Mixing Alcohol and Metronidazole (Flagyl)

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Combining alcohol with other substances is a dangerous practice that negatively contributes to the substance use epidemic. In the United States, approximately 61.2 million individuals, ages 12 years of age or older, reportedly engaged in the use of a substance during the year 2021. (1) In terms of alcohol, approximately 219.2 million individuals reported that they engaged in  alcohol use during some point of their lives. (2) Of those engaging in alcohol use, approximately 29.5 million individuals met the diagnostic criteria for alcohol use disorder. (3) Those that are prescribed certain medications, such as antibiotics, may find it difficult to cease their alcohol use, though it is crucial that alcohol is not mixed with antibiotics.

If you, or someone you love, are finding it difficult to stop alcohol use, or other substance use, evidence-based treatment may be necessary. At Guardian Recovery, we offer comprehensive treatment options for those experiencing substance use disorders. With dual diagnosis options, we offer treatment plans for those experiencing substance use and mental health diagnoses simultaneously. Our trained clinicians can provide you, or a loved one, with psychoeducation and therapeutic interventions to help reach long-term sobriety. Contact us today to begin your road to recovery.

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What Is Metronidazole & How Is It Used?

Metronidazole, also known as Flagyl, is an antibiotic that is used to help treat bacterial infections of the vagina, liver, stomach, joints, skin, lungs, brain, and spinal cord. (4) Metronidazole is also used to help treat a sexually transmitted disease known as trichomoniasis. (5) Metronidazole can be taken orally, in the form of a tablet or liquid, or is given as an intravenous infusion. Metronidazole is usually prescribed to be taken for up to 10 days consecutively. (6) Metronidazole should be taken in its entirety, even if symptoms improve before the dosage is completed. It is important to take Metronidazole exactly as it is prescribed.

Commonly Known Side Effects of Metronidazole

There are various side effects associated with Metronidazole. These side effects may be more severe in those who are older in age.

Common side effects associated with Metronidazole include: (7)

  • Depression
  • Difficulty falling or staying asleep
  • Feelings of irritability
  • Headache
  • Dizziness
  • General feelings of weakness
  • Nausea or vomiting
  • Loss of appetite
  • Stomach pain
  • Diarrhea
  • Constipation
  • Experiencing an unpleasant, metallic taste
  • Rash
  • Itching
  • Vaginal itching or discharge
  • Pain during sex
  • Mouth sores
  • Swollen or hairy tongue

What Happens if You Drink Alcohol With Metronidazole?

Drinking alcohol while taking Metronidazole is not advised. Metronidazole should not be taken if an individual has engaged in alcohol use within 3 days. (8) Combining alcohol and Metronidazole can cause a reaction, known as a disulfiram-like reaction. (9)

Does Alcohol Affect the Absorption of Metronidazole?

Alcohol does affect the absorption of Metronidazole. Metronidazole can interfere with how the body breaks down alcohol. (10) In order for Metronidazole to be effective, it is important not to mix it with other substances unless advised by a doctor.

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Can Drinking Alcohol While Taking Metronidazole Cause Adverse Side Effects?

Drinking alcohol while taking Metronidazole can cause various adverse effects. These adverse effects can last for 30 minutes to several hours. (11)

Side effects associated with mixing alcohol and Metronidazole include: (12)

  • Flushing
  • Headache
  • Nausea
  • Vomiting
  • Stomach cramps
  • Sweating
  • Increased thirst

Are There Potentially Dangerous Side Effects of Mixing the Two?

Mixing alcohol and Metronidazole can lead to some dangerous side effects. Individuals can develop a dangerously rapid heart rate and a sudden drop in blood pressure. (13) These dangerous side effects caused by taking alcohol and Metronidazole simultaneously have led to fatalities. (14)

Does Alcohol Counteract the Effects of Antibiotics?

Alcohol directly impacts the effectiveness of antibiotics, and can cause a wide range of adverse effects. Alcohol can increase feelings of nausea, leading to vomiting. Vomiting after taking an antibiotic can cause the medication to not be completely absorbed by the body. Alcohol use can impact important bodily processes, such as hydration, which can interfere with recovering from a bacterial infection. (15)

Alcohol Can Weaken the Immune System

Our immune system is an important system within the body that helps keep individuals healthy. The body’s immune system helps fight off infections, toxins, and diseases. Alcohol use is associated with a weakened immune system. (16) Alcohol can interfere with the body’s recovery process. Alcohol use can also slow down the healing process, increasing an individual’s likelihood of developing another infection. Consuming 5 or more alcoholic drinks can impact the immune system negatively for up to 24 hours. (17)

Effects that alcohol can have on the immune system include: (18)

  • Causing more intense illnesses.
  • Causing negative symptoms to be present for longer periods of time.
  • Causing the immune system needing to work harder.

Is it Safe to Drink Alcohol While Taking Any Antibiotics?

