Supplement·Interactions·Reviewed June 9, 2026
Alcohol interactions.
Alcohol has 65 documented interactions in the NutriStack database: 20 to avoid or watch closely and 45 that need timing or caution. The full list, with what each pairing does, is below.
In short
Alcohol at a glance.
A quick, data-grounded summary. The full table is below.
Alcohol has 65 documented interactions in the NutriStack database: 20 to avoid or watch closely and 45 that need timing or caution. The full list, with what each pairing does, is below.
Interactions
Everything that interacts with alcohol.
Every supplement and medication in the NutriStack database with a documented interaction with this substance, highest-severity first. Open any pair for the mechanism and sources.
| Substance | Interaction | What happens |
|---|---|---|
| Acitretin | Contraindicated | Alcohol can convert acitretin back into etretinate, a much more lipophilic retinoid with a very long elimination time. This is especially dangerous... details → |
| Alprazolam | Contraindicated | Alcohol can sharply amplify alprazolam's sedating and coordination-impairing effects. The combination increases risk of blackouts, falls, motor... details → |
| Clonazepam | Contraindicated | Alcohol adds to clonazepam's CNS-depressant effects and can produce marked drowsiness, slowed reaction time, ataxia, memory gaps, and respiratory... details → |
| Cocaine | Contraindicated | Combining cocaine with alcohol produces cocaethylene in the liver, a longer-lasting and more cardiotoxic compound that sharply increases the risk of... details → |
| Diazepam | Contraindicated | Alcohol and diazepam together produce additive psychomotor impairment, slowed reactions, memory problems, and excessive sedation. Diazepam and its... details → |
| Eszopiclone | Contraindicated | Alcohol can add to eszopiclone's hypnotic and psychomotor-impairing effects. The combination can cause excessive sedation, impaired coordination,... details → |
| Hydrocodone | Contraindicated | Alcohol can dangerously amplify hydrocodone's sedating and breathing-slowing effects. The combination increases the risk of profound sleepiness,... details → |
| Ketamine | Contraindicated | Combining ketamine with alcohol produces additive central nervous system and respiratory depression, raising the risk of profound sedation, airway... details → |
| Lorazepam | Contraindicated | Alcohol compounds lorazepam's sedating, amnestic, and coordination-impairing effects. Even if lorazepam is not strongly CYP-metabolized, the... details → |
| Metronidazole | Contraindicated | Metronidazole inhibits acetaldehyde dehydrogenase, and concurrent alcohol can trigger a disulfiram-like reaction including flushing, severe nausea,... details → |
| Morphine | Contraindicated | Alcohol can add to morphine's opioid sedation and respiratory depression. This can lead to extreme drowsiness, impaired airway protection, slow... details → |
| Oxycodone | Contraindicated | Alcohol substantially increases the respiratory depression caused by oxycodone. In a controlled human study, oxycodone reduced ventilation and... details → |
| Tramadol | Contraindicated | Alcohol can add to tramadol's opioid sedation and respiratory depression while also worsening judgment and coordination. Tramadol also lowers the... details → |
| Zolpidem | Contraindicated | Alcohol adds to zolpidem's hypnotic and psychomotor-impairing effects. Controlled testing showed both zolpidem and alcohol impaired cognitive and... details → |
| Allopurinol | Conflict | Alcohol can trigger gout attacks and raise the urate burden that allopurinol is meant to control. Beer and spirits are the clearest concerns, and... details → |
| Cannabis (THC-Dominant) | Conflict | Combining THC-dominant cannabis with alcohol produces additive central nervous system depression and impairment, with greater sedation, dizziness,... details → |
| Febuxostat | Conflict | Alcohol can undermine febuxostat therapy by increasing gout flare risk and raising urate pressure. Febuxostat lowers urate through xanthine oxidase... details → |
| MDMA | Conflict | Combining MDMA with alcohol increases dehydration, cardiovascular strain, and impaired judgment, and alcohol can mask MDMA's perceived effects while... details → |
| Nicotine | Conflict | Combining nicotine and alcohol increases cardiovascular strain (heart rate and blood pressure) and reinforces co-dependence, with the two substances... details → |
| Vitamin B1 | Conflict | Chronic alcohol intake depletes thiamine (B1) and impairs its absorption and activation, raising the risk of Wernicke encephalopathy and Korsakoff... details → |
| Alfuzosin | Caution | Alfuzosin is an alpha1 blocker used for urinary symptoms and can contribute to dizziness or low blood pressure in susceptible patients. Alcohol can... details → |
| Amitriptyline | Caution | Alcohol can markedly worsen amitriptyline-related impairment. Human studies found ethanol increased free amitriptyline exposure during absorption... details → |
| Amphetamine/Dextroamphetamine | Caution | Amphetamine/dextroamphetamine can partially counter alcohol-related psychomotor slowing without making the person sober. This can make intoxication... details → |
| Aspirin Low-Dose | Caution | Alcohol increases the risk of upper gastrointestinal bleeding from low-dose aspirin. Aspirin impairs platelet function and weakens gastric mucosal... details → |
| Baclofen | Caution