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The Dangers of Mixing Alcohol and Bactrim

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Bactrim is an antibiotic that fights bacterial infections in the body that is considered relatively safe with little risk of severe side effects. However, if you are using Bactrim, you are advised to avoid drinking alcohol in any amount to prevent serious medical consequences. Have you been attempting to limit your alcohol intake due to Bactrim use and have been unable to do so? If this is the case, it might be time to consider seeking long-term treatment to help you regain control of your life.

At Guardian Recovery, we have extensive experience treating individuals with alcohol use disorder and other dependencies. We understand that this condition will progress and become more severe if not thoroughly addressed. Contact us today to learn more about how alcohol can interfere with Bactrim or other antibiotics. We are ready to answer your questions and discuss how our individualized, comprehensive treatment programs can help you break free from the cycle of addiction for good.

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Risks of Mixing Alcohol & Bactrim

Bactrim (sulfamethoxazole and trimethoprim) is a prescription-only antibiotic used to treat bacterial infections, including bronchitis, traveler’s diarrhea, and urinary tract and middle ear infections, among others.

Generally speaking, if you are ill enough to need antibiotics, you should probably not be drinking alcohol in any amount. While it is unlikely that moderate alcohol use will mitigate Bactrim’s effectiveness, it can compromise your immune system and the body’s capacity to heal. It can also interfere with the enzyme that breaks down toxic alcohol byproducts.

Alcohol, the Immune System, & Bacterial Infections

Alcohol consumed at above-moderate levels can reduce the body’s ability to fight off illnesses. Heavy alcohol users are particularly vulnerable to lung infections, including bacterial pneumonia and tuberculosis.

Alcohol also compromises the immune system through its effects on the liver, which produces a wide variety of antibacterial proteins. When the liver is damaged by alcohol use, it is less capable of making these proteins, therefore increasing bacterial infection susceptibility.

Heavy drinkers have also been shown to be at a heightened risk of “traveler’s diarrhea and for infections with Klebsiella pneumoniae, Haemophilus influenzae, and Streptococcus pneumoniae.” 

The takeaway here is that alcohol use impairs the immune system, particularly its responses to bacterial infections, which Bactrim is prescribed to treat. In other words, alcohol does the opposite of Bactrim by promoting harmful bacteria rather than destroying them.

Bactrim Can Impede the Function of Enzymes That Metabolize Alcohol & Toxins

The body uses specific enzymes to break down alcohol and its byproducts. Alcohol dehydrogenase is responsible for metabolizing alcohol, thereby resulting in the toxic byproduct acetaldehyde. This is then broken down to acetate by another enzyme. Acetate is further metabolized to water and carbon dioxide, which are then eliminated from the body.

Bactrim can impair the function of this enzyme, thereby leading to an accumulation of toxins that can cause many serious side effects, as listed below. This is also referred to as a “disulfiram-like reaction,” which “produces symptoms similar to those that occur when alcohol is consumed after taking disulfiram (Antabuse).” Disulfiram is a prescription drug that causes unpleasant symptoms after alcohol intake.

Bactrim Side Effects

Bactrim is not likely to cause severe, long-lasting side effects when used as prescribed. However, the same can not be said for alcohol. When combined, these two substances can compound the side effects of one another and contribute to a third set of side effects that can potentially be dangerous.

Bactrim Severe Side Effects Include:

  • Aplastic anemia (low red and white blood cells and platelets)
  • Bruising or bleeding
  • Hepatic necrosis (drug toxicity to the liver)
  • Jaundice
  • Joint aches
  • Mouth sores

Seek emergency medical intervention immediately if you have symptoms of an allergic reaction.

Allergic Reaction Symptoms Include: 

  • Face and throat swelling
  • Severe skin rash with blistering, peeling, and itching
  • Shortness of breath
  • Chest pain
  • Sore throat
  • Burning eyes

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Alcohol Side Effects

A blood alcohol concentration (BAC) of up to .10%, although over the legal driving limit, is unlikely to cause significant symptoms. However, severe alcohol intoxication, which is .16% to .30%, can result in substantial impairments and lead to dangerous situations, as “all driving-related skills [are] dangerously impaired.”