Drinking alcohol while taking antibiotics can be dangerous. Alcohol can impair the digestive tract and lead to blood in the stool, uncontrollable vomiting, severe diarrhea, fever, and intense stomach pain. (19) Drinking alcohol while taking antibiotics can also cause damage to vital organs in the body, such as the liver and kidneys. (20) Combining alcohol with antibiotics can cause the kidney and liver to be overworked.

Signs and Symptoms Associated With Alcohol Use Disorder

It can be difficult to stop alcohol use when prescribed antibiotics if an individual engages in it daily or chronically. Understanding the signs and symptoms associated with alcohol use disorder can help identify if you or someone you know are experiencing it.

Signs and symptoms associated with alcohol use disorder include:

  • Experiencing intense psychological cravings.
  • Continuing to engage in alcohol use despite experiencing negative consequences.
  • Experiencing poor work or school performance.
  • Neglecting occupational, relational, personal or other important obligations.
  • Socially isolating oneself from friends and family.
  • Experiencing financial instability or issues related to alcohol use.
  • Engaging in risky and dangerous behavior, such as driving while under the influence of alcohol.
  • Experiencing mood swings.
  • Experiencing blackouts, or not remembering events that occurred while one was intoxicated.
  • Experiencing feelings of guilt or shame associated with alcohol use.
  • Drinking larger amounts of alcohol than intended.
  • Developing tolerance, or the need to consume larger quantities of alcohol in order to reach the desired effect.
  • Experiencing withdrawal symptoms when alcohol use is cut back or suddenly stopped.

Stopping alcohol use can be dangerous. At Guardian Recovery, we offer alcohol detox in order to provide a safe transition into sobriety. In addition, medication assisted treatment may be utilized to help with any negative withdrawal symptoms that may occur.

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Disclaimer: Does not guarantee specific treatment outcomes, as individual results may vary. Our services are not a substitute for professional medical advice or diagnosis; please consult a qualified healthcare provider for such matters.

  1. https://www.hhs.gov/about/news/2023/01/04/samhsa-announces-national-survey-drug-use-health-results-detailing-mental-illness-substance-use-levels-2021.html
  2. https://www.niaaa.nih.gov/alcohols-effects-health/alcohol-topics/alcohol-facts-and-statistics/alcohol-use-united-states-age-groups-and-demographic-characteristics
  3. https://www.hhs.gov/about/news/2023/01/04/samhsa-announces-national-survey-drug-use-health-results-detailing-mental-illness-substance-use-levels-2021.html
  4. https://www.drugs.com/metronidazole.html
  5. https://www.drugs.com/metronidazole.html
  6. https://www.drugs.com/metronidazole.html
  7. https://www.drugs.com/metronidazole.html
  8. https://www.drugs.com/metronidazole.html
  9. https://www.drugs.com/medical-answers/you-drink-alcohol-metronidazole-3567844/
  10. https://www.news-medical.net/news/20121218/Alcohol-and-antibiotics-an-interview-with-Dr-Randall.aspx
  11. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7038249/
  12. https://www.drugs.com/medical-answers/you-drink-alcohol-metronidazole-3567844/
  13. https://www.drugs.com/medical-answers/you-drink-alcohol-metronidazole-3567844/
  14. https://www.drugs.com/medical-answers/you-drink-alcohol-metronidazole-3567844/
  15. https://www.alcoholrehabguide.org/alcohol/drinking-drugs/antibiotics/
  16. https://www.alcoholrehabguide.org/alcohol/drinking-drugs/antibiotics/
  17. https://adf.org.au/insights/alcohol-immune-system/#:~:text=Our%20immune%20system%20helps%20keep,vulnerable%20to%20infections%20and%20diseases.
  18. https://adf.org.au/insights/alcohol-immune-system/#:~:text=Our%20immune%20system%20helps%20keep,vulnerable%20to%20infections%20and%20diseases.
  19. https://www.alcoholrehabguide.org/alcohol/drinking-drugs/antibiotics/
  20. https://www.alcoholrehabguide.org/alcohol/drinking-drugs/antibiotics/

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Reviewed professionally for accuracy by:

Ryan Soave


Ryan Soave brings deep experience as a Licensed Mental Health Counselor, certified trauma therapist, program developer, and research consultant for Huberman Lab at Stanford University Department of Neurobiology. Post-graduation from Wake Forest University, Ryan quickly discovered his acumen for the business world. After almost a decade of successful entrepreneurship and world traveling, he encountered a wave of personal and spiritual challenges; he felt a calling for something more. Ryan returned to school and completed his Master’s Degree in Mental Health Counseling. When he started working with those suffering from addiction and PTSD, he found his passion. He has never looked back.

Written by:

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Cayla Clark

Cayla Clark grew up in Santa Barbara, CA and graduated from UCLA with a degree in playwriting. Since then she has been writing on addiction recovery and psychology full-time, and has found a home as part of the Guardian Recovery team.

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