QI | Why Shouldn't You Drink On Antibiotics?

This clip is from QI Series H, Episode 10, 'Health and Safety' with Stephen Fry, Alan Davies, Jeremy Clarkson, David Mitchell and Ross Noble.

[jakobsmith]

I love how David looks so pleased with himself after saying something smart and/or funny. Especially when getting approval from Stephan, lol.

[nyaarla]

I think one of the Dr. Ken Jeong’s youtube pieces explains this pretty well.

The short version is, drinking alcohol with certain types of antibiotics may either reduces the efficacy of the antibiotics and/or increase the side effects of the antibiotics. As a rule of thumb though, if you are a layperson, you are better off abstaining during medications than to identify which antibiotics don’t work well with alcohol. That and #giveyourliverabreak

[egodreas]

While the syphilis story certainly is a funny anecdote, it isn't at all why modern doctors recommend you do not drink alcohol while on antibiotics. Even though the majority of antibiotics won't be affected by the alcohol, your general immune system will be. You will take longer to recover from your illness, and the antibiotics will have to do more work than they should have to. And since misuse of antibiotics is also the main cause of resistant strains of bacteria, that's another good reason to make sure they work as effectively as possible.

[musewolfman]

Ross Noble uses his accent better than most anyone else uses theirs.

[aidenparker]

That’s not true, most oral antibiotics require metabolism by the liver. Drinking can occupy the liver and may interfere with drug processing. Love the show. Source: I studied drug metabolism and kinetics.

[GijsvanDam]

In general, when taking medicines you want to take it easy with the liquor. Most medicines take a toll on your liver and you don't want to add insult to injury by making at even harder for it to do it's job.

[garybyma]

There is in fact a general reason. Both antibiotics and alcohol as well as other drugs and medications are cleared from the blood by the liver. So taking them together can affect the dosage in your blood.

[HighLordBlazeReborn]

There's no specific reason why you shouldn't drink with antibiotics in your system, but there IS a general rule for drugs in general: alcohol affects how well the drug is absorbed by your body and the way it's metabolized.

[Minotaur]

I'm of the opinion that if I'm sick enough to need to be taking antibiotics, then I should probably be resting and not drinking.

[Anoneeeemouse]

There are some antibiotics, such as metronidazole, that can have extreme side effects, even death

[smthB]

When I was a houseman in 1984 I developed a gum infection called gingivitis - probably brought on through chronic sleep deprivation. I was given a 3 day course of metronidazole (brand name Flagyl), which I took over my 3 day weekend on call. On Monday morning I took the last dose, and on Monday night, I did what everyone does after being released after 80 hours stuck in the hospital - I went to the pub with my mates, and purely in the interest of science I tried a few pints, and am pleased to report that there was no difference.
I have repeated the experiment a few times just to check that it wasn’t a fluke - same result.
My explanation is that this is something that ‘everyone knows’, based on theory rather than actual evidence.
Isn’t science wonderful!

[tomchitling]

- Minus 3 x10 points to Steven.
1. Very few doctors wear white coats any more in the UK . They were implicated in spreading MRSA infection from their baggy sleves, especially if not changed regularly. A daily laundered shirt makes washing hands and wrists far easier.
2. As for Flagyl with alcohol, it's NOT a true disulfiram(Antabuse) reaction at all, some people react very badly though. Search it on "Pubmed" if you are interested.
3. Most early antibiotics were poorly (>40%) absorbed, so it was generally held that alcohol might make absoprtion worse and cause more diaorrhoea, probably still applies to a few like tetracyclines. Basically just read the label.
4. Fun fact: Erythromycin improves stomach emptying, so you can get drunk faster :) But it irritates your stomach so you will throw up faster too.
Time for an update from Sandy methinks.

[angelamuircroft]

Friend took flagyl and had 2 drinks then vomitted rest of night despite reading info leaflet!

[BumMcFluff]

Given QI's track records on facts which later turn out not to be quite so true, I'll stick to not mixing drink and drugs. To be fair, I hardly do either anyway, but it's the principle of the thing.

[thewilltheway]

Ethanol also opens the 4-membered Beta-Lactam ring that is present in Penicillin, which deactivates the drug. That's like the one thing I learned about anti-biotics in organic chemistry.

[anononomous]

The first answer from Ross Noble is actually the correct one.

[redred]

A doctor in Spain gave me antibiotics a few years ago. I asked him if that meant I couldn't drink and he looked at me like I was mad. In Spain they've never heard of this "no drinking on antibiotics" thing.

[TheMinecraftSandbox]

Some antibiotics, when mixed with Alcohol exhibit a ‘disulphram-like reaction’. Disulphram was a drug given to alcoholics that caused vomiting if the ingested alcohol while taking the drug to try get them to stop drinking. Some antibiotics (such as metronidazole) can cause a similar reaction

[jakbowtell]

He’s correct it is it Flagyl, although mostly sold as a generic now ‘metronidazole’. And indeed mixing even a small amount of alcohol with metronidazole will cause a ‘disulfiram-like reaction’. Antabuse is the brand name for disulfiram. That reaction is extremely violent, to the point where it can cause death in extreme cases. It would make you violently sick, trembly, nauseous, off balance, high blood pressure, uncontrollable flushing, heart arrhythmia etc.

[RodneyMcMinge]

I asked my doctor this very question. He said, " some people get an upset stomach ". Oh the alarm bells rang in my head, just enough to pour another brandy.