Alcohol can interact with many types of medications, but how does it interact with Flagyl?

Article at a Glance:

Serious interactions can occur from taking Flagyl and drinking even a small amount of alcohol. Because of this reason, avoid drinking and taking Flagyl. Important points to remember about alcohol and Flagyl include:

It is not recommended to drink alcohol while taking antibiotics like Flagyl

Even a small amount of alcohol can react badly with Flagyl

The combination of Flagyl and alcohol can cause serious side effects including hot flashes, blood pressure changes, and liver damage

If you need to take antibiotics and plan on drinking alcohol, be sure to tell your doctor

If you are finishing up a course of Flagyl, wait a few days before drinking alcohol

Alcohol and Flagyl

Alcohol can interact with antibiotics like Flagyl. A commonly prescribed antibiotic, Flagyl treats bacterial and parasitic infections, including those in the vagina, abdomen, and skin, and it’s available both in pill and gel forms. Flagyl is also available in its generic name, metronidazole.

While most antibiotics are safe to take while drinking a moderate amount of alcohol, unfortunately, Flagyl is not one of them. Mixing alcohol and Flagyl can cause and worsen side effects.

Side Effects of Mixing Alcohol and Flagyl

The body relies on specific enzymes to break down alcohol into substances that can be eliminated. Several by-products are created through this complex process. One of the byproducts is a toxic substance called acetaldehyde. Flagyl can prevent the functioning of enzymes that are responsible for breaking down acetaldehyde.

When this interaction happens, acetaldehyde can build up in the body, leading to many side effects, including:

  • Abdominal cramps
  • Nausea
  • Vomiting
  • Headache
  • Flushing

These effects usually occur five to 15 minutes after consuming alcohol. These side effects are similar to a disulfiram-like reaction. Disulfiram is a drug that helps treat alcohol addiction by, when mixed with alcohol, causes side effects that discourage people from drinking.

Flagyl can increase a person’s sensitivity to alcohol. Even having a small amount of alcohol while on Flagyl can make some people very sick, and they experience not only nausea and vomiting but also the feeling of shortness of breath. Some other side effects of mixing alcohol and Flagyl may include:

  • Changes in blood pressure
  • Liver damage
  • Rapid heart rate
  • Stomach pain
  • Hot flashes

The risk of having a reaction varies from person to person. For example, some people may experience no symptoms, while others can experience a range of the symptoms mentioned above. A 1996 case study reported the death of a 31-year-old woman who mixed the two substances.

How Long Should You Wait Before Drinking Again?

Even after your last dose of Flagyl, it remains in your system for some time. Flagyl may be cleared from your body within 48 hours, but the elimination rate varies depending on a person’s age and metabolism, among other factors.

The Flagyl manufacturer recommends waiting at least one day after the last dose of Flagyl before drinking alcohol. However, some experts recommending waiting up to three days after the last dose.

Another factor that may affect how long Flagyl stays in the system is liver functioning. The liver eliminates metronidazole from the body, so if you have impaired liver function because of alcoholism or any other reason, you should let your doctor know.

Taking the Next Step

If you or a loved one need treatment for an alcohol abuse or alcohol use disorder, don’t wait to get help. The Recovery Village offers specialized alcohol addiction treatment programs at centers across the country. Call todayto learn more about treatment options that could work for you.

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Editor – Camille Renzoni
Cami Renzoni is a creative writer and editor for The Recovery Village. As an advocate for behavioral health, Cami is certified in mental health first aid and encourages people who face substance use disorders to ask for the help they deserve. Read more
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Medically Reviewed By – Nathan Jakowski, PharmD
Nate Jakowski is a clinical pharmacist specializing in drug information and managed care. He completed his Doctor of Pharmacy degree at the University of Wisconsin. Read more

Caporuscio, J. “Is it safe to mix Flagyl and alcohol?.” Medical News Today, April 23, 2019. Accessed September 15, 2021.

Cina, S J et al. “Sudden death due to metronidazole/ethanol interaction.” The American journal of forensic medicine and pathology, 1996. Accessed September 15, 2021.

Heleon MW, White M. “Disulfuram-cotrimoxazole reaction.” Published in July 1998. Accessed March 22, 2019

NHS. “When can I drink alcohol after finish[…]ng metronidazole?” Last updated 2018. Accessed March 2019.

Steckelberg, James M. “What are the effects of drinking alcohol while taking antibiotics?” Published on February 6, 2018. Accessed March 22, 2019.

University of Michigan. “Metronidazole”. (n.d.). Accessed March 23, 2019.

Watson Labs. “Metronidazole Package Insert”. Updated February 6, 2006. Accessed March 23, 2019.

Medical Disclaimer

The Recovery Village aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.