Severe Alcohol Intoxication Side Effects Include:

  • Loss of inhibition
  • Significant coordination and psychomotor skill impairments, such as unsteadiness, clumsiness
  • Increasingly impaired attention, memory, and judgment
  • Reduction in responsiveness, alertness, and reaction time
  • Uncontrolled eye movements
  • Confusion
  • Slurred speech
  • Sleepiness
  • Dizziness
  • Nausea and vomiting
  • Impaired vision and hearing
  • Memory loss and blackouts

A BAC of .30% or higher is considered alcohol poisoning and a medical emergency. If you or someone you know are experiencing the following symptoms, call 911 or visit the nearest emergency room immediately. Failure to treat an alcohol overdose can result in permanent brain damage and death.

Alcohol Overdose Side Effects Include:

  • Visual and auditory hallucinations and delusions
  • Severe difficulty speaking
  • Severe dizziness
  • Severe coordination and psychomotor skill impairments
  • Low body temperature and hypothermia
  • Low blood sugar and hypoglycemia
  • Slow heart rate
  • Bluish or pale skin
  • Seizures
  • Vomiting and severe dehydration
  • Loss of gag reflex, risk of choking
  • Stupor or unresponsiveness
  • Loss of consciousness, cannot be awakened
  • Respiratory distress (slow or labored breathing) or failure (stopped breathing)
  • Coma
  • Brain Damage
  • Death

Side Effects of Mixing Alcohol & Bactrim

Antibiotics and alcohol can cause similar side effects, and combining Bactrim with alcohol can amplify these side effects. As previously discussed, Bactrim can cause an interaction related to the metabolism of alcohol, which can result in adverse side effects occurring 5-15 minutes after alcohol use. 

Bactrim and Alcohol Side Effects Include:

  • Headache
  • Flushing
  • Dizziness
  • Extreme drowsiness
  • Severely upset stomach
  • Nausea and vomiting
  • Difficulty breathing
  • Rapid heart rate

The only way to prevent a Bactrim-alcohol interaction is to avoid drinking. Doing so can allow this medication to do its job and reduce alcohol’s impairment of alcohol metabolism. It will also ensure your immune system is working correctly and that healing is not delayed or hindered.

Alcohol Use Disorder Symptoms

Bactrim is not believed to have any potential to cause addiction. Alcohol, on the other hand, definitely does. 

Effects of Alcohol Use Disorder Include:

  • Drinking for longer or in a greater amount that you originally intended
  • Attempting more than once to reduce or stop drinking but were unable
  • Spending significant time drinking or recovering
  • Having cravings or urges to drink
  • Drinking has interfered with your life, work, or school
  • Drinking has resulted in conflict with family and friends
  • Neglecting enjoyable or important events and activities in order to drink
  • Getting into dangerous situations while drinking, such as driving while intoxicated or engaging in risky or impulsive sexual activity
  • Continuing to drink despite its effects on your mental or physical health
  • Needing to drink more to experience the desired effects (tolerance)
  • Having withdrawal symptoms, such as shakiness, anxiety, restlessness, etc., that occur several hours after last use (dependence)

If you have encountered at least a few of these signs and symptoms, you may have an alcohol use disorder. To be sure, you should consult with an addiction specialist or contact a substance abuse treatment center. 

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If you cannot control your drinking despite conflicts with your medication, you would likely benefit from intensive alcohol addiction treatment. The first step to healing physically, emotionally, and spiritually is reaching out for professional help. To get started, we urge you to contact us to learn more about our streamlined admissions process and integrated, evidence-based programs. 

At Guardian Recovery, we understand how challenging it can be to deal with an alcohol use disorder and that every person’s circumstances are unique in their own way. For this reason, our comprehensive recovery programs are customized to meet your individual needs and goals.

When you contact us for a complimentary, no-obligation assessment and health insurance benefits verification, you will speak with an experienced Treatment Advisor. They will help you understand more about the treatment process and determine the level of care best suited for you. We hope to talk with you soon and help you start your recovery journey!


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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:

Cayla Clark

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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