcohol when prescribing opioid medications. If the patient is unlikely to be compliant with avoiding alcohol, consider prescribing naloxone especially if additional risk factors for opioid overdose are present. (Major) Concomitant ingestion of alcohol with salicylates, especially aspirin, ASA, increases the risk of developing gastric irritation and GI mucosal bleeding. Alcohol and salicylates are mucosal irritants and aspirin decreases platelet aggregation. Routine ingestion of alcohol and aspirin can cause significant GI bleeding, which may or may not be overt. Even occasional concomitant use of salicylates and alcohol should be avoided. Chronic ingestion of alcohol is often associated with hypoprothrombinemia and this condition increases the risk of salicylate-induced bleeding. Patients should be warned regarding the potential for increased risk of GI bleeding if alcohol-containing beverages are taken concurrently with salicylates.
Butorphanol: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Calcium, Magnesium, Potassium, Sodium Oxybates: (Contraindicated) Alcohol is contraindicated in patients using sodium oxybate or other oxybates. Dangerous, additive CNS depressant effects are possible, including respiratory depression. Patients should be strongly warned against the use of any alcohol-containing beverages in conjunction with oxybates.
Canagliflozin; Metformin: (Major) Patients taking metformin should be advised to avoid alcohol use. Blood lactate concentrations and the lactate to pyruvate ratio are increased during excessive (acute or chronic) intake of alcohol with metformin.
Candesartan; Hydrochlorothiazide, HCTZ: (Major) Advise patients to avoid alcohol while taking thiazide diuretics. Ingesting alcohol can increase the risk for orthostatic hypotension when taking a thiazide diuretic.
Cannabidiol: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression. Alcohol has also been observed to increase cannabidiol exposure with a 93% increase in Cmax and a 63% greater AUC.
Capsaicin; Metaxalone: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Captopril; Hydrochlorothiazide, HCTZ: (Major) Advise patients to avoid alcohol while taking thiazide diuretics. Ingesting alcohol can increase the risk for orthostatic hypotension when taking a thiazide diuretic.
Carbamazepine: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Carbidopa; Levodopa; Entacapone: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Carbinoxamine: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Cariprazine: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Carisoprodol: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Cefotetan: (Major) Cefotetan has been reported to cause disulfiram-like reactions when administered to patients who have ingested ethanol. It is recommended that patients receiving this combination be warned about the possible disulfiram-like reaction. Ethanol should be avoided during and for 2-3 days after discontinuing therapy with cefotetan.
Celecoxib: (Major) Advise patients to avoid alcohol and alcohol-containing products while taking NSAIDs. Concomitant ingestion of alcohol with NSAIDs increases the risk of developing gastric irritation and GI mucosal bleeding. Alcohol is a mucosal irritant and NSAIDs decrease platelet aggregation. Routine ingestion of alcohol and NSAIDs can cause significant GI bleeding, which may or may not be overt. Even occasional concomitant use of NSAIDs and alcohol should be avoided. Chronic alcohol ingestion is often associated with hypoprothrombinemia and this condition increases the risk of bleeding.
Celecoxib; Tramadol: (Major) Advise patients to avoid alcohol and alcohol-containing products while taking NSAIDs. Concomitant ingestion of alcohol with NSAIDs increases the risk of developing gastric irritation and GI mucosal bleeding. Alcohol is a mucosal irritant and NSAIDs decrease platelet aggregation. Routine ingestion of alcohol and NSAIDs can cause significant GI bleeding, which may or may not be overt. Even occasional concomitant use of NSAIDs and alcohol should be avoided. Chronic alcohol ingestion is often associated with hypoprothrombinemia and this condition increases the risk of bleeding. (Major) Advise patients to avoid alcohol consumption while taking opioids. Alcohol consumption may result in additive CNS depression and may increase the risk for opioid overdose. Consider the patient's use of alcohol when prescribing opioid medications. If the patient is unlikely to be compliant with avoiding alcohol, consider prescribing naloxone especially if additional risk factors for opioid overdose are present.
Cenobamate: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Cetirizine: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Cetirizine; Pseudoephedrine: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Chlophedianol; Dexbrompheniramine: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Chlophedianol; Dexchlorpheniramine; Pseudoephedrine: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Chlorcyclizine: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Chlordiazepoxide: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Chlordiazepoxide; Amitriptyline: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants such as tricyclic antidepressants (TCAs). TCAs may exaggerate the CNS depressant response to alcohol, leading to an increase in sedation or psychomotor impairment. In some studies, alcohol has increased the unbound form of the TCA in the blood, which might be related to exaggerated clinical effect. (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Chlordiazepoxide; Clidinium: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Chlorothiazide: (Major) Advise patients to avoid alcohol while taking thiazide diuretics. Ingesting alcohol can increase the risk for orthostatic hypotension when taking a thiazide diuretic.
Chlorpheniramine: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Chlorpheniramine; Codeine: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression. (Major) Advise patients to avoid alcohol consumption while taking opioids. Alcohol consumption may result in additive CNS depression and may increase the risk for opioid overdose. Consider the patient's use of alcohol when prescribing opioid medications. If the patient is unlikely to be compliant with avoiding alcohol, consider prescribing naloxone especially if additional risk factors for opioid overdose are present.
Chlorpheniramine; Dextromethorphan: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Chlorpheniramine; Dextromethorphan; Phenylephrine: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Chlorpheniramine; Dextromethorphan; Pseudoephedrine: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Chlorpheniramine; Hydrocodone: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression. (Major) Advise patients to avoid alcohol consumption while taking opioids. Alcohol consumption may result in additive CNS depression and may increase the risk for opioid overdose. Alcohol may also increase opioid drug exposure and the risk for fatal overdose by disrupting extended- or delayed-release opioid formulations. Consider the patient's use of alcohol when prescribing opioid medications. If the patient is unlikely to be compliant with avoiding alcohol, consider prescribing naloxone especially if additional risk factors for opioid overdose are present.
Chlorpheniramine; Ibuprofen; Pseudoephedrine: (Major) Advise patients to avoid alcohol and alcohol-containing products while taking NSAIDs. Concomitant ingestion of alcohol with NSAIDs increases the risk of developing gastric irritation and GI mucosal bleeding. Alcohol is a mucosal irritant and NSAIDs decrease platelet aggregation. Routine ingestion of alcohol and NSAIDs can cause significant GI bleeding, which may or may not be overt. Even occasional concomitant use of NSAIDs and alcohol should be avoided. Chronic alcohol ingestion is often associated with hypoprothrombinemia and this condition increases the risk of bleeding. (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Chlorpheniramine; Phenylephrine: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Chlorpheniramine; Pseudoephedrine: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Chlorpromazine: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Chlorpropamide: (Major) Patients should be advised to avoid or limit alcohol ingestion when treated with sulfonylureas. Alcohol ingestion increases hypoglycemic risk. In some patients, hypoglycemia can be prolonged. Patients should be educated regarding the signs, symptoms, and self-management of delayed hypoglycemia after drinking alcohol, especially when using sulfonylureas. The importance of glucose monitoring after drinking alcoholic beverages to reduce hypoglycemia risk should be emphasized.
Chlorthalidone: (Major) Advise patients to avoid alcohol while taking thiazide diuretics. Ingesting alcohol can increase the risk for orthostatic hypotension when taking a thiazide diuretic.
Chlorzoxazone: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Choline Salicylate; Magnesium Salicylate: (Major) Concomitant ingestion of alcohol with salicylates, especially aspirin, ASA, increases the risk of developing gastric irritation and GI mucosal bleeding. Alcohol and salicylates are mucosal irritants and aspirin decreases platelet aggregation. Routine ingestion of alcohol and aspirin can cause significant GI bleeding, which may or may not be overt. Even occasional concomitant use of salicylates and alcohol should be avoided. Chronic ingestion of alcohol is often associated with hypoprothrombinemia and this condition increases the risk of salicylate-induced bleeding. Patients should be warned regarding the potential for increased risk of GI bleeding if alcohol-containing beverages are taken concurrently with salicylates.
Citalopram: (Major) Advise patients to avoid alcohol consumption while taking citalopram. Alcohol intolerance has been reported in patients receiving citalopram.
Clemastine: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Clobazam: (Major) Advise patients to avoid alcohol-containing beverages while taking clobazam. Concomitant administration of clobazam with other CNS depressants including alcohol can potentiate the CNS effects (i.e., increased sedation or respiratory depression) of either agent. In addition, consumption of alcohol increases the maximum plasma exposure of clobazam by about 50%.
Clomipramine: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants such as tricyclic antidepressants (TCAs). TCAs may exaggerate the CNS depressant response to alcohol, leading to an increase in sedation or psychomotor impairment. In some studies, alcohol has increased the unbound form of the TCA in the blood, which might be related to exaggerated clinical effect.
Clonazepam: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Clonidine: (Major) Advise patients to avoid alcohol use while taking clonidine. Clonidine may potentiate the CNS-depressive effects of alcohol.
Clorazepate: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Clozapine: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Codeine: (Major) Advise patients to avoid alcohol consumption while taking opioids. Alcohol consumption may result in additive CNS depression and may increase the risk for opioid overdose. Consider the patient's use of alcohol when prescribing opioid medications. If the patient is unlikely to be compliant with avoiding alcohol, consider prescribing naloxone especially if additional risk factors for opioid overdose are present.
Codeine; Guaifenesin: (Major) Advise patients to avoid alcohol consumption while taking opioids. Alcohol consumption may result in additive CNS depression and may increase the risk for opioid overdose. Consider the patient's use of alcohol when prescribing opioid medications. If the patient is unlikely to be compliant with avoiding alcohol, consider prescribing naloxone especially if additional risk factors for opioid overdose are present.
Codeine; Guaifenesin; Pseudoephedrine: (Major) Advise patients to avoid alcohol consumption while taking opioids. Alcohol consumption may result in additive CNS depression and may increase the risk for opioid overdose. Consider the patient's use of alcohol when prescribing opioid medications. If the patient is unlikely to be compliant with avoiding alcohol, consider prescribing naloxone especially if additional risk factors for opioid overdose are present.
Codeine; Phenylephrine; Promethazine: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression. (Major) Advise patients to avoid alcohol consumption while taking opioids. Alcohol consumption may result in additive CNS depression and may increase the risk for opioid overdose. Consider the patient's use of alcohol when prescribing opioid medications. If the patient is unlikely to be compliant with avoiding alcohol, consider prescribing naloxone especially if additional risk factors for opioid overdose are present.
Codeine; Promethazine: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression. (Major) Advise patients to avoid alcohol consumption while taking opioids. Alcohol consumption may result in additive CNS depression and may increase the risk for opioid overdose. Consider the patient's use of alcohol when prescribing opioid medications. If the patient is unlikely to be compliant with avoiding alcohol, consider prescribing naloxone especially if additional risk factors for opioid overdose are present.
Cyclobenzaprine: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Cyclosporine: (Major) Advise patients to avoid consuming red wine with cyclosporine. In a healthy volunteer study involving non-modified cyclosporine, consuming red wine while taking cyclosporine decreased cyclosporine peak and overall exposure by 38% and 30% respectively. The effect of other forms of alcohol and the impact to modified cyclosporine dosage forms in unknown.
Cyproheptadine: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Cysteamine: (Major) Avoid alcohol ingestion during treatment with cysteamine. Consumption of alcohol may increase the rate of cysteamine release and/or adversely affect the pharmacokinetics of cysteamine, altering the safety and effectiveness.
Dantrolene: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Dapagliflozin; Metformin: (Major) Patients taking metformin should be advised to avoid alcohol use. Blood lactate concentrations and the lactate to pyruvate ratio are increased during excessive (acute or chronic) intake of alcohol with metformin.
