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Doxycycline and Alcohol: Safety Guidelines

Medically reviewed on April 4, 2024 by Jordan Stachel, M.S., RDN, CPT. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.

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Doxycycline is a kind of tetracycline antibiotic that’s prescribed to treat many different kinds of infections. [1] For instance, healthcare providers may use it to treat cases of acne or rosacea, though it’s also used to treat dangerous bacterial infections like anthrax. [1]

When you’re prescribed doxycycline (or any other antibiotic), it isn’t always clear what lifestyle adjustments you’ll need to make while using it. To that end, you may be wondering, can you drink alcohol on antibiotics like doxycycline?

In general, it is considered safe to drink alcohol during a doxycycline course. [2] However, it’s important to be aware of the drawbacks and risks of using doxycycline and alcohol together. At present, the relationship between antibiotics and alcohol is largely considered under-researched. [2] That said, having a general grasp of the interactions and potential risks can help support a more efficient recovery—without causing any undue harm to your health in the process.

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What to Know About Doxycycline

Antibiotics can be classed on a spectrum based on how many bacteria they target:

  • Broad-spectrum antibiotics are used to reduce the presence of a variety of infection-causing bacteria (rather than specific strains).
  • Narrow-spectrum antibiotics work to eliminate or reduce the presence of only several, specific strains of bacteria.

Doxycycline is generally considered a moderate or broad-spectrum antibiotic. [3, 1] Because they deal with a broader range of bacteria, broad-spectrum antibiotics like doxycycline carry some risks. [4]

The main concern is that taking these antibiotics makes it more likely for the bacteria in your body to become resistant to your medication (this is known as antibiotic resistance). [4] This occurs when microorganisms adapt and evolve in your body, making antibiotic treatment much less effective or ineffective over time.

To lower your risk of developing resistance, it may be best to make some temporary lifestyle changes to help your antibiotic medication act as effectively as possible. For some people, this may mean avoiding recreational substances like alcohol, which can interfere with antibiotics’ ability to treat the bacterial infection. [2]

Risks and Side Effects of Mixing Antibiotics and Alcohol

Aside from potential long-term health consequences, another consideration for mixing alcohol and antibiotics is that alcohol may elevate your risk of potential antibiotic side effects. [5] Some people also report that drinking alcohol makes existing antibiotic side effects worse. These include [5]:

  • Drowsiness – Alcohol intake can make many people sleepy, and these effects can be exaggerated when you’re taking antibiotics. In addition, you may also experience more dizziness or lightheadedness. [5]
  • Digestive upset – Diarrhea and digestive discomfort are considered the most common side effects of taking antibiotics. [6] People taking antibiotics often report noticing more digestive distress if they drink while taking their medication. [5]
  • Slower recovery time – Using alcohol while taking most antibiotics may deplete your energy, contributing to a longer recovery period. [5] Though mild or moderate alcohol use may not have much of an impact, heavy or binge drinking can delay your body’s ability to heal. [5]

Research indicates that certain antibiotics, like erythromycin, are definitively inhibited when taken with alcohol. [2] Data also suggests that people with a history of alcohol use disorder or chronic alcoholism are more likely to experience reduced efficacy of doxycycline, specifically. [2]

Alcohol use also introduces variables that can indirectly interfere with infection recovery. For instance, alcohol can adversely impact sleep and energy levels, making it more difficult for your body to recover from infection. [5] For this reason, many people elect to avoid alcohol until they’ve completed their prescribed course of antibiotics. [5]

Is it Safe to Mix Antibiotics and Alcohol?

The current data suggests that many antibiotics won’t cause toxicity or adverse reactions if used together, though there are exceptions. [2]

Antibiotics that are generally considered safe to use alongside alcohol include [2]:

  • Doxycycline
  • Penicillin (oral route)
  • Cefdinir
  • Cefpodoxime
  • Fluoroquinolones
  • Azithromycin
  • Tetracycline
  • Nitrofurantoin
  • Secnidazole
  • Tinidazole
  • Fluconazole

Other antibiotics can result in severe reactions when mixed with or when combined with alcohol. These include [2]:

  • Metronidazole
  • Tinidazole
  • Sulfamethoxazole
  • Trimethoprim
  • Nitrofurantoin
  • Griseofulvin
  • Ketoconazole
  • Isoniazid
  • Cycloserine
  • Azithromycin

One of the largest concerns for mixing the aforementioned antibiotics with alcohol is the consequences for your liver. [2] Like other antibiotics, drinking alcohol can also heighten your risk of experiencing potential side effects unique to each type of medication, which may be physical as well as mental or mood-related. [2]

Sometimes, only certain types of alcoholic beverages carry a risk of interfering with antibiotics. For instance, linezolid (also known as Zyvox) has only been found to produce adverse reactions when combined with specific alcoholic beverages like tap beer and red wine. [5]

Taking Antibiotics With Alcohol Use Disorder

Certain antibiotics may yield few or no side effects when combined with mild or moderate drinking. However, people who struggle with heavy or binge drinking, or chronic alcohol use disorder, may experience more health consequences.

The National Institute on Alcohol Abuse and Alcoholism currently defines moderate drinking as [7]:

  • For women and people assigned female at birth – 1 drink per day (or fewer). Or, fewer than 8 drinks per week.
  • For men and people assigned male at birth – 2 drinks per day (or fewer). Or, fewer than 15 drinks per week.

If you’ve been prescribed antibiotics and are struggling to stop drinking, your healthcare provider can help you design a plan for treating your infection without harming your overall health. You might also consider speaking to them about options for treating struggles with substance abuse.

