Don’t Play Russian Roulette with Drugs and Alcohol

There’s increasing encouragement for people to drink alcohol. Headlines state that a drink or two a day may protect against heart attacks, strokes and maybe even Alzheimer’s disease. At holidays, the social pressure to drink a toast is even greater.
But some people should never drink, even at holidays. Despite the apparent health benefits of a glass or two of wine, these folks may be at risk when alcohol interacts with their medicine. Some could even get into trouble with the law.
Several years ago we heard from a reader who was arrested for driving while intoxicated. He admitted he’d had two glasses of wine at a holiday party, but that didn’t seem enough to raise his blood alcohol level into the danger zone.
He hadn’t realized that the aspirin he took to protect his heart and the cimetidine he took for an ulcer teamed up to boost his blood alcohol. Although the clinical implications of these drug and alcohol interactions are debated, there is reason to be cautious.
More than a decade ago, alcohol expert Charles Lieber, MD, reported that aspirin, cimetidine and ranitidine could all increase blood alcohol concentrations in susceptible people. He told his colleagues that such interactions “may result in unexpected impairment to perform complex tasks, such as driving. Thus, patients treated with these drugs should be warned of this possible side effect��? (Digestive Diseases Nov/Dec 1994).
More recently Dr. Lieber warned, “Under conditions mimicking social drinking, ranitidine increases blood alcohol to levels known to impair psychomotor skills needed for driving��? (American Journal of Gastroenterology, Jan. 2000). Prescription blood pressure medications such as verapamil (Calan, Covera-HS, Isoptin, Verelan) may also increase blood alcohol levels. Physicians and pharmacists should warn patients about this, but sometimes they forget.
Many other medications are incompatible with alcohol. If you would like to learn more about them, you can request a copy of Graedons’ Guide to Drugs that Interact with Alcohol. Please send a large (no. 10) self-addressed stamped envelope and $2 to: Graedons’ The People’s Pharmacy®, Dept. K, P. O. Box 52027, Durham, NC 27717-2027.
Over-the-counter remedies could also pose a risk. Since cimetidine and ranitidine are available without prescription, many people rely regularly on such drugs to combat heartburn. They may not realize there are potential interactions.
Most people don’t consider that prescription or OTC drugs might be incompatible with alcohol. Someone with the sniffles might reach for a cold remedy containing an antihistamine or acetaminophen. Both ingredients can be hazardous in combination with alcohol.
Many antihistamines are sedating by themselves. Combined with alcohol they would make someone a threat on the highway. Acetaminophen, which is found in hundreds of over-the-counter and prescription products, can damage the liver in the presence of alcohol. Even ibuprofen (Advil Motrin IB, etc) is risky. It is more likely to damage the digestive tract if someone has been drinking.
Moderate alcohol consumption may have health benefits, but revelers should be wary. Mixing alcohol with many medications could be life threatening.