Daridorexant: (Major) Advise patients to avoid the use of alcohol with daridorexant as concurrent use increases the risk for additive CNS depression and impairment.
Deferiprone: (Major) Advise patients to avoid alcohol while taking deferiprone twice a day tablets. Consumption of alcohol while taking deferiprone twice a day tablets may result in more rapid release of deferiprone. At 40% (v/v) alcohol concentration in vitro dissolution studies, there was 88% release of deferiprone from a 1,000 mg deferiprone tablet (twice a day) within two hours compared to 4% release of deferiprone within 2 hours in the absence of alcohol.
Desipramine: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants such as tricyclic antidepressants (TCAs). TCAs may exaggerate the CNS depressant response to alcohol, leading to an increase in sedation or psychomotor impairment. In some studies, alcohol has increased the unbound form of the TCA in the blood, which might be related to exaggerated clinical effect.
Deutetrabenazine: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Dexbrompheniramine: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Dexbrompheniramine; Pseudoephedrine: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Dexchlorpheniramine: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Dexchlorpheniramine; Dextromethorphan; Pseudoephedrine: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Dexlansoprazole: (Major) Avoid alcohol-containing beverages when taking dexlansoprazole delayed-release orally disintegrating tablets (SoluTabs). Alcohol may modify the release rate of dexlansoprazole from the SoluTab, possibly resulting in reduced efficacy or worsening side effects.
Dexmedetomidine: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Dextroamphetamine: (Major) Advise patients to avoid alcohol while taking some dosage forms (e.g., Mydayis extended-release capsules) of amphetamine/dextroamphetamine salts. Consumption of alcohol while taking such dosage forms may result in a more rapid release of the dose of mixed amphetamine salts. Such effects may potentially lead to serious side effects such as acute anxiety, problems with sleep, or increases in heart rate or blood pressure that may lead to heart problems or stroke.
Dextromethorphan; Bupropion: (Major) Advise patients to avoid alcohol consumption while taking bupropion. Bupropion is associated with a dose-related risk of seizures. Alcohol abuse and abrupt discontinuation of alcohol have also been associated with seizures. Neuropsychiatric events and reduced alcohol tolerance have also been described in postmarketing reports.
Dextromethorphan; Diphenhydramine; Phenylephrine: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Diazepam: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Diclofenac: (Major) Advise patients to avoid alcohol and alcohol-containing products while taking NSAIDs. Concomitant ingestion of alcohol with NSAIDs increases the risk of developing gastric irritation and GI mucosal bleeding. Alcohol is a mucosal irritant and NSAIDs decrease platelet aggregation. Routine ingestion of alcohol and NSAIDs can cause significant GI bleeding, which may or may not be overt. Even occasional concomitant use of NSAIDs and alcohol should be avoided. Chronic alcohol ingestion is often associated with hypoprothrombinemia and this condition increases the risk of bleeding.
Diclofenac; Misoprostol: (Major) Advise patients to avoid alcohol and alcohol-containing products while taking NSAIDs. Concomitant ingestion of alcohol with NSAIDs increases the risk of developing gastric irritation and GI mucosal bleeding. Alcohol is a mucosal irritant and NSAIDs decrease platelet aggregation. Routine ingestion of alcohol and NSAIDs can cause significant GI bleeding, which may or may not be overt. Even occasional concomitant use of NSAIDs and alcohol should be avoided. Chronic alcohol ingestion is often associated with hypoprothrombinemia and this condition increases the risk of bleeding.
Diflunisal: (Major) Advise patients to avoid alcohol and alcohol-containing products while taking NSAIDs. Concomitant ingestion of alcohol with NSAIDs increases the risk of developing gastric irritation and GI mucosal bleeding. Alcohol is a mucosal irritant and NSAIDs decrease platelet aggregation. Routine ingestion of alcohol and NSAIDs can cause significant GI bleeding, which may or may not be overt. Even occasional concomitant use of NSAIDs and alcohol should be avoided. Chronic alcohol ingestion is often associated with hypoprothrombinemia and this condition increases the risk of bleeding.
Diltiazem: (Major) Advise patients to avoid alcohol consumption while taking diltiazem; there may be additive effects on blood pressure that may increase the risk for orthostatic hypotension, dizziness or syncope. Alcohol also increases the rate at which some controlled and extended-release formulas of diltiazem (such as Cardizem CD) release diltiazem in vitro. This effect may lead to more rapid absorption and an increase in the systemic exposure of diltiazem, and associated dose-related adverse reactions.
Dimenhydrinate: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Diphenhydramine: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Diphenhydramine; Ibuprofen: (Major) Advise patients to avoid alcohol and alcohol-containing products while taking NSAIDs. Concomitant ingestion of alcohol with NSAIDs increases the risk of developing gastric irritation and GI mucosal bleeding. Alcohol is a mucosal irritant and NSAIDs decrease platelet aggregation. Routine ingestion of alcohol and NSAIDs can cause significant GI bleeding, which may or may not be overt. Even occasional concomitant use of NSAIDs and alcohol should be avoided. Chronic alcohol ingestion is often associated with hypoprothrombinemia and this condition increases the risk of bleeding. (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Diphenhydramine; Naproxen: (Major) Advise patients to avoid alcohol and alcohol-containing products while taking NSAIDs. Concomitant ingestion of alcohol with NSAIDs increases the risk of developing gastric irritation and GI mucosal bleeding. Alcohol is a mucosal irritant and NSAIDs decrease platelet aggregation. Routine ingestion of alcohol and NSAIDs can cause significant GI bleeding, which may or may not be overt. Even occasional concomitant use of NSAIDs and alcohol should be avoided. Chronic alcohol ingestion is often associated with hypoprothrombinemia and this condition increases the risk of bleeding. (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Diphenhydramine; Phenylephrine: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Diphenoxylate; Atropine: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Diphtheria Equine Antitoxin: (Major) Do not drink alcohol during treatment with diphtheria equine antitoxin (DAT).
Diroximel Fumarate: (Major) Alcohol should not be taken at the time of a diroximel fumarate delayed-release capsule dose. The active metabolite of diroximel fumarate is monomethyl fumarate, or MMF. The mean peak plasma MMF concentration decreased by 9% and 21%, when the dose was coadministered with 240 mL of 5% v/v and 40% v/v of alcohol, respectively. Total MMF exposure is not altered; coingestion of ethanol does not induce "dose dumping".
Disulfiram: (Contraindicated) Advise patients to avoid alcohol and alcohol-containing products, including food products and topical preparations, while taking disulfiram. Patients should abstain from alcohol for at least 12 hours prior to beginning disulfiram therapy and should continue to avoid alcohol for at least 14 days after their last dose of disulfiram. When alcohol is consumed, disulfiram increases serum acetaldehyde concentrations causing a disulfiram-alcohol reaction that can last from 30 minutes to several hours. Disulfiram-alcohol reactions are extremely unpleasant. Symptom intensity and duration are generally dependent upon the disulfiram dosage and the amount of alcohol ingested. Symptoms may include flushing, throbbing in the head and neck, throbbing headache, respiratory difficulty, nausea, copious vomiting, sweating, thirst, chest pain, palpitation, dyspnea, hyperventilation, tachycardia, hypotension, syncope, marked uneasiness, weakness, vertigo, blurred vision, and confusion. In severe reactions, respiratory depression, cardiovascular collapse, arrhythmias, myocardial infarction, acute congestive heart failure, unconsciousness, convulsions, and death may occur.
Doxazosin: (Major) Advise patients to avoid alcohol consumption while taking alpha-blockers. Concomitant use may increase the risk for hypotension.
Doxepin: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants such as tricyclic antidepressants (TCAs). TCAs may exaggerate the CNS depressant response to alcohol, leading to an increase in sedation or psychomotor impairment. In some studies, alcohol has increased the unbound form of the TCA in the blood, which might be related to exaggerated clinical effect.
Doxylamine: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Doxylamine; Pyridoxine: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Dronabinol: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Efavirenz: (Major) Advise patients to avoid alcohol while taking efavirenz. It is possible that CNS symptoms such as dizziness, trouble sleeping, drowsiness, difficulty concentrating and/or abnormal dreams may be more severe if efavirenz is taken with alcohol.
Efavirenz; Emtricitabine; Tenofovir Disoproxil Fumarate: (Major) Advise patients to avoid alcohol while taking efavirenz. It is possible that CNS symptoms such as dizziness, trouble sleeping, drowsiness, difficulty concentrating and/or abnormal dreams may be more severe if efavirenz is taken with alcohol.
Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate: (Major) Advise patients to avoid alcohol while taking efavirenz. It is possible that CNS symptoms such as dizziness, trouble sleeping, drowsiness, difficulty concentrating and/or abnormal dreams may be more severe if efavirenz is taken with alcohol.
Empagliflozin; Linagliptin; Metformin: (Major) Patients taking metformin should be advised to avoid alcohol use. Blood lactate concentrations and the lactate to pyruvate ratio are increased during excessive (acute or chronic) intake of alcohol with metformin.
Empagliflozin; Metformin: (Major) Patients taking metformin should be advised to avoid alcohol use. Blood lactate concentrations and the lactate to pyruvate ratio are increased during excessive (acute or chronic) intake of alcohol with metformin.
Enalapril; Hydrochlorothiazide, HCTZ: (Major) Advise patients to avoid alcohol while taking thiazide diuretics. Ingesting alcohol can increase the risk for orthostatic hypotension when taking a thiazide diuretic.
Entacapone: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Eprosartan; Hydrochlorothiazide, HCTZ: (Major) Advise patients to avoid alcohol while taking thiazide diuretics. Ingesting alcohol can increase the risk for orthostatic hypotension when taking a thiazide diuretic.
Ertugliflozin; Metformin: (Major) Patients taking metformin should be advised to avoid alcohol use. Blood lactate concentrations and the lactate to pyruvate ratio are increased during excessive (acute or chronic) intake of alcohol with metformin.
Escitalopram: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Esketamine: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Estazolam: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Eszopiclone: (Major) Advise patients not to use eszopiclone if they drank alcohol that evening or before bed. An additive effect on psychomotor performance was seen with coadministration of eszopiclone and alcohol. Concomitant use may also increase the risk for next-day impairment.
Ethionamide: (Major) Advise patients to avoid alcohol consumption while taking ethionamide. A psychotic reaction has been reported with excessive alcohol ingestion.
Ethosuximide: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Ethotoin: (Major) Phenytoin theoretically can add to the CNS-depressant effects of alcohol. Chronic ingestion of alcohol induces hepatic microsomal isozymes and increases the clearance of phenytoin. Alcohol also exhibits epileptogenic potential. Alcohol should generally be avoided in patients on fosphenytoin or phenytoin. Acute ingestion of small amounts of ethanol in non-alcoholic patients does not appear to affect the hepatic metabolism of phenytoin to a clinically significant degree.
Etodolac: (Major) Advise patients to avoid alcohol and alcohol-containing products while taking NSAIDs. Concomitant ingestion of alcohol with NSAIDs increases the risk of developing gastric irritation and GI mucosal bleeding. Alcohol is a mucosal irritant and NSAIDs decrease platelet aggregation. Routine ingestion of alcohol and NSAIDs can cause significant GI bleeding, which may or may not be overt. Even occasional concomitant use of NSAIDs and alcohol should be avoided. Chronic alcohol ingestion is often associated with hypoprothrombinemia and this condition increases the risk of bleeding.
