Last Updated:
September 13th, 2024
When a doctor prescribes an antibiotic, it’s common for the patient to ask, ‘Can I drink on this?’ This is because hundreds of different antibiotics are available in the UK, some of which will interact with alcohol and some won’t. You might find it inconvenient to be prescribed antibiotics when you’re planning a night out – but there are many good reasons to reduce your alcohol consumption or abstain from it completely if your doctor advises you to do so.
Doxycycline is a commonly prescribed antibiotic, used to treat bacterial infections and some parasitic infections. It’s also known as Vibramycin-D, Efracea, and Periostat. While there are hundreds of different antibiotics in the UK, they mainly fall into six categories. Doxycycline is a tetracyclic antibiotic, and it is not recommended to mix it with alcohol as it can stop it from working properly.
Why might I be prescribed doxycycline?
Some antibiotics are better at treating certain conditions than others – this is one of the reasons why so many of them are available. Doxycycline is often prescribed for skin conditions like rosacea, chest and dental infections and sexually transmitted infections. It can also be prescribed to prevent malaria.
If you’re prescribed doxycycline for rosacea, it tends to work slowly, so you will be prescribed it over a much longer period – about four weeks. While this might sound like a long time to stay away from alcohol, it’s important to do so to make sure the condition is treated effectively.
Why should you not mix doxycycline with alcohol?
Some people choose to take the risk of their antibiotics not working as well and to drink on them, as they don’t consider the consequences to be very serious. While not everyone who drinks on antibiotics will experience any consequences for doing so, there are multiple reasons why drinking on doxycycline is a bad idea.
Alcohol can make doxycycline less effective
Research on the efficacy of doxycycline when consumed with alcohol is sparse – but studies suggest alcohol can interfere with its effectiveness, particularly in people who consume a lot of alcohol. Some guidelines state that chronic alcoholics require twice the dose of doxycycline, which strongly suggests that alcohol reduces its effectiveness. Doxycycline’s half-life is also significantly shorter in the body for people who are struggling with alcoholism, meaning it stays in the body for less time, and concentrations of it in the blood are lower. This means there are fewer antibiotics in your body to fight the infection.
Substances that lower the effectiveness of antibiotics and interfere with their ability to clear the infection from your body can prolong the infection. Doxycycline is processed in the liver – and so is alcohol, so consuming them together can make the doxycycline less effective.
Because doxycycline is metabolised in the liver, your doctor may not prescribe it to you if you have liver problems and choose another antibiotic instead.
Antibiotic resistance
Much like not completing a course of antibiotics, drinking on certain antibiotics can reduce their effectiveness – and cause the infection to only partially kill the bacteria. If you drink while taking doxycycline, there can be lower concentrations of it in the blood, and the dose may not be high enough to treat the infection properly.
When an antibiotic does not fully eradicate bacteria, some of them remain in your body. The remaining bacteria can multiply, leading to the infection coming back. If this happens, the infection can be even harder to treat because bacteria can mutate into a strain that’s harder to eradicate with the same antibiotic. The strains of bacteria that remain in the body after an ineffective course of antibiotics are also more likely to resist the antibiotic as they were the last ones to be cleared out. If this happens, you will need to return to your doctor to be prescribed a different antibiotic to treat your infection.
This is not guaranteed to happen if you do not complete a course of antibiotics or if you drink on them – but the safest thing to do is take the course of antibiotics as directed to ensure the infection is cleared from the body.
Drinking on doxycycline and alcohol symptoms
All medications have side effects, but this doesn’t mean you will definitely experience them. However, side effects of doxycycline include digestive issues – stomach cramps, diarrhoea, nausea and loss of appetite. Alcoholic symptoms like gastric irritation can be exacerbated by taking antibiotics that are hard on your stomach.
Because both doxycycline and alcohol are processed in the liver, combining them can be risky for people who drink a lot. One of the symptoms of alcohol abuse is liver damage – so if you are experiencing alcohol addiction, it’s wisest to disclose this to your doctor when you’re prescribed a course of antibiotics so they can treat you safely.
Drug addiction and doxycycline
It’s important to be honest with your doctor about other substances you’re taking if you’re being prescribed a course of antibiotics. This is because the liver plays a critical role in filtering the blood, so one of the signs of drug addiction can be impaired liver function. Alcohol’s effects on the liver are well-known, but fewer people know that one of the symptoms of drug addiction, including prescription drug addiction, can be reduced liver function.
Illicit or prescription drug addiction side effects generally don’t include liver damage unless taken at very high doses – but opioids can harm the liver, as can benzodiazepines.
What to do if you’ve mixed doxycycline and alcohol
While alcohol can make doxycycline less effective, studies on mixing doxycycline and alcohol suggest that this is most pronounced in people who are drinking heavily. If you’ve accidentally had a few drinks when taking a course of doxycycline, the safest option is to finish the course of antibiotics as prescribed and make sure you don’t drink any more. Talk to your doctor if the infection isn’t going away.
If your drinking is heavy enough to impair your medication’s ability to do its job, or you find yourself unable to stop drinking when a doctor has recommended it, this could be a symptom of alcohol addiction. If you’re worried that your drinking is no longer under your control, we can help.
(Click here to see works cited)
- NHS (2022). Overview – Antibiotics. [online] Antibiotics. Available at: https://www.nhs.uk/conditions/antibiotics/.
- NHS Choices (2019). Doxycycline. [online] NHS. Available at: https://www.nhs.uk/medicines/doxycycline/.
- NHS (2022). Common questions about doxycycline. [online] nhs.uk. Available at: https://www.nhs.uk/medicines/doxycycline/common-questions-about-doxycycline/.
- NHS (2022). About doxycycline. [online] nhs.uk. Available at: https://www.nhs.uk/medicines/doxycycline/about-doxycycline/.
- Mergenhagen, K.A., Wattengel, B.A., Skelly, M.K., Clark, C.M. and Russo, T.A. (2019). Fact versus Fiction: a Review of the Evidence behind Alcohol and Antibiotic Interactions. Antimicrobial Agents and Chemotherapy, [online] 64(3). doi:https://doi.org/10.1128/aac.02167-19.
- Glenn, C. and Feldman, S.R. (2011). Tetracycline-induced hepatotoxicity. Dermatology Online Journal, 17(12). doi:https://doi.org/10.5070/d31ds9v5z0.
- Mayo Clinic. (2024). Antibiotics: Are you misusing them? [online] Available at: https://mayoclinic.org/healthy-lifestyle/consumer-health/in-depth/antibiotics/art-20045720 [Accessed 9 Aug. 2024].
- World Health Organization (2020). Antimicrobial resistance: Does stopping a course of antibiotics early lead to antibiotic resistance? [online] www.who.int. Available at: https://www.who.int/news-room/questions-and-answers/item/antimicrobial-resistance-does-stopping-a-course-of-antibiotics-early-lead-to-antibiotic-resistance.
- Doxycycline and alcohol: Can I drink if I take doxycycline? (n.d.). Miiskin. [online] Available at: https://miiskin.com/acne/medications/doxycycline-and-alcohol/.
- Nih.gov. (2019). Opioids. [online] Available at: https://www.ncbi.nlm.nih.gov/books/NBK547864/.
- PubMed. (2012). Lorazepam. [online] Available at: https://www.ncbi.nlm.nih.gov/books/NBK548563/.