Students who take prescription drugs should know about possible reactions with alcohol, warns one pharmacist. The most severe symptoms to these reactions include seizures, cardiovascular collapse, arrhythmia, unconsciousness and ultimately death. The disulfiram-alcohol reaction is most well-known, said Laura Hall, a pharmacist pursuing a doctorate at Ohio State. Disulfiram originated as an "anti-abuse" drug for alcoholics, she said. "When combined with alcohol it produces horrible side effects to deter a person from drinking," Hall said. "The symptoms are usually mild but can be severe depending on the drug, how much you drink and the length of time between (disulfiram ingestion and alcohol consumption)." Symptoms include increased heart rate and respiration, flushing, sweating and lightheadedness followed by fatigue. However a lesser-known fact is that disulfiram-like symptoms can result from the combination of alcohol and other drugs. Hall said Metronidazole (Flagyl), which is used to treat sexually transmitted diseases, is the number one concern for the student population. Drugdex, a computer-based pharmacy information system, said that Metronidazole has a 2 to 24 percent chance of producing a disulfiram-like reaction when combined with alcohol. Another drug that may result in similar reactions is Doxycycleine (Vibramycin), a type of tetracycline used to treat a variety of things from acne to sexually transmitted diseases, Hall said. "The reaction here is a little different," she said. "Because alcohol can rev up liver enzymes it breaks down these antibiotics much faster than you would expect." Hall said this rapid breakdown may render the medication ineffective. Other drugs that may result in adverse reactions include Nitrofurantoin (Macrodantin) and Sulfonamides, which are used to treat urinary track infections, ulcerative colitis and occasionally pulmonary infections, she said. Ketoconazole (Nizoral), an antifungal antibiotic, also has the potential of producing a typical disulfiram reaction. Hall advised all students to consult their pharmacists if they have questions about their medication. "If an alcohol (warning) sticker is put on their prescription bottle, and they don't understand why or the timing involved they should talk to their pharmacist," she said. "Usually a good rule of thumb is to avoid alcohol for 24 to 48 hours after you have stopped taking (medication)." Hall said underlying health conditions can intensify symptoms and cause them to become quite severe. "A worst case scenario could produce a significant disulfiram reaction which could mean less oxygen to the heart and a potential heart attack," she said.
Mixing alcohol, prescription drugs may have harmful effects
Published: Monday, August 3, 1998
Updated: Sunday, June 21, 2009
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