Felbamate: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Fenfluramine: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Fenoprofen: (Major) Advise patients to avoid alcohol and alcohol-containing products while taking NSAIDs. Concomitant ingestion of alcohol with NSAIDs increases the risk of developing gastric irritation and GI mucosal bleeding. Alcohol is a mucosal irritant and NSAIDs decrease platelet aggregation. Routine ingestion of alcohol and NSAIDs can cause significant GI bleeding, which may or may not be overt. Even occasional concomitant use of NSAIDs and alcohol should be avoided. Chronic alcohol ingestion is often associated with hypoprothrombinemia and this condition increases the risk of bleeding.
Fentanyl: (Major) Advise patients to avoid alcohol consumption while taking opioids. Alcohol consumption may result in additive CNS depression and may increase the risk for opioid overdose. Consider the patient's use of alcohol when prescribing opioid medications. If the patient is unlikely to be compliant with avoiding alcohol, consider prescribing naloxone especially if additional risk factors for opioid overdose are present.
Fexinidazole: (Major) Advise patients to avoid alcohol-containing beverages and other forms of alcohol (including medicines with significant alcohol content) during and up to 2 days after therapy with fexinidazole. A disulfiram-like reaction may occur if used together.
Finasteride; Tadalafil: (Major) Advise patients to avoid alcohol consumption while taking tadalafil. Both alcohol and tadalafil, a PDE5 inhibitor, act as mild vasodilators. When mild vasodilators are taken in combination, blood pressure lowering effects may be increased. Substantial consumption of alcohol (e.g., 5 units or greater) in combination with tadalafil can increase the potential for orthostatic signs and symptoms, including an increase in heart rate, decrease in standing blood pressure, dizziness, and headache. Tadalafil (10 mg or 20 mg) did not affect alcohol plasma concentrations and alcohol did not affect tadalafil plasma concentrations.
Flibanserin: (Major) Advise patients to wait at least 2 hours after consuming 1 or 2 standard alcohol-containing drinks before taking flibanserin at bedtime. Patients who consume 3 or more standard alcohol-containing drinks should skip their flibanserin dose. After taking flibanserin at bedtime, advise patients not to consume alcohol until the following day. Severe hypotension including systolic blood pressure drops of up to 50 mmHg, syncope, and additive CNS depression may occur if flibanserin and alcohol are taken together in close proximity.
Fluphenazine: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Flurazepam: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Flurbiprofen: (Major) Advise patients to avoid alcohol and alcohol-containing products while taking NSAIDs. Concomitant ingestion of alcohol with NSAIDs increases the risk of developing gastric irritation and GI mucosal bleeding. Alcohol is a mucosal irritant and NSAIDs decrease platelet aggregation. Routine ingestion of alcohol and NSAIDs can cause significant GI bleeding, which may or may not be overt. Even occasional concomitant use of NSAIDs and alcohol should be avoided. Chronic alcohol ingestion is often associated with hypoprothrombinemia and this condition increases the risk of bleeding.
Fluvoxamine: (Major) As with other psychotropic medications, patients should be advised to avoid alcohol while taking fluvoxamine. Studies involving single 40 gram doses of alcohol (oral administration in one study and intravenous in the other) and multiple dosing with fluvoxamine (50 mg twice daily) revealed no effect of either drug on the pharmacokinetics or pharmacodynamics of the other. Multiple doses have not been studied. It is possible that ethanol may adversely affect mood or behavior.
Fomepizole: (Major) Avoid concomitant use of fomepizole and alcohol-containing beverages. In healthy volunteers, moderate oral doses of fomepizole significantly reduced the rate of elimination of alcohol by approximately 40%. Additionally, alcohol decreased the rate of elimination of fomepizole by approximately 50%. Both interactions occur via alcohol dehydrogenase inhibition.
Fosinopril; Hydrochlorothiazide, HCTZ: (Major) Advise patients to avoid alcohol while taking thiazide diuretics. Ingesting alcohol can increase the risk for orthostatic hypotension when taking a thiazide diuretic.
Fosphenytoin: (Major) Phenytoin theoretically can add to the CNS-depressant effects of alcohol. Chronic ingestion of alcohol induces hepatic microsomal isozymes and increases the clearance of phenytoin. Alcohol also exhibits epileptogenic potential. Alcohol should generally be avoided in patients on fosphenytoin or phenytoin. Acute ingestion of small amounts of ethanol in non-alcoholic patients does not appear to affect the hepatic metabolism of phenytoin to a clinically significant degree.
Gabapentin: (Major) Advise patients to avoid alcohol while taking gabapentin. Concomitant use of alcohol with gabapentin may cause excessive sedation, somnolence, and respiratory depression. Alcohol causes a more rapid release of gabapentin enacarbil from the extended-release tablets that may increase the risk for adverse events. In an in vitro dissolution study, 63% of the gabapentin enacarbil dose was released at 1 hour at the highest alcohol concentration studied (40%). At a 5% alcohol concentration, 43% of the dose was released at 1 hour.
Glimepiride: (Major) Patients should be advised to avoid or limit alcohol ingestion when treated with sulfonylureas. Alcohol ingestion increases hypoglycemic risk. In some patients, hypoglycemia can be prolonged. Patients should be educated regarding the signs, symptoms, and self-management of delayed hypoglycemia after drinking alcohol, especially when using sulfonylureas. The importance of glucose monitoring after drinking alcoholic beverages to reduce hypoglycemia risk should be emphasized.
Glipizide: (Major) Patients should be advised to avoid or limit alcohol ingestion when treated with sulfonylureas. Alcohol ingestion increases hypoglycemic risk. In some patients, hypoglycemia can be prolonged. Patients should be educated regarding the signs, symptoms, and self-management of delayed hypoglycemia after drinking alcohol, especially when using sulfonylureas. The importance of glucose monitoring after drinking alcoholic beverages to reduce hypoglycemia risk should be emphasized.
Glipizide; Metformin: (Major) Patients should be advised to avoid or limit alcohol ingestion when treated with sulfonylureas. Alcohol ingestion increases hypoglycemic risk. In some patients, hypoglycemia can be prolonged. Patients should be educated regarding the signs, symptoms, and self-management of delayed hypoglycemia after drinking alcohol, especially when using sulfonylureas. The importance of glucose monitoring after drinking alcoholic beverages to reduce hypoglycemia risk should be emphasized. (Major) Patients taking metformin should be advised to avoid alcohol use. Blood lactate concentrations and the lactate to pyruvate ratio are increased during excessive (acute or chronic) intake of alcohol with metformin.
Glyburide: (Major) Patients should be advised to avoid or limit alcohol ingestion when treated with sulfonylureas. Alcohol ingestion increases hypoglycemic risk. In some patients, hypoglycemia can be prolonged. Patients should be educated regarding the signs, symptoms, and self-management of delayed hypoglycemia after drinking alcohol, especially when using sulfonylureas. The importance of glucose monitoring after drinking alcoholic beverages to reduce hypoglycemia risk should be emphasized.
Glyburide; Metformin: (Major) Patients should be advised to avoid or limit alcohol ingestion when treated with sulfonylureas. Alcohol ingestion increases hypoglycemic risk. In some patients, hypoglycemia can be prolonged. Patients should be educated regarding the signs, symptoms, and self-management of delayed hypoglycemia after drinking alcohol, especially when using sulfonylureas. The importance of glucose monitoring after drinking alcoholic beverages to reduce hypoglycemia risk should be emphasized. (Major) Patients taking metformin should be advised to avoid alcohol use. Blood lactate concentrations and the lactate to pyruvate ratio are increased during excessive (acute or chronic) intake of alcohol with metformin.
Griseofulvin: (Major) Advise patients to avoid alcohol consumption while taking griseofulvin. Nausea, vomiting, flushing, tachycardia, and severe hypotension have been reported following alcohol ingestion during griseofulvin therapy.
Guaifenesin; Hydrocodone: (Major) Advise patients to avoid alcohol consumption while taking opioids. Alcohol consumption may result in additive CNS depression and may increase the risk for opioid overdose. Alcohol may also increase opioid drug exposure and the risk for fatal overdose by disrupting extended- or delayed-release opioid formulations. Consider the patient's use of alcohol when prescribing opioid medications. If the patient is unlikely to be compliant with avoiding alcohol, consider prescribing naloxone especially if additional risk factors for opioid overdose are present.
Guanfacine: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Haloperidol: (Major) Advise patients to avoid alcohol during haloperidol treatment. Haloperidol may impair alertness, mental and/or physical abilities, and cause hypotension. These effects may be potentiated by alcohol.
Homatropine; Hydrocodone: (Major) Advise patients to avoid alcohol consumption while taking opioids. Alcohol consumption may result in additive CNS depression and may increase the risk for opioid overdose. Alcohol may also increase opioid drug exposure and the risk for fatal overdose by disrupting extended- or delayed-release opioid formulations. Consider the patient's use of alcohol when prescribing opioid medications. If the patient is unlikely to be compliant with avoiding alcohol, consider prescribing naloxone especially if additional risk factors for opioid overdose are present.
Hydrochlorothiazide, HCTZ: (Major) Advise patients to avoid alcohol while taking thiazide diuretics. Ingesting alcohol can increase the risk for orthostatic hypotension when taking a thiazide diuretic.
Hydrochlorothiazide, HCTZ; Moexipril: (Major) Advise patients to avoid alcohol while taking thiazide diuretics. Ingesting alcohol can increase the risk for orthostatic hypotension when taking a thiazide diuretic.
Hydrocodone: (Major) Advise patients to avoid alcohol consumption while taking opioids. Alcohol consumption may result in additive CNS depression and may increase the risk for opioid overdose. Alcohol may also increase opioid drug exposure and the risk for fatal overdose by disrupting extended- or delayed-release opioid formulations. Consider the patient's use of alcohol when prescribing opioid medications. If the patient is unlikely to be compliant with avoiding alcohol, consider prescribing naloxone especially if additional risk factors for opioid overdose are present.
Hydrocodone; Ibuprofen: (Major) Advise patients to avoid alcohol and alcohol-containing products while taking NSAIDs. Concomitant ingestion of alcohol with NSAIDs increases the risk of developing gastric irritation and GI mucosal bleeding. Alcohol is a mucosal irritant and NSAIDs decrease platelet aggregation. Routine ingestion of alcohol and NSAIDs can cause significant GI bleeding, which may or may not be overt. Even occasional concomitant use of NSAIDs and alcohol should be avoided. Chronic alcohol ingestion is often associated with hypoprothrombinemia and this condition increases the risk of bleeding. (Major) Advise patients to avoid alcohol consumption while taking opioids. Alcohol consumption may result in additive CNS depression and may increase the risk for opioid overdose. Alcohol may also increase opioid drug exposure and the risk for fatal overdose by disrupting extended- or delayed-release opioid formulations. Consider the patient's use of alcohol when prescribing opioid medications. If the patient is unlikely to be compliant with avoiding alcohol, consider prescribing naloxone especially if additional risk factors for opioid overdose are present.
Hydrocodone; Pseudoephedrine: (Major) Advise patients to avoid alcohol consumption while taking opioids. Alcohol consumption may result in additive CNS depression and may increase the risk for opioid overdose. Alcohol may also increase opioid drug exposure and the risk for fatal overdose by disrupting extended- or delayed-release opioid formulations. Consider the patient's use of alcohol when prescribing opioid medications. If the patient is unlikely to be compliant with avoiding alcohol, consider prescribing naloxone especially if additional risk factors for opioid overdose are present.
Hydromorphone: (Major) Advise patients to avoid alcohol consumption while taking opioids. Alcohol consumption may result in additive CNS depression and may increase the risk for opioid overdose. Consider the patient's use of alcohol when prescribing opioid medications. If the patient is unlikely to be compliant with avoiding alcohol, consider prescribing naloxone especially if additional risk factors for opioid overdose are present.
Hydroxyzine: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate; Sodium Biphosphate: (Major) Concomitant ingestion of alcohol with salicylates, especially aspirin, ASA, increases the risk of developing gastric irritation and GI mucosal bleeding. Alcohol and salicylates are mucosal irritants and aspirin decreases platelet aggregation. Routine ingestion of alcohol and aspirin can cause significant GI bleeding, which may or may not be overt. Even occasional concomitant use of salicylates and alcohol should be avoided. Chronic ingestion of alcohol is often associated with hypoprothrombinemia and this condition increases the risk of salicylate-induced bleeding. Patients should be warned regarding the potential for increased risk of GI bleeding if alcohol-containing beverages are taken concurrently with salicylates.
Ibuprofen: (Major) Advise patients to avoid alcohol and alcohol-containing products while taking NSAIDs. Concomitant ingestion of alcohol with NSAIDs increases the risk of developing gastric irritation and GI mucosal bleeding. Alcohol is a mucosal irritant and NSAIDs decrease platelet aggregation. Routine ingestion of alcohol and NSAIDs can cause significant GI bleeding, which may or may not be overt. Even occasional concomitant use of NSAIDs and alcohol should be avoided. Chronic alcohol ingestion is often associated with hypoprothrombinemia and this condition increases the risk of bleeding.
Ibuprofen; Famotidine: (Major) Advise patients to avoid alcohol and alcohol-containing products while taking NSAIDs. Concomitant ingestion of alcohol with NSAIDs increases the risk of developing gastric irritation and GI mucosal bleeding. Alcohol is a mucosal irritant and NSAIDs decrease platelet aggregation. Routine ingestion of alcohol and NSAIDs can cause significant GI bleeding, which may or may not be overt. Even occasional concomitant use of NSAIDs and alcohol should be avoided. Chronic alcohol ingestion is often associated with hypoprothrombinemia and this condition increases the risk of bleeding.
Ibuprofen; Oxycodone: (Major) Advise patients to avoid alcohol and alcohol-containing products while taking NSAIDs. Concomitant ingestion of alcohol with NSAIDs increases the risk of developing gastric irritation and GI mucosal bleeding. Alcohol is a mucosal irritant and NSAIDs decrease platelet aggregation. Routine ingestion of alcohol and NSAIDs can cause significant GI bleeding, which may or may not be overt. Even occasional concomitant use of NSAIDs and alcohol should be avoided. Chronic alcohol ingestion is often associated with hypoprothrombinemia and this condition increases the risk of bleeding. (Major) Advise patients to avoid alcohol consumption while taking opioids. Alcohol consumption may result in additive CNS depression and may increase the risk for opioid overdose. Consider the patient's use of alcohol when prescribing opioid medications. If the patient is unlikely to be compliant with avoiding alcohol, consider prescribing naloxone especially if additional risk factors for opioid overdose are present.
Ibuprofen; Pseudoephedrine: (Major) Advise patients to avoid alcohol and alcohol-containing products while taking NSAIDs. Concomitant ingestion of alcohol with NSAIDs increases the risk of developing gastric irritation and GI mucosal bleeding. Alcohol is a mucosal irritant and NSAIDs decrease platelet aggregation. Routine ingestion of alcohol and NSAIDs can cause significant GI bleeding, which may or may not be overt. Even occasional concomitant use of NSAIDs and alcohol should be avoided. Chronic alcohol ingestion is often associated with hypoprothrombinemia and this condition increases the risk of bleeding.
Iloperidone: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Imipramine: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants such as tricyclic antidepressants (TCAs). TCAs may exaggerate the CNS depressant response to alcohol, leading to an increase in sedation or psychomotor impairment. In some studies, alcohol has increased the unbound form of the TCA in the blood, which might be related to exaggerated clinical effect.
Indomethacin: (Major) Advise patients to avoid alcohol and alcohol-containing products while taking NSAIDs. Concomitant ingestion of alcohol with NSAIDs increases the risk of developing gastric irritation and GI mucosal bleeding. Alcohol is a mucosal irritant and NSAIDs decrease platelet aggregation. Routine ingestion of alcohol and NSAIDs can cause significant GI bleeding, which may or may not be overt. Even occasional concomitant use of NSAIDs and alcohol should be avoided. Chronic alcohol ingestion is often associated with hypoprothrombinemia and this condition increases the risk of bleeding.
Insulin Aspart: (Major) Patients should be advised to avoid or limit alcohol ingestion when treated with insulin. Alcohol ingestion increases hypoglycemic risk. In some patients, hypoglycemia can be prolonged. Educate regarding the importance of glucose monitoring, as well as the signs, symptoms, and self-management of delayed hypoglycemia after drinking alcohol, especially when using insulin. Moderate alcohol intake does not have major detrimental effects on long-term blood glucose management in people with diabetes.
Insulin Aspart; Insulin Aspart Protamine: (Major) Patients should be advised to avoid or limit alcohol ingestion when treated with insulin. Alcohol ingestion increases hypoglycemic risk. In some patients, hypoglycemia can be prolonged. Educate regarding the importance of glucose monitoring, as well as the signs, symptoms, and self-management of delayed hypoglycemia after drinking alcohol, especially when using insulin. Moderate alcohol intake does not have major detrimental effects on long-term blood glucose management in people with diabetes.
Insulin Degludec: (Major) Patients should be advised to avoid or limit alcohol ingestion when treated with insulin. Alcohol ingestion increases hypoglycemic risk. In some patients, hypoglycemia can be prolonged. Educate regarding the importance of glucose monitoring, as well as the signs, symptoms, and self-management of delayed hypoglycemia after drinking alcohol, especially when using insulin. Moderate alcohol intake does not have major detrimental effects on long-term blood glucose management in people with diabetes.
Insulin Degludec; Liraglutide: (Major) Patients should be advised to avoid or limit alcohol ingestion when treated with insulin. Alcohol ingestion increases hypoglycemic risk. In some patients, hypoglycemia can be prolonged. Educate regarding the importance of glucose monitoring, as well as the signs, symptoms, and self-management of delayed hypoglycemia after drinking alcohol, especially when using insulin. Moderate alcohol intake does not have major detrimental effects on long-term blood glucose management in people with diabetes.
Insulin Detemir: (Major) Patients should be advised to avoid or limit alcohol ingestion when treated with insulin. Alcohol ingestion increases hypoglycemic risk. In some patients, hypoglycemia can be prolonged. Educate regarding the importance of glucose monitoring, as well as the signs, symptoms, and self-management of delayed hypoglycemia after drinking alcohol, especially when using insulin. Moderate alcohol intake does not have major detrimental effects on long-term blood glucose management in people with diabetes.
Insulin Glargine: (Major) Patients should be advised to avoid or limit alcohol ingestion when treated with insulin. Alcohol ingestion increases hypoglycemic risk. In some patients, hypoglycemia can be prolonged. Educate regarding the importance of glucose monitoring, as well as the signs, symptoms, and self-management of delayed hypoglycemia after drinking alcohol, especially when using insulin. Moderate alcohol intake does not have major detrimental effects on long-term blood glucose management in people with diabetes.
Insulin Glargine; Lixisenatide: (Major) Patients should be advised to avoid or limit alcohol ingestion when treated with insulin. Alcohol ingestion increases hypoglycemic risk. In some patients, hypoglycemia can be prolonged. Educate regarding the importance of glucose monitoring, as well as the signs, symptoms, and self-management of delayed hypoglycemia after drinking alcohol, especially when using insulin. Moderate alcohol intake does not have major detrimental effects on long-term blood glucose management in people with diabetes.
Insulin Glulisine: (Major) Patients should be advised to avoid or limit alcohol ingestion when treated with insulin. Alcohol ingestion increases hypoglycemic risk. In some patients, hypoglycemia can be prolonged. Educate regarding the importance of glucose monitoring, as well as the signs, symptoms, and self-management of delayed hypoglycemia after drinking alcohol, especially when using insulin. Moderate alcohol intake does not have major detrimental effects on long-term blood glucose management in people with diabetes.
Insulin Lispro: (Major) Patients should be advised to avoid or limit alcohol ingestion when treated with insulin. Alcohol ingestion increases hypoglycemic risk. In some patients, hypoglycemia can be prolonged. Educate regarding the importance of glucose monitoring, as well as the signs, symptoms, and self-management of delayed hypoglycemia after drinking alcohol, especially when using insulin. Moderate alcohol intake does not have major detrimental effects on long-term blood glucose management in people with diabetes.
Insulin Lispro; Insulin Lispro Protamine: (Major) Patients should be advised to avoid or limit alcohol ingestion when treated with insulin. Alcohol ingestion increases hypoglycemic risk. In some patients, hypoglycemia can be prolonged. Educate regarding the importance of glucose monitoring, as well as the signs, symptoms, and self-management of delayed hypoglycemia after drinking alcohol, especially when using insulin. Moderate alcohol intake does not have major detrimental effects on long-term blood glucose management in people with diabetes.
Insulin, Inhaled: (Major) Patients should be advised to avoid or limit alcohol ingestion when treated with insulin. Alcohol ingestion increases hypoglycemic risk. In some patients, hypoglycemia can be prolonged. Educate regarding the importance of glucose monitoring, as well as the signs, symptoms, and self-management of delayed hypoglycemia after drinking alcohol, especially when using insulin. Moderate alcohol intake does not have major detrimental effects on long-term blood glucose management in people with diabetes.
Irbesartan; Hydrochlorothiazide, HCTZ: (Major) Advise patients to avoid alcohol while taking thiazide diuretics. Ingesting alcohol can increase the risk for orthostatic hypotension when taking a thiazide diuretic.
Isocarboxazid: (Major) Alcohol may cause additive CNS depression and some alcohol-containing products may also contain tyramine. Many manufacturers contraindicate the use of alcohol during traditional, non-selective MAOI therapy such as treatment with isocarboxazid, phenelzine, or tranylcypromine. Certain alcohol-containing beverages thatare tyramine-rich can precipitate a hypertensive reaction if consumed by patients during therapy with these MAOIs. These include some beers; wines; sherry; hard liquor; or liqueurs.
Isoniazid, INH: (Major) Advise patients to avoid alcohol consumption while taking isoniazid. Daily consumption of alcohol increases the risk of isoniazid-induced hepatitis and can increase the clearance of isoniazid.
Isoniazid, INH; Pyrazinamide, PZA; Rifampin: (Major) Advise patients to avoid alcohol consumption while taking isoniazid. Daily consumption of alcohol increases the risk of isoniazid-induced hepatitis and can increase the clearance of isoniazid. (Major) Rifampin is associated with dose-related hepatoxicity. Daily use of alcohol while receiving rifampin increases the risk of drug-induced hepatitis. Liver-function tests should be conducted prior to and every 2-4 weeks during treatment in patients who consume alcohol routinely while receiving rifampin therapy.
Isoniazid, INH; Rifampin: (Major) Advise patients to avoid alcohol consumption while taking isoniazid. Daily consumption of alcohol increases the risk of isoniazid-induced hepatitis and can increase the clearance of isoniazid. (Major) Rifampin is associated with dose-related hepatoxicity. Daily use of alcohol while receiving rifampin increases the risk of drug-induced hepatitis. Liver-function tests should be conducted prior to and every 2-4 weeks during treatment in patients who consume alcohol routinely while receiving rifampin therapy.
Isophane Insulin (NPH): (Major) Patients should be advised to avoid or limit alcohol ingestion when treated with insulin. Alcohol ingestion increases hypoglycemic risk. In some patients, hypoglycemia can be prolonged. Educate regarding the importance of glucose monitoring, as well as the signs, symptoms, and self-management of delayed hypoglycemia after drinking alcohol, especially when using insulin. Moderate alcohol intake does not have major detrimental effects on long-term blood glucose management in people with diabetes.