Guidelines for Safely Using Antibiotics

The primary guideline for using antibiotics safely is to always ask your healthcare provider before deciding to use alcohol or another recreational substance while taking them. [7]

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In fact, to protect all areas of your well-being, it’s recommended you ask for information about [5]:

  • Whether mixing alcohol and your prescribed antibiotic could result in liver damage
  • Whether you may experience heightened side effects as a result of using alcohol
  • Whether drinking alcohol could make your prescribed antibiotic less effective
  • Whether drinking alcohol could delay your recovery time
  • When you should stop drinking alcohol to ensure the efficacy of your antibiotic
  • When you may begin drinking again after you’ve finished your course of antibiotics

Ultimately, your healthcare provider should have the final word regarding the safety of alcohol and antibiotic use. With that, there are several general guidelines for optimizing antibiotic efficacy and helping you make the safest and speediest recovery possible.

Be Mindful of Prescription Label Warnings

One 2020 study showed that prescription labels do not necessarily provide universal advisories about mixing alcohol and certain antibiotics. [2] For instance, while one pharmacy may advise users to “limit intake of alcoholic beverages,” others may not provide a warning at all. [2]

With that said, if you’re prescribed antibiotics and are considering drinking alcohol, it’s a wise idea to reach out to a healthcare provider for clearance. They can assess your specific prescription medication, alcohol use habits, and unique health history to arrive at the best recommendation possible.

Consider Avoiding or Eliminating Certain Foods

If you’re eliminating alcohol to enhance the efficacy of your prescribed antibiotics, you might consider avoiding foods that can have a similar effect. These include:

  • Grapefruit or grapefruit juice, which has been found to inhibit the actions of antibiotics [8]
  • Calcium-fortified foods, like calcium-fortified orange juice, which has been shown to inhibit your digestive system from absorbing antibiotics [9]

Keep an Eye Out for Side Effects

While some potential side effects of antibiotics are mild and normal, others may be cause for concern. These include [1]:

  • Blisters
  • Facial, throat, tongue, or lip swelling
  • Trouble breathing
  • Wheezing

Symptoms like these typically indicate an allergy to your prescribed antibiotic. They require emergency treatment by a healthcare provider to curb severe and even fatal health consequences.

Never use Another Person’s Antibiotics

It’s important to never use someone else’s antibiotics, even if you’ve been diagnosed with the same infection or have been using the same type of medication.

Antibiotic prescriptions are highly personal, prescribed according to your unique health history. Moreover, prescriptions can differ in:

  • Dosage
  • Duration of treatment
  • Types of antibiotics

Using anyone else’s antibiotics can raise your likelihood of developing resistance. If you get an infection in the future, resistance can result in fewer treatment options. In this way, avoiding using someone else's prescription medication can help prevent overuse.

Never use Antibiotics Without a Prescription

No matter what type of infection you have, never use antibiotics without a prescription. Not only will obtaining a prescription help prevent resistance, but it can also help ensure:

  • Your infection is properly diagnosed
  • Your infection and treatment are properly recorded in your personal health history
  • You are prescribed an appropriate dosage
  • You can follow a healthcare professional’s educated instructions regarding antibiotic use

Ultimately, obtaining a prescription promotes the best possible health outcome—for both your short-term recovery and your long-term health. If you’re unable to meet with a primary healthcare provider in person, you may still be able to obtain prescription services through telehealth services.

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Can You Take Probiotics With Antibiotics?

Do Antibiotics Make You Tired? Antibiotic Insights

Can You Drink Alcohol on Antibiotics? Potential Risks

References
  1. Doxycycline: MedlinePlus drug information. Last reviewed June 15, 2022. Medical Citation URL. Accessed March 26, 2024.
  2. Mergenhagen KA, Wattengel BA, Skelly MK, Clark CM, Russo TA. Fact versus Fiction: a Review of the Evidence behind Alcohol and Antibiotic Interactions. Antimicrobial Agents and Chemotherapy. 2020;64(3). doi:10.1128/aac.02167-19. Medical Citation URL. Accessed March 26, 2024.
  3. Antibiotic Stewardship and Spectrum Guide. Infectious Diseases Management Program at UCSF. Last reviewed July 2021. Medical Citation URL. Accessed March 26, 2024.
  4. The antibiotic resistance crisis: part 1: causes and threats. PubMed. Published April 1, 2015. Medical Citation URL. Accessed March 26, 2024.
  5. Website N. Interactions. nhs.uk. Published November 18, 2022. Medical Citation URL. Accessed March 26, 2024.
  6. Barbut F. Managing antibiotic associated diarrhoea. The BMJ. 2002;324(7350):1345-1346. doi:10.1136/bmj.324.7350.1345. Medical Citation URL. Accessed March 26, 2024.
  7. Drinking levels defined | National Institute on Alcohol Abuse and Alcoholism (NIAAA). Last reviewed 2023. Medical Citation URL. Accessed March 26, 2024.
  8. Petrić Z, Žuntar I, Barba FJ, Kovačević DB. Food–Drug Interactions with Fruit Juices. Foods. 2020;10(1):33. doi:10.3390/foods10010033. Medical Citation URL. Accessed March 26, 2024.
  9. Walden DM, Khotimchenko M, Hou H, Chakravarty K, Varshney J. Effects of magnesium, calcium, and aluminum chelation on fluoroquinolone absorption rate and bioavailability: a computational study. Pharmaceutics. 2021;13(5):594. doi:10.3390/pharmaceutics13050594. Medical Citation URL. Accessed March 26, 2024.
Jordan Stachel, M.S., RDN, CPT is most fulfilled when guiding others towards making stepwise, sustainable changes that add up to big results over time. Jordan works with a wide variety of individuals, ranging in age from children to the elderly, with an assortment of concerns and clinical conditions, and has written for publications such as Innerbody. She helps individuals optimize overall health and/or manage disease states using personalized medical nutrition therapy techniques.
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