Caffeine, Alcohol, and Medications: What You Should Know

Caffeine and alcohol are two widely consumed products. Over 85% of people in the U.S. consume at least 1 caffeinated drink per day, and according to the CDC over 50% of adults are regular alcohol drinkers. Most people know not to mix alcohol and Tylenol, but both alcohol and caffeine can interact with other prescription medications in unpredictable ways.

What is a Medication Interaction?

A medication interaction occurs when two or more medications are taken at the same time, and they alter each other’s effects. Medications can act on the same part of the body or be broken down by the same enzyme. If the medications are trying to occupy the same metabolic or body process they can compete, synergize, or act unexpectedly. Many interactions with caffeine and alcohol are based results that increase the effect and side effects of your medications.

What Should I Know About Caffeine?

Caffeine is a stimulating agent. It can raise your heart rate and promote wakefulness. Medications that have stimulating effects can be enhanced with caffeine and become overwhelming for your body. This occurs because these both the medication and caffeine activate your sympathetic nervous system also known as sympathomimetic drugs. Common stimulants that may interact with caffeine include:

• Adderall
• Vyvanse
• Ephedrine
• Sudafed

Another type of interaction between a medication and caffeine might occur if both are metabolized by the same enzyme in the liver. For example, taking a medication like givosiran (used for Porphobilinogen synthase deficiency) may lower your breakdown of caffeine. Medications that might interact with caffeine through liver enzymes include:

• Depression and anxiety medications known collectively as SSRIs or SNRIs
• Medications for irregular heartbeat
• Antipsychotics
• Some asthma and COPD medications
• Broad spectrum antibiotics known as quinolones.

What You Should Know About Alcohol

Alcohol is known to interact with a wide variety of medications, including over the counter medications. Alcohol can make you sleepy or drowsy and excessive amounts of alcohol can suppress or alter bodily functions. Medications like Xanax and Percocet (which also has Tylenol) in combination with alcohol can result in serious side effects like respiratory depression or death. The National Institute of Health has an extensive guide on mixing medications with alcohol. The list has medications from almost every category including

• Colds
• Anxiety
• Epilepsy
• Arthritis
• Blood clots
• Depression
• Diabetes
• High blood pressure
• High cholesterol
• Seizures
• Pain
• Many others

Key Takeaways

Caffeine will interact with most stimulant medications and should be closely monitored if you are taking any stimulants. Caffeine only has a few enzyme-based interactions and is fine with most medications after a discussion with your healthcare provider. Alcohol will interact with most medication and has a handful of life-threatening interactions. Bottom line, medications and alcohol do not mix.

References:

1. Age-Adjusted Percent Distribution (with Standard Errors) of Alcohol Drinking Status among Adults Aged 18 and over, by Selected Characteristics: United States. CDC, 2018, ftp.cdc.gov/pub/Health_Statistics/NCHS/NHIS/SHS/2018_SHS_Table_A-13.pdf.
2. Mitchell, Diane C, et al. “Beverage Caffeine Intakes in the U.S.” Food and Chemical Toxicology: An International Journal Published for the British Industrial Biological Research Association, U.S. National Library of Medicine, Jan. 2014, www.ncbi.nlm.nih.gov/pubmed/24189158
3. “Dangers of Mixing Alcohol with Caffeine and Energy Drinks.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 4 Feb. 2020, www.cdc.gov/alcohol/fact-sheets/caffeine-and-alcohol.htm.
4. “Harmful Interactions.” National Institute on Alcohol Abuse and Alcoholism, U.S. Department of Health and Human Services, 5 June 2019, www.niaaa.nih.gov/publications/brochures-and-fact-sheets/harmful-interactions-mixing-alcohol-with-medicines.