Ketamine: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Ketoconazole: (Major) Advise patients to avoid alcohol consumption while taking ketoconazole. A disulfiram-like reaction has rarely been reported when alcohol was consumed concurrently with ketoconazole. Symptoms include facial flushing, difficult breathing, slight fever, and tightness of the chest. This reaction usually resolves spontaneously within 24 hours, with no lasting effects.
Ketoprofen: (Major) Advise patients to avoid alcohol and alcohol-containing products while taking NSAIDs. Concomitant ingestion of alcohol with NSAIDs increases the risk of developing gastric irritation and GI mucosal bleeding. Alcohol is a mucosal irritant and NSAIDs decrease platelet aggregation. Routine ingestion of alcohol and NSAIDs can cause significant GI bleeding, which may or may not be overt. Even occasional concomitant use of NSAIDs and alcohol should be avoided. Chronic alcohol ingestion is often associated with hypoprothrombinemia and this condition increases the risk of bleeding.
Ketorolac: (Major) Advise patients to avoid alcohol and alcohol-containing products while taking NSAIDs. Concomitant ingestion of alcohol with NSAIDs increases the risk of developing gastric irritation and GI mucosal bleeding. Alcohol is a mucosal irritant and NSAIDs decrease platelet aggregation. Routine ingestion of alcohol and NSAIDs can cause significant GI bleeding, which may or may not be overt. Even occasional concomitant use of NSAIDs and alcohol should be avoided. Chronic alcohol ingestion is often associated with hypoprothrombinemia and this condition increases the risk of bleeding.
Lacosamide: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Lasmiditan: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Lemborexant: (Major) Advise patients to avoid the use of alcohol with lemborexant as concurrent use increases lemborexant exposure and the risk for additive CNS depression and impairment, including daytime impairment. Use of alcohol with lemborexant increased the lemborexant AUC by 1.5- to 2-fold.
Levocetirizine: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Levoketoconazole: (Major) Advise patients to avoid alcohol consumption while taking ketoconazole. A disulfiram-like reaction has rarely been reported when alcohol was consumed concurrently with ketoconazole. Symptoms include facial flushing, difficult breathing, slight fever, and tightness of the chest. This reaction usually resolves spontaneously within 24 hours, with no lasting effects.
Levomilnacipran: (Major) Alcohol use should be avoided during treatment with levomilnacipran. Use of alcohol while taking levomilnacipran can cause levomilnacipran to enter the bloodstream too quickly, which may cause serious side effects.
Levorphanol: (Major) Advise patients to avoid alcohol consumption while taking opioids. Alcohol consumption may result in additive CNS depression and may increase the risk for opioid overdose. Consider the patient's use of alcohol when prescribing opioid medications. If the patient is unlikely to be compliant with avoiding alcohol, consider prescribing naloxone especially if additional risk factors for opioid overdose are present.
Linagliptin; Metformin: (Major) Patients taking metformin should be advised to avoid alcohol use. Blood lactate concentrations and the lactate to pyruvate ratio are increased during excessive (acute or chronic) intake of alcohol with metformin.
Linezolid: (Major) Advise patients to avoid beverages with a high tyramine content, such as some red wines, while taking linezolid. A significant pressor response has been observed in normal adult subjects receiving linezolid and tyramine doses of more than 100 mg.
Lisinopril; Hydrochlorothiazide, HCTZ: (Major) Advise patients to avoid alcohol while taking thiazide diuretics. Ingesting alcohol can increase the risk for orthostatic hypotension when taking a thiazide diuretic.
Lofexidine: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Lomitapide: (Major) Alcohol may increase levels of hepatic fat and induce or exacerbate liver injury. Patients taking lomitapide should not consume more than one alcohol-containing drink per day.
Lorazepam: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression. Alcohol may also increase drug exposure and the risk for overdose by disrupting extended-release lorazepam capsules.
Losartan; Hydrochlorothiazide, HCTZ: (Major) Advise patients to avoid alcohol while taking thiazide diuretics. Ingesting alcohol can increase the risk for orthostatic hypotension when taking a thiazide diuretic.
Loxapine: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Lumateperone: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Lurasidone: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Magnesium Salicylate: (Major) Concomitant ingestion of alcohol with salicylates, especially aspirin, ASA, increases the risk of developing gastric irritation and GI mucosal bleeding. Alcohol and salicylates are mucosal irritants and aspirin decreases platelet aggregation. Routine ingestion of alcohol and aspirin can cause significant GI bleeding, which may or may not be overt. Even occasional concomitant use of salicylates and alcohol should be avoided. Chronic ingestion of alcohol is often associated with hypoprothrombinemia and this condition increases the risk of salicylate-induced bleeding. Patients should be warned regarding the potential for increased risk of GI bleeding if alcohol-containing beverages are taken concurrently with salicylates.
Maprotiline: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Meclizine: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Meclofenamate Sodium: (Major) Advise patients to avoid alcohol and alcohol-containing products while taking NSAIDs. Concomitant ingestion of alcohol with NSAIDs increases the risk of developing gastric irritation and GI mucosal bleeding. Alcohol is a mucosal irritant and NSAIDs decrease platelet aggregation. Routine ingestion of alcohol and NSAIDs can cause significant GI bleeding, which may or may not be overt. Even occasional concomitant use of NSAIDs and alcohol should be avoided. Chronic alcohol ingestion is often associated with hypoprothrombinemia and this condition increases the risk of bleeding.
Mefenamic Acid: (Major) Advise patients to avoid alcohol and alcohol-containing products while taking NSAIDs. Concomitant ingestion of alcohol with NSAIDs increases the risk of developing gastric irritation and GI mucosal bleeding. Alcohol is a mucosal irritant and NSAIDs decrease platelet aggregation. Routine ingestion of alcohol and NSAIDs can cause significant GI bleeding, which may or may not be overt. Even occasional concomitant use of NSAIDs and alcohol should be avoided. Chronic alcohol ingestion is often associated with hypoprothrombinemia and this condition increases the risk of bleeding.
Melatonin: (Major) Advise patients to avoid alcohol-containing beverages while taking melatonin. Concomitant administration of alcohol with melatonin may cause additive CNS depression and impairment of psychomotor performance. Alcohol may also interfere with the efficacy of melatonin for inducing sleep.
Meloxicam: (Major) Advise patients to avoid alcohol and alcohol-containing products while taking NSAIDs. Concomitant ingestion of alcohol with NSAIDs increases the risk of developing gastric irritation and GI mucosal bleeding. Alcohol is a mucosal irritant and NSAIDs decrease platelet aggregation. Routine ingestion of alcohol and NSAIDs can cause significant GI bleeding, which may or may not be overt. Even occasional concomitant use of NSAIDs and alcohol should be avoided. Chronic alcohol ingestion is often associated with hypoprothrombinemia and this condition increases the risk of bleeding.
Meperidine: (Major) Advise patients to avoid alcohol consumption while taking opioids. Alcohol consumption may result in additive CNS depression and may increase the risk for opioid overdose. Consider the patient's use of alcohol when prescribing opioid medications. If the patient is unlikely to be compliant with avoiding alcohol, consider prescribing naloxone especially if additional risk factors for opioid overdose are present.
Meprobamate: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Metaxalone: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Metformin: (Major) Patients taking metformin should be advised to avoid alcohol use. Blood lactate concentrations and the lactate to pyruvate ratio are increased during excessive (acute or chronic) intake of alcohol with metformin.
Metformin; Repaglinide: (Major) Patients should be advised to avoid or limit alcohol ingestion when treated with meglitinides. Alcohol ingestion increases hypoglycemic risk. In some patients, hypoglycemia can be prolonged. Patients should be educated regarding the signs, symptoms, and self-management of delayed hypoglycemia after drinking alcohol, especially when using meglitinides. The importance of glucose monitoring after drinking alcoholic beverages to reduce hypoglycemia risk should be emphasized. (Major) Patients taking metformin should be advised to avoid alcohol use. Blood lactate concentrations and the lactate to pyruvate ratio are increased during excessive (acute or chronic) intake of alcohol with metformin.
Metformin; Saxagliptin: (Major) Patients taking metformin should be advised to avoid alcohol use. Blood lactate concentrations and the lactate to pyruvate ratio are increased during excessive (acute or chronic) intake of alcohol with metformin.
Metformin; Sitagliptin: (Major) Patients taking metformin should be advised to avoid alcohol use. Blood lactate concentrations and the lactate to pyruvate ratio are increased during excessive (acute or chronic) intake of alcohol with metformin.
Methadone: (Major) Advise patients to avoid alcohol consumption while taking opioids. Alcohol consumption may result in additive CNS depression and may increase the risk for opioid overdose. Consider the patient's use of alcohol when prescribing opioid medications. If the patient is unlikely to be compliant with avoiding alcohol, consider prescribing naloxone especially if additional risk factors for opioid overdose are present.
Methenamine; Sodium Salicylate: (Major) Concomitant ingestion of alcohol with salicylates, especially aspirin, ASA, increases the risk of developing gastric irritation and GI mucosal bleeding. Alcohol and salicylates are mucosal irritants and aspirin decreases platelet aggregation. Routine ingestion of alcohol and aspirin can cause significant GI bleeding, which may or may not be overt. Even occasional concomitant use of salicylates and alcohol should be avoided. Chronic ingestion of alcohol is often associated with hypoprothrombinemia and this condition increases the risk of salicylate-induced bleeding. Patients should be warned regarding the potential for increased risk of GI bleeding if alcohol-containing beverages are taken concurrently with salicylates.
Methocarbamol: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Methohexital: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Methotrexate: (Major) Alcohol may increase the risk for liver-related side effects of methotrexate. Patients should be advised to avoid intake of alcohol-containing beverages during methotrexate therapy. Patients who are noncompliant with alcohol restrictions should not receive methotrexate.
Methscopolamine: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Methsuximide: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Methylphenidate: (Major) Alcohol consumption should be avoided during treatment with certain extended-release (ER) dosage forms of methylphenidate (e.g., Ritalin LA, Metadate CD). Results from an in vitro study showed that at an alcohol concentration of 40%, there was a 98% release of extended-release methylphenidate (Ritalin LA) from the 40 mg capsule in the first hour after administration. In addition, concurrent use with alcohol may exacerbate the CNS-related adverse effects of methylphenidate.
Metoclopramide: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Metolazone: (Major) Advise patients to avoid alcohol while taking thiazide diuretics. Ingesting alcohol can increase the risk for orthostatic hypotension when taking a thiazide diuretic.
Metoprolol: (Major) Avoid alcohol-containing beverages when taking metoprolol extended-release capsules. Alcohol may cause a rapid release of metoprolol from the capsule, possibly resulting in increased side effects and reduced efficacy.
Metoprolol; Hydrochlorothiazide, HCTZ: (Major) Advise patients to avoid alcohol while taking thiazide diuretics. Ingesting alcohol can increase the risk for orthostatic hypotension when taking a thiazide diuretic. (Major) Avoid alcohol-containing beverages when taking metoprolol extended-release capsules. Alcohol may cause a rapid release of metoprolol from the capsule, possibly resulting in increased side effects and reduced efficacy.
Metronidazole: (Major) Advise patients to discontinue alcohol-containing beverages and other forms of alcohol (including medicines with significant alcohol content and any products containing propylene glycol) before, during, and up to 3 days after therapy with systemic metronidazole. Disulfiram-like side effects including nausea, vomiting, tachycardia, headache, flushing, and abdominal cramps may occur if used together.
Metyrosine: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Midazolam: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Mirtazapine: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Modafinil: (Major) Advise patients to avoid alcohol-containing beverages while taking modafinil. There is no information on the effects of concurrent administration of ethanol or alcohol-containing medications with modafinil; the CNS depressant effect of alcohol may reduce the response to modafinil.
Molindone: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Morphine: (Major) Advise patients to avoid alcohol consumption while taking opioids. Alcohol consumption may result in additive CNS depression and may increase the risk for opioid overdose. Alcohol may also increase opioid drug exposure and the risk for fatal overdose by disrupting extended- or delayed-release opioid formulations. Consider the patient's use of alcohol when prescribing opioid medications. If the patient is unlikely to be compliant with avoiding alcohol, consider prescribing naloxone especially if additional risk factors for opioid overdose are present.
Morphine; Naltrexone: (Major) Advise patients to avoid alcohol consumption while taking opioids. Alcohol consumption may result in additive CNS depression and may increase the risk for opioid overdose. Alcohol may also increase opioid drug exposure and the risk for fatal overdose by disrupting extended- or delayed-release opioid formulations. Consider the patient's use of alcohol when prescribing opioid medications. If the patient is unlikely to be compliant with avoiding alcohol, consider prescribing naloxone especially if additional risk factors for opioid overdose are present.
Nabilone: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Nabumetone: (Major) Advise patients to avoid alcohol and alcohol-containing products while taking NSAIDs. Concomitant ingestion of alcohol with NSAIDs increases the risk of developing gastric irritation and GI mucosal bleeding. Alcohol is a mucosal irritant and NSAIDs decrease platelet aggregation. Routine ingestion of alcohol and NSAIDs can cause significant GI bleeding, which may or may not be overt. Even occasional concomitant use of NSAIDs and alcohol should be avoided. Chronic alcohol ingestion is often associated with hypoprothrombinemia and this condition increases the risk of bleeding.
Nalbuphine: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Naproxen: (Major) Advise patients to avoid alcohol and alcohol-containing products while taking NSAIDs. Concomitant ingestion of alcohol with NSAIDs increases the risk of developing gastric irritation and GI mucosal bleeding. Alcohol is a mucosal irritant and NSAIDs decrease platelet aggregation. Routine ingestion of alcohol and NSAIDs can cause significant GI bleeding, which may or may not be overt. Even occasional concomitant use of NSAIDs and alcohol should be avoided. Chronic alcohol ingestion is often associated with hypoprothrombinemia and this condition increases the risk of bleeding.
Naproxen; Esomeprazole: (Major) Advise patients to avoid alcohol and alcohol-containing products while taking NSAIDs. Concomitant ingestion of alcohol with NSAIDs increases the risk of developing gastric irritation and GI mucosal bleeding. Alcohol is a mucosal irritant and NSAIDs decrease platelet aggregation. Routine ingestion of alcohol and NSAIDs can cause significant GI bleeding, which may or may not be overt. Even occasional concomitant use of NSAIDs and alcohol should be avoided. Chronic alcohol ingestion is often associated with hypoprothrombinemia and this condition increases the risk of bleeding.
Naproxen; Pseudoephedrine: (Major) Advise patients to avoid alcohol and alcohol-containing products while taking NSAIDs. Concomitant ingestion of alcohol with NSAIDs increases the risk of developing gastric irritation and GI mucosal bleeding. Alcohol is a mucosal irritant and NSAIDs decrease platelet aggregation. Routine ingestion of alcohol and NSAIDs can cause significant GI bleeding, which may or may not be overt. Even occasional concomitant use of NSAIDs and alcohol should be avoided. Chronic alcohol ingestion is often associated with hypoprothrombinemia and this condition increases the risk of bleeding.
Nateglinide: (Major) Patients should be advised to avoid or limit alcohol ingestion when treated with meglitinides. Alcohol ingestion increases hypoglycemic risk. In some patients, hypoglycemia can be prolonged. Patients should be educated regarding the signs, symptoms, and self-management of delayed hypoglycemia after drinking alcohol, especially when using meglitinides. The importance of glucose monitoring after drinking alcoholic beverages to reduce hypoglycemia risk should be emphasized.
Nefazodone: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Niacin, Niacinamide: (Moderate) Alcohol-containing beverages or hot beverages/foods can exacerbate cutaneous vasodilation caused by niacin and should be avoided around the time of niacin ingestion. In general, this interaction would not be harmful, but might decrease patient tolerance of niacin. Alcohol and niacin, particularly sustained-release niacin, are both potentially hepatotoxic. Although no data are available regarding enhanced hepatotoxicity, excessive alcohol use should be discouraged.
Nifurtimox: (Contraindicated) Nifurtimox is contraindicated in patients who consume alcohol during treatment. Concomitant use of nifurtimox with alcohol may increase the incidence and severity of undesirable effects (i.e., abdominal cramps, nausea, vomiting, headaches, and flushing) similar to other nitrofurans and nitroheterocyclic compounds.
Nilutamide: (Major) Advise patients to avoid alcohol and alcohol-containing products while taking nilutamide. Alcohol intolerance has been reported in about 5% of patients treated with nilutamide. Facial flushing, malaise, and hypotension may occur following ingestion of nilutamide with alcohol. The mechanism of this interaction is not known.
Nitroglycerin: (Major) Alcohol may increase the frequency of nitroglycerin-related adverse effects including lightheadedness on standing, especially just after rising from a recumbent or seated position. The vasodilating effects of nitroglycerin may also be additive with those of alcohol.
Nortriptyline: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants such as tricyclic antidepressants (TCAs). TCAs may exaggerate the CNS depressant response to alcohol, leading to an increase in sedation or psychomotor impairment. In some studies, alcohol has increased the unbound form of the TCA in the blood, which might be related to exaggerated clinical effect.
Olanzapine: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Olanzapine; Fluoxetine: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Olanzapine; Samidorphan: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Oliceridine: (Major) Advise patients to avoid alcohol consumption while taking opioids. Alcohol consumption may result in additive CNS depression and may increase the risk for opioid overdose. Consider the patient's use of alcohol when prescribing opioid medications. If the patient is unlikely to be compliant with avoiding alcohol, consider prescribing naloxone especially if additional risk factors for opioid overdose are present.
Olmesartan; Amlodipine; Hydrochlorothiazide, HCTZ: (Major) Advise patients to avoid alcohol while taking thiazide diuretics. Ingesting alcohol can increase the risk for orthostatic hypotension when taking a thiazide diuretic.
Olmesartan; Hydrochlorothiazide, HCTZ: (Major) Advise patients to avoid alcohol while taking thiazide diuretics. Ingesting alcohol can increase the risk for orthostatic hypotension when taking a thiazide diuretic.
Olopatadine: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Olopatadine; Mometasone: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Orphenadrine: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Oxaprozin: (Major) Advise patients to avoid alcohol and alcohol-containing products while taking NSAIDs. Concomitant ingestion of alcohol with NSAIDs increases the risk of developing gastric irritation and GI mucosal bleeding. Alcohol is a mucosal irritant and NSAIDs decrease platelet aggregation. Routine ingestion of alcohol and NSAIDs can cause significant GI bleeding, which may or may not be overt. Even occasional concomitant use of NSAIDs and alcohol should be avoided. Chronic alcohol ingestion is often associated with hypoprothrombinemia and this condition increases the risk of bleeding.
Oxazepam: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Oxcarbazepine: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Oxybutynin: (Major) Advise patients to avoid alcohol consumption while taking oxybutynin. Alcohol is a CNS-depressant and may cause additive sedative effects when used concomitantly with oxybutynin.
Oxycodone: (Major) Advise patients to avoid alcohol consumption while taking opioids. Alcohol consumption may result in additive CNS depression and may increase the risk for opioid overdose. Consider the patient's use of alcohol when prescribing opioid medications. If the patient is unlikely to be compliant with avoiding alcohol, consider prescribing naloxone especially if additional risk factors for opioid overdose are present.
Oxymorphone: (Major) Advise patients to avoid alcohol consumption while taking opioids. Alcohol consumption may result in additive CNS depression and may increase the risk for opioid overdose. Alcohol may also increase opioid drug exposure and the risk for fatal overdose by disrupting extended- or delayed-release opioid formulations. Consider the patient's use of alcohol when prescribing opioid medications. If the patient is unlikely to be compliant with avoiding alcohol, consider prescribing naloxone especially if additional risk factors for opioid overdose are present.
Paliperidone: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Pentazocine: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Pentazocine; Naloxone: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Pentobarbital: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Perampanel: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Perphenazine: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Perphenazine; Amitriptyline: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants such as tricyclic antidepressants (TCAs). TCAs may exaggerate the CNS depressant response to alcohol, leading to an increase in sedation or psychomotor impairment. In some studies, alcohol has increased the unbound form of the TCA in the blood, which might be related to exaggerated clinical effect. (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Phenelzine: (Major) Alcohol may cause additive CNS depression and some alcohol-containing products may also contain tyramine. Many manufacturers contraindicate the use of alcohol during traditional, non-selective MAOI therapy such as treatment with isocarboxazid, phenelzine, or tranylcypromine. Certain alcohol-containing beverages thatare tyramine-rich can precipitate a hypertensive reaction if consumed by patients during therapy with these MAOIs. These include some beers; wines; sherry; hard liquor; or liqueurs.
Phenobarbital: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Phenobarbital; Hyoscyamine; Atropine; Scopolamine: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Phenoxybenzamine: (Major) Advise patients to avoid alcohol consumption while taking alpha-blockers. Concomitant use may increase the risk for hypotension.
Phentermine; Topiramate: (Major) Advise patients to avoid alcohol consumption while taking topiramate. Topiramate is a CNS depressant. Concomitant administration of topiramate with alcohol can result in significant CNS depression. Trokendi XR is contraindicated with recent alcohol use (i.e., within 6 hours before and 6 hours after use). In the presence of alcohol, the pattern of topiramate release from Trokendi XR is significantly altered. As a result, plasma concentrations of topiramate may be markedly higher soon after dosing and subtherapeutic later in the day.
Phentolamine: (Major) Advise patients to avoid alcohol consumption while taking alpha-blockers. Concomitant use may increase the risk for hypotension.
Phenytoin: (Major) Phenytoin theoretically can add to the CNS-depressant effects of alcohol. Chronic ingestion of alcohol induces hepatic microsomal isozymes and increases the clearance of phenytoin. Alcohol also exhibits epileptogenic potential. Alcohol should generally be avoided in patients on fosphenytoin or phenytoin. Acute ingestion of small amounts of ethanol in non-alcoholic patients does not appear to affect the hepatic metabolism of phenytoin to a clinically significant degree.
Pimozide: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Pioglitazone; Glimepiride: (Major) Patients should be advised to avoid or limit alcohol ingestion when treated with sulfonylureas. Alcohol ingestion increases hypoglycemic risk. In some patients, hypoglycemia can be prolonged. Patients should be educated regarding the signs, symptoms, and self-management of delayed hypoglycemia after drinking alcohol, especially when using sulfonylureas. The importance of glucose monitoring after drinking alcoholic beverages to reduce hypoglycemia risk should be emphasized.
Pioglitazone; Metformin: (Major) Patients taking metformin should be advised to avoid alcohol use. Blood lactate concentrations and the lactate to pyruvate ratio are increased during excessive (acute or chronic) intake of alcohol with metformin.
