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The interactions between drugs and alcohol They are bidirectional; that is to say, Drugs can influence alcohol effects in the body and, Alcohol, in turn, can influence drug behaviorincreasing or reducing its concentration, enhancing its adverse effects or increasing or reducing its effects, says the General Council of Pharmaceutical Colleges of Spain.
Thus they warn that currently, There are 292 active ingredients that present interactions with alcohol intakeof which 119 are described as high risk interactionaccording to the data of Bot Plus, the medicine database of the General Council updated to August 1, 2025. In addition, the pharmacists clarify that this number refers to active ingredients and? Each of them can be part of different medications, combinations or formatsso, if the number of commercial presentations available, this number would be much greater.
The risk depends on the type of consumption, the amount ingested and the type of medication
They also differentiate between a acute and chronic consumption. If a person takes alcohol chronicly, he will metabolize some drugs more quickly, so The pharmacological effect It will be less durable And your activity will be reduced, they point out. On the other hand, when alcohol consumption is acute, occasionally, it makes the body not metabolize certain drugs as it should, therefore, The concentrations of these medications “can be increased” with the consequent increase in Risk of adverse reactions Or sometimes its effects. In this sense, pharmacists put the focus on Central Nervous System Depressant Drugs (CNS), such as anxiolytic, hypnotic, antihistamines or opioids.
On the other hand, they point out that The lower the amount ingested, the lower the risk will be of interactions. However, although In certain cases, moderate alcohol consumption does not cause serious interactions With certain medications, “It is always necessary to consult with the doctor or the pharmacist To guarantee safe use “, taking into account that recommendations should be adapted to each patient based on their specific situation, since in many situations there may be important interactions, pharmacists advise.
Finally they expose that The time you have to pass From the taking of medication and alcohol intake to ensure that they do not interact will vary depending on the drug consumedof the pharmacological and toxic effects that it can cause, as well as its duration or the half -life of the drug and its metabolites (the compounds to which it is degraded, which can also have pharmacological and toxic effects) on the body.
Caution in special populations
Factors such as age or sex They condition the way in which drugs behave in the body, they affirm from the Council. Specifically, In the elderly, the processes of metabolism and elimination of many drugs are reducedso many times “lower doses” are necessary to those of the rest of the population. In the case of alcohol, metabolism is also diminished, by presenting a physiological reduction of liver activity related to metabolism and lower body water. In addition, they warn that, very often, This population group receives various medications that present alcohol interactions So it would be necessary Provide special caution to consumption.
On the other hand, pharmacists indicate that Women They present less amount of an enzyme in the gastric mucosa that eliminates a part of alcohol in the digestive system and, therefore, “Condition your absorption”. Thus, they add the fact that they have lower mass and a greater proportion of body fat. “All this means that Higher blood alcohol concentrations are reached by ingesting the same amount of alcohol as menwhich could increase the risk of interactions with the medication. “
The most affected medications
The General Council explains that drugs that can be affected by alcohol consumption are the most opioidssince it can enhance the depressing effects on the CNCbeing able to happen loss of consciousness and respiratory depression that can become deadly without treatment; the anxiolytic of the type of benzodiazepines, with effects similar to those described for opioids; Non -steroidal antii -inflammatories (NSAIDs), such as ibuprofenin which the combination with alcohol causes an additive effect on the gastric irritation which already present these drugs, as well as digestive lesions, increasing the risk of intestinal bleeding; either Paracetamol, since alcohol can increase its toxicity.
Likewise, the antihypertensiveswhose effect can be enhanced; the Antidiabeticsin which it can enhance the effects or cause a Uncommon adverse reactionsuch as lactic acidosis, increasing nausea, vomiting, muscle weakness and breathing involvement; and Antibiotics, which can lose their efficacy or cause side effects Serious.
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