One of the most common doubts or apprehensions on the minds of individuals prescribed antibiotics is the impact of alcohol. This figures as the most frequently queried clarification, and deserves a detailed reply. While it may not be possible to generalize all cases or club all patients into a single category and give a reply that applies to all, it is possible to give a broad reference. This can be interpreted easily and individuals on antibiotics will find it easy to take a call on indulging. The following subsections answer the question can you drink alcohol with amoxicillin? by profiling the antibiotic, its mechanism of action and the mechanism of action of alcohol to learn how it may cause an interaction or possible effects.

What is amoxicillin?

The antibiotic belongs to the category of penicillin derivatives, and is used in treating infections that are attributed to gram-positive bacteria. It is regarded as highly effective in treating upper respiratory tract infections linked to streptococcal bacteria. In use for almost five decades since FDA approval, it is known to have properties or actions that are similar to penicillin or ampicillin. It is typically used in treating bacterial infections in the ear, or the nose, or throat, apart from susceptible bacteria caused infections in the genitourinary tract, the respiratory tract or the skin. It is also part of combination treatment for certain conditions, including:

How does amoxicillin work?

As outlined above, a full understanding of the actions, or the effects that could occur when amoxicillin is taken with alcohol is possible only when the mechanism of action is understood. The antibiotic inhibits penicillin-binding protein 1 in a manner that is known as competitive binding action. These proteins are responsible for the actions that contribute to the building and repairing of cell walls. When this action is inhibited, it results in bactericidal action or effects. In other words, the bacteria are killed by the substance, and this in turn relieves the symptoms and treats the condition caused by the bacteria.

How does alcohol work in the body?

With the little background information about the mechanism of action of amoxicillin, it is time to learn how alcohol works in the body. This will help to understand the possible effects of taking both together. Alcohol, upon being consumed, enters into circulation in the body and ultimately reaches all the tissues. This includes the brain, and this is responsible for the intoxicating effect. The human body has a natural response to substances, and this includes the elimination of alcohol after it enters the body. This is a natural response, and the purpose is to stop the substance from its actions.

Alcohol, upon being consumed, enters the GI tract, following which it makes an entry into the capillaries around the stomach and the small intestines. From here, it moves to the liver, through the portal vein. During this process, it is known to undergo a diffusive action, and enters the primary cells of the liver, known as the hepatic cells. Here, a small portion of the alcohol is converted, to inactive products by enzymes in the liver. In other words, the alcohol undergoes a detoxifying effect, that reduces its capabilities.

When a substance is metabolized in the liver by enzymes, the enzymes function as catalysts that drive the reaction speed. This speed of action, this rate of metabolism is not the same among all individuals, and depends on various factors, including inherited genes. This is actually the reason behind different individuals reacting differently to alcohol or other drugs.

How is alcohol metabolized by the body?

The process explained above, is essentially the metabolism, and the products that are created through this action are called metabolites. The dual purpose of metabolism of alcohol by the enzymes in the liver includes

  1. Switching off or terminating the action of alcohol, and
  2. Converting the substance into a water soluble substance that can be flushed out.

As outlined above, metabolism results in the creation of metabolites; and this is known to have relatively lesser biological activities or properties when compared with the actual or pre-metabolized compound. This is the usual action that occurs during metabolism. However, this is not always the case, as some compounds or substances have a different or slightly changed outcome, and this list includes alcohol.

There are two different stages in the metabolism of alcohol – from simple alcohol to acetaldehyde, and from acetaldehyde to acetic acid. The liver contains enzymes known as ADH, acronym for alcohol dehydrogenase, which is responsible for driving the oxidation of alcohol, resulting in acetaldehyde. This compound, is responsible for various tell-tale symptoms of drinking – flushed appearance, throbbing headache, feelings of nausea, and spike in heart beat rate. During the second stage, ALDH, acronym for acetaldehyde dehydrogenase, that are also different enzymes in the liver, causes metabolization of acetaldehyde to acetic acid. This in turn ends up as carbon dioxide and water. To sum up, the liver metabolizes alcohol in two stages, wherein the first compound is till toxic, which is then oxidized to a substance that is inert.

Effect of alcohol and antibiotics

Alcohol that does get metabolized in the first stage, ends up circulating the body. It is because of this difference in metabolism and unmetabolized alcohol that circulates in the body, individuals experience effects when on medications. For instance, an individual is likely to experience a stomach upset, and may feel dizzy apart from the usual drowsiness that is common to all individuals who consume alcohol. Amoxicillin is relatively safe when compared with other drugs such as metronidazole, tinidazole, sulfamethoxazole and trimethoprim. Individuals consuming alcohol in moderation when on amoxicillin are unlikely to experience any strong effects, other than a small reduction in energy levels, and the speed of outcomes of the antibiotic. There are no other known adverse effects; however, as emphasized earlier, the actual effects depend on the individual’s metabolism, and it is safe to seek medical advice.

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