Piroxicam: (Major) Advise patients to avoid alcohol and alcohol-containing products while taking NSAIDs. Concomitant ingestion of alcohol with NSAIDs increases the risk of developing gastric irritation and GI mucosal bleeding. Alcohol is a mucosal irritant and NSAIDs decrease platelet aggregation. Routine ingestion of alcohol and NSAIDs can cause significant GI bleeding, which may or may not be overt. Even occasional concomitant use of NSAIDs and alcohol should be avoided. Chronic alcohol ingestion is often associated with hypoprothrombinemia and this condition increases the risk of bleeding.
Posaconazole: (Major) Advise patients that administration of the posaconazole delayed-release oral suspension with alcohol is not recommended. Posaconazole was found to release faster from the delayed-release oral suspension in the presence of alcohol in vitro, which may interfere with its delayed release characteristics.
Pramipexole: (Major) Advise patients to avoid the ingestion of alcohol-containing beverages while taking pramipexole. The use of alcohol in combination with pramipexole may increase the risk of clinically significant sedation and falling asleep during activities of daily living.
Pramlintide: (Major) Patients should be advised to avoid alcohol ingestion when treated with pramlintide. Drinking alcohol increases the risk for hypoglycemia.
Prazosin: (Major) Advise patients to avoid alcohol consumption while taking alpha-blockers. Concomitant use may increase the risk for hypotension.
Pregabalin: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Pretomanid: (Major) Advise patients to avoid alcohol while taking pretomanid due to an increased risk for hepatotoxicity.
Primidone: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Procainamide: (Major) Advise patients to avoid alcohol consumption while taking procainamide. Alcohol consumption has been observed to decrease procainamide overall exposure by approximately 20% in healthy volunteers.
Procarbazine: (Major) A disulfiram-like reaction can occur in patients who drink alcohol while they are receiving procarbazine. Patients should be counseled to avoid alcohol-containing products while receiving procarbazine therapy.
Prochlorperazine: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Promethazine: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Promethazine; Dextromethorphan: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Promethazine; Phenylephrine: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Propofol: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Protriptyline: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants such as tricyclic antidepressants (TCAs). TCAs may exaggerate the CNS depressant response to alcohol, leading to an increase in sedation or psychomotor impairment. In some studies, alcohol has increased the unbound form of the TCA in the blood, which might be related to exaggerated clinical effect.
Pseudoephedrine; Triprolidine: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Quazepam: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Quetiapine: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Quinapril; Hydrochlorothiazide, HCTZ: (Major) Advise patients to avoid alcohol while taking thiazide diuretics. Ingesting alcohol can increase the risk for orthostatic hypotension when taking a thiazide diuretic.
Ramelteon: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Ranolazine: (Major) Advise patients taking ranolazine extended-release oral granules to avoid alcohol ingestion; alcohol may cause a rapid-release of medication that can cause serious side effects, including QT prolongation.
Rasagiline: (Major) Advise patients to avoid alcohol consumption while taking rasagiline. Dopaminergic medications, including rasagiline, may cause a sudden onset of somnolence which sometimes has resulted in motor vehicle accidents. Patients may not perceive warning signs, such as excessive drowsiness, or they may report feeling alert immediately prior to the event. Such events may increase when rasagiline is combined with alcohol or other CNS depressants. Because of possible additive effects, advise patients about the potential for increased somnolence during concurrent use of alcohol. Ingestion of alcohol-containing beverages with high tyramine content (e.g., tap beers) also may place some patients at risk for hypertension. If a patient ingests beverages very rich in tyramine and does not feel well soon after, the patient should contact their healthcare provider.
Regular Insulin: (Major) Patients should be advised to avoid or limit alcohol ingestion when treated with insulin. Alcohol ingestion increases hypoglycemic risk. In some patients, hypoglycemia can be prolonged. Educate regarding the importance of glucose monitoring, as well as the signs, symptoms, and self-management of delayed hypoglycemia after drinking alcohol, especially when using insulin. Moderate alcohol intake does not have major detrimental effects on long-term blood glucose management in people with diabetes.
Regular Insulin; Isophane Insulin (NPH): (Major) Patients should be advised to avoid or limit alcohol ingestion when treated with insulin. Alcohol ingestion increases hypoglycemic risk. In some patients, hypoglycemia can be prolonged. Educate regarding the importance of glucose monitoring, as well as the signs, symptoms, and self-management of delayed hypoglycemia after drinking alcohol, especially when using insulin. Moderate alcohol intake does not have major detrimental effects on long-term blood glucose management in people with diabetes.
Remifentanil: (Major) Advise patients to avoid alcohol consumption while taking opioids. Alcohol consumption may result in additive CNS depression and may increase the risk for opioid overdose. Consider the patient's use of alcohol when prescribing opioid medications. If the patient is unlikely to be compliant with avoiding alcohol, consider prescribing naloxone especially if additional risk factors for opioid overdose are present.
Repaglinide: (Major) Patients should be advised to avoid or limit alcohol ingestion when treated with meglitinides. Alcohol ingestion increases hypoglycemic risk. In some patients, hypoglycemia can be prolonged. Patients should be educated regarding the signs, symptoms, and self-management of delayed hypoglycemia after drinking alcohol, especially when using meglitinides. The importance of glucose monitoring after drinking alcoholic beverages to reduce hypoglycemia risk should be emphasized.
Rifampin: (Major) Rifampin is associated with dose-related hepatoxicity. Daily use of alcohol while receiving rifampin increases the risk of drug-induced hepatitis. Liver-function tests should be conducted prior to and every 2-4 weeks during treatment in patients who consume alcohol routinely while receiving rifampin therapy.
Risperidone: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Ropinirole: (Major) Patients should be advised that alcohol use may increase the risk of somnolence during treatment with ropinirole. In addition, the sudden onset of sleep during activities that require active participation (e.g., driving a vehicle, conversations, eating) has occurred during treatment with dopamine agonists, including ropinirole. In some cases, excessive drowsiness due to ropinirole or other dopamine agonists has resulted in auto accidents or other harmful events in the course of daily living. Advise patients to avoid alcohol and notify their healthcare provider if they experience excess sedation or sudden sleep onset while receiving ropinirole.
Rotigotine: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Rufinamide: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Safinamide: (Major) Advise patients to avoid alcohol consumption while taking safinamide. Alcohol consumption may increase the risk for somnolence and hypertension. Dopaminergic medications, including safinamide, may cause a sudden onset of somnolence which sometimes has resulted in motor vehicle accidents. Patients may not perceive warning signs, such as excessive drowsiness, or they may report feeling alert immediately prior to the event. Such events may increase when safinamide is combined with alcohol. Ingestion of alcohol-containing beverages with high tyramine content (i.e., more than 150 mg of tyramine) may also place some patients at risk for hypertension.
Salsalate: (Major) Concomitant ingestion of alcohol with salicylates, especially aspirin, ASA, increases the risk of developing gastric irritation and GI mucosal bleeding. Alcohol and salicylates are mucosal irritants and aspirin decreases platelet aggregation. Routine ingestion of alcohol and aspirin can cause significant GI bleeding, which may or may not be overt. Even occasional concomitant use of salicylates and alcohol should be avoided. Chronic ingestion of alcohol is often associated with hypoprothrombinemia and this condition increases the risk of salicylate-induced bleeding. Patients should be warned regarding the potential for increased risk of GI bleeding if alcohol-containing beverages are taken concurrently with salicylates.
Scopolamine: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Secnidazole: (Major) Advise patients to discontinue alcohol-containing beverages and other forms of alcohol (including medicines with significant alcohol content and any products containing propylene glycol) before, during, and up to 2 days after therapy with secnidazole. Side effects, including nausea, vomiting, diarrhea, abdominal pain, dizziness, and headache, may occur if used together.
Secobarbital: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Selegiline: (Major) Advise patients to avoid the use of alcohol or alcohol-containing products with selegiline. Use may cause additive CNS depression and some alcohol-containing products may also contain tyramine. Certain alcohol-containing beverages that are tyramine-rich can precipitate a hypertensive reaction if consumed by patients during therapy with selegiline. These include some beers; wines; sherry; hard liquor; or liqueurs.
Sevoflurane: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Sodium Oxybate: (Contraindicated) Alcohol is contraindicated in patients using sodium oxybate or other oxybates. Dangerous, additive CNS depressant effects are possible, including respiratory depression. Patients should be strongly warned against the use of any alcohol-containing beverages in conjunction with oxybates.
Spironolactone; Hydrochlorothiazide, HCTZ: (Major) Advise patients to avoid alcohol while taking thiazide diuretics. Ingesting alcohol can increase the risk for orthostatic hypotension when taking a thiazide diuretic.
Stiripentol: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Sufentanil: (Major) Advise patients to avoid alcohol consumption while taking opioids. Alcohol consumption may result in additive CNS depression and may increase the risk for opioid overdose. Consider the patient's use of alcohol when prescribing opioid medications. If the patient is unlikely to be compliant with avoiding alcohol, consider prescribing naloxone especially if additional risk factors for opioid overdose are present.
Sulfacetamide; Sulfur: (Moderate) Alcohol-containing beverages or hot beverages/foods can exacerbate cutaneous vasodilation caused by niacin and should be avoided around the time of niacin ingestion.
Sulindac: (Major) Advise patients to avoid alcohol and alcohol-containing products while taking NSAIDs. Concomitant ingestion of alcohol with NSAIDs increases the risk of developing gastric irritation and GI mucosal bleeding. Alcohol is a mucosal irritant and NSAIDs decrease platelet aggregation. Routine ingestion of alcohol and NSAIDs can cause significant GI bleeding, which may or may not be overt. Even occasional concomitant use of NSAIDs and alcohol should be avoided. Chronic alcohol ingestion is often associated with hypoprothrombinemia and this condition increases the risk of bleeding.
Sumatriptan; Naproxen: (Major) Advise patients to avoid alcohol and alcohol-containing products while taking NSAIDs. Concomitant ingestion of alcohol with NSAIDs increases the risk of developing gastric irritation and GI mucosal bleeding. Alcohol is a mucosal irritant and NSAIDs decrease platelet aggregation. Routine ingestion of alcohol and NSAIDs can cause significant GI bleeding, which may or may not be overt. Even occasional concomitant use of NSAIDs and alcohol should be avoided. Chronic alcohol ingestion is often associated with hypoprothrombinemia and this condition increases the risk of bleeding.
Suvorexant: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Tacrolimus: (Major) Alcohol-containing beverages should not be consumed while taking the extended-release tacrolimus capsules (Astagraf XL). Concomitant alcohol use may increase the rate of release of tacrolimus and/or adversely alter the pharmacokinetic properties and effectiveness and safety. A flushing syndrome (alcohol intolerance) has been reported in patients treated with topical tacrolimus upon ingestion of alcohol. The flushing occurred in the face or at the sites of medication application, usually within 5 to 15 minutes of alcohol ingestion, and lasted for an average duration of 1 hour. Patients describe redness and warm sensations, which sometimes result in discomfort. The reaction does not appear to occur in all patients; roughly 3% to 7% report a notable effect. The possible mechanism of the effect is the inhibition of acetaldehyde dehydrogenase, leading to increased acetaldehyde dehydrogenase concentrations in the skin.
Tadalafil: (Major) Advise patients to avoid alcohol consumption while taking tadalafil. Both alcohol and tadalafil, a PDE5 inhibitor, act as mild vasodilators. When mild vasodilators are taken in combination, blood pressure lowering effects may be increased. Substantial consumption of alcohol (e.g., 5 units or greater) in combination with tadalafil can increase the potential for orthostatic signs and symptoms, including an increase in heart rate, decrease in standing blood pressure, dizziness, and headache. Tadalafil (10 mg or 20 mg) did not affect alcohol plasma concentrations and alcohol did not affect tadalafil plasma concentrations.
Tapentadol: (Major) Advise patients to avoid alcohol consumption while taking opioids. Alcohol consumption may result in additive CNS depression and may increase the risk for opioid overdose. Alcohol may also increase opioid drug exposure and the risk for fatal overdose by disrupting extended- or delayed-release opioid formulations. Consider the patient's use of alcohol when prescribing opioid medications. If the patient is unlikely to be compliant with avoiding alcohol, consider prescribing naloxone especially if additional risk factors for opioid overdose are present.
Tasimelteon: (Major) Advise patients to avoid alcohol consumption while taking tasimelteon. A single dose study indicated a trend towards additive effects of tasimelteon and alcohol on some psychomotor tests.
Telmisartan; Hydrochlorothiazide, HCTZ: (Major) Advise patients to avoid alcohol while taking thiazide diuretics. Ingesting alcohol can increase the risk for orthostatic hypotension when taking a thiazide diuretic.
Temazepam: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Terazosin: (Major) Advise patients to avoid alcohol consumption while taking alpha-blockers. Concomitant use may increase the risk for hypotension.
Tetrabenazine: (Major) Advise patients to avoid alcohol-containing beverages while taking tetrabenazine. Additive effects are possible when tetrabenazine is combined with other drugs that cause CNS depression.
Thalidomide: (Major) Avoid the concomitant use of thalidomide with alcohol due to the potential for additive sedative effects. Additionally, using thalidomide and alcohol together may potentiate the adverse effect of peripheral neuropathy.
Thiazolidinediones: (Moderate) Patients should be advised to limit alcohol ingestion when treated with a thiazolidinedione. A single administration of a moderate amount of alcohol did not increase the risk of acute hypoglycemia in type 2 diabetes mellitus patients treated with thiazolidinediones in clinical studies. However, alcohol inhibits gluconeogenesis, which can contribute to or increase the risk for hypoglycemia. In some patients, hypoglycemia can be prolonged. If a patient with diabetes ingests alcohol, they should be counselled to to avoid ingestion of alcohol on an empty stomach, which increases risk for low blood sugar. Patients should also be aware of the carbohydrate intake provided by certain types of alcohol in the diet, which can contribute to poor glycemic control. If a patient chooses to ingest alcohol, they should monitor their blood glucose frequently. Many non-prescription drug products may be formulated with alcohol; instruct patients to scrutinize product labels prior to consumption.
Thioridazine: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Thiothixene: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Tiagabine: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Tinidazole: (Major) Avoid alcohol and preparations containing alcohol or propylene glycol during tinidazole therapy and for 3 days after because abdominal cramps, nausea, vomiting, headaches, and flushing may occur.
Tiopronin: (Major) Avoid alcohol consumption 2 hours before and 3 hours after taking tiopronin EC. Tiopronin is released faster from tiopronin EC in the presence of alcohol; the risk for adverse events associated with tiopronin EC when taken with alcohol is unknown.
Tizanidine: (Major) Advise patients to avoid alcohol-containing beverages while taking tizanidine. Concurrent use of tizanidine and CNS depressants can cause additive CNS depression and hypotension. Alcohol also increases the overall amount of drug in the bloodstream after a dose of tizanidine. Alcohol increases the AUC and Cmax of tizanidine by about 20% and 15%, respectively, resulting in an increase in side effects associated with tizanidine.
Tolcapone: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Tolmetin: (Major) Advise patients to avoid alcohol and alcohol-containing products while taking NSAIDs. Concomitant ingestion of alcohol with NSAIDs increases the risk of developing gastric irritation and GI mucosal bleeding. Alcohol is a mucosal irritant and NSAIDs decrease platelet aggregation. Routine ingestion of alcohol and NSAIDs can cause significant GI bleeding, which may or may not be overt. Even occasional concomitant use of NSAIDs and alcohol should be avoided. Chronic alcohol ingestion is often associated with hypoprothrombinemia and this condition increases the risk of bleeding.
Topiramate: (Major) Advise patients to avoid alcohol consumption while taking topiramate. Topiramate is a CNS depressant. Concomitant administration of topiramate with alcohol can result in significant CNS depression. Trokendi XR is contraindicated with recent alcohol use (i.e., within 6 hours before and 6 hours after use). In the presence of alcohol, the pattern of topiramate release from Trokendi XR is significantly altered. As a result, plasma concentrations of topiramate may be markedly higher soon after dosing and subtherapeutic later in the day.
Tramadol: (Major) Advise patients to avoid alcohol consumption while taking opioids. Alcohol consumption may result in additive CNS depression and may increase the risk for opioid overdose. Consider the patient's use of alcohol when prescribing opioid medications. If the patient is unlikely to be compliant with avoiding alcohol, consider prescribing naloxone especially if additional risk factors for opioid overdose are present.
Tramadol; Acetaminophen: (Major) Advise patients to avoid alcohol consumption while taking opioids. Alcohol consumption may result in additive CNS depression and may increase the risk for opioid overdose. Consider the patient's use of alcohol when prescribing opioid medications. If the patient is unlikely to be compliant with avoiding alcohol, consider prescribing naloxone especially if additional risk factors for opioid overdose are present. (Major) The risk of developing hepatotoxicity from acetaminophen appears to be increased in patients who regularly consume alcohol. Patients who drink more than 3 alcohol-containing drinks a day and take acetaminophen are at increased risk of developing hepatotoxicity. Acute or chronic alcohol use increases acetaminophen-induced hepatotoxicity by inducing CYP2E1 leading to increased formation of the hepatotoxic metabolite of acetaminophen. Also, chronic alcohol use can deplete liver glutathione stores. Administration of acetaminophen should be limited or avoided altogether in patients with alcoholism or patients who consume alcohol regularly.
Trandolapril; Verapamil: (Major) Advise patients to avoid alcohol and alcohol-containing products while taking verapamil. Verapamil has been found to significantly inhibit alcohol elimination resulting in elevated blood alcohol concentrations that may prolong the intoxicating effects of alcohol. The patient may experience an increase in sedation, dizziness, hypotension, and CNS depression.
Tranylcypromine: (Major) Alcohol may cause additive CNS depression and some alcohol-containing products may also contain tyramine. Many manufacturers contraindicate the use of alcohol during traditional, non-selective MAOI therapy such as treatment with isocarboxazid, phenelzine, or tranylcypromine. Certain alcohol-containing beverages thatare tyramine-rich can precipitate a hypertensive reaction if consumed by patients during therapy with these MAOIs. These include some beers; wines; sherry; hard liquor; or liqueurs.
Trazodone: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Triamterene; Hydrochlorothiazide, HCTZ: (Major) Advise patients to avoid alcohol while taking thiazide diuretics. Ingesting alcohol can increase the risk for orthostatic hypotension when taking a thiazide diuretic.
Triazolam: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Trifluoperazine: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Trihexyphenidyl: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Trimethobenzamide: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Trimipramine: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants such as tricyclic antidepressants (TCAs). TCAs may exaggerate the CNS depressant response to alcohol, leading to an increase in sedation or psychomotor impairment. In some studies, alcohol has increased the unbound form of the TCA in the blood, which might be related to exaggerated clinical effect.
Triprolidine: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Trospium: (Major) Advise patients to avoid alcohol and alcohol-containing products while taking trospium. Alcohol consumption may result in additive CNS depression. Alcohol should not be consumed within 2 hours of trospium extended-release capsules.
Valerian, Valeriana officinalis: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Valoctocogene Roxaparvovec: (Major) Advise patients to avoid alcohol-containing beverages for 1 year after treatment with valoctocogene roxaparvovec. Drinking alcohol with this medication increases the risk of hepatotoxicity.
Valproic Acid, Divalproex Sodium: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Valsartan; Hydrochlorothiazide, HCTZ: (Major) Advise patients to avoid alcohol while taking thiazide diuretics. Ingesting alcohol can increase the risk for orthostatic hypotension when taking a thiazide diuretic.
Varenicline: (Major) Patients should be advised to avoid alcohol while taking varenicline as it may affect their tolerance for alcohol. Some reported neuropsychiatric events, including unusual and sometimes aggressive behavior directed to oneself or others, may have been worsened by a patient's concomitant use of alcohol. There have been postmarketing reports of patients experiencing increased alcohol intoxication while taking varenicline. Some cases described unusual and sometimes aggressive behavior, and were often accompanied by amnesia for the events.
Venlafaxine: (Major) Advise patients to avoid alcohol while taking some dosage forms (e.g., venlafaxine extended-release capsules and tablets) of venlafaxine. Consumption of alcohol while taking such dosage forms may result in a more rapid release of the dose of venlafaxine which may potentially lead to serious side effects.
Verapamil: (Major) Advise patients to avoid alcohol and alcohol-containing products while taking verapamil. Verapamil has been found to significantly inhibit alcohol elimination resulting in elevated blood alcohol concentrations that may prolong the intoxicating effects of alcohol. The patient may experience an increase in sedation, dizziness, hypotension, and CNS depression.
Vilazodone: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Vitamin B Complex Supplements: (Moderate) Alcohol-containing beverages or hot beverages/foods can exacerbate cutaneous vasodilation caused by niacin and should be avoided around the time of niacin ingestion. (Moderate) Alcohol-containing beverages or hot beverages/foods can exacerbate cutaneous vasodilation caused by niacin and should be avoided around the time of niacin ingestion. In general, this interaction would not be harmful, but might decrease patient tolerance of niacin. Alcohol and niacin, particularly sustained-release niacin, are both potentially hepatotoxic. Although no data are available regarding enhanced hepatotoxicity, excessive alcohol use should be discouraged.
Zaleplon: (Major) Advise patients not to use zaleplon if they drank alcohol that evening or before bed. There are additive effects of alcohol with zaleplon, leading to additive CNS depression and psychomotor impairment. Zaleplon potentiated the CNS-impairing effects of alcohol 0.75 g/kg on balance testing and reaction time for 1 hour after alcohol administration and on the digit symbol substitution test (DSST), symbol copying test, and the variability component of the divided attention test for 2.5 hours after alcohol administration. The potentiation resuls from a CNS pharmacodynamic interaction; zaleplon did not affect the pharmacokinetics of alcohol.
Ziconotide: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Ziprasidone: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Zolpidem: (Major) Advise patients not to use zolpidem if they drank alcohol that evening or before bed. An additive adverse effect on psychomotor performance between alcohol and zolpidem has been demonstrated. The risk of next-day psychomotor impairment, including impaired driving, is increased if zolpidem is taken with alcohol.
Zuranolone: (Major) Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.
Dehydrated alcohol is a tissue toxin, producing injury to tissue cells by dehydration and lysis. When used therapeutically to induce cardiac septal infarction in patients with hypertrophic obstructive cardiomyopathy, injection into the targeted septal vessel causes the hypertrophied septum to thin. When injected near nerve tissues, it produces neuritis and nerve degeneration. Deliberate injury to selected nerves or ganglia results in lasting block of sensory, motor, and autonomic function.
Alcohols exhibit rapid broad-spectrum antimicrobial activity against vegetative bacteria (including mycobacteria), viruses, and fungi but are not sporicidal. They can inhibit sporulation and spore germination, but this effect is reversible. The antibacterial mechanism may be related to membrane damage and rapid denaturation of proteins. Subsequent interference with metabolism and cell lysis may occur. Alcohols may also disrupt biofilms produced by bacteria.
Dehydrated alcohol is administered percutaneously or by intraneural or subarachnoid injection. Of ethyl alcohol that enters the body, 90% to 98% is completely oxidized.
The pharmacokinetics of dehydrated alcohol are not expected to be clinically significant when used for septal ablation or therapeutic neurolysis; injection is not expected to increase systemic concentrations of endogenous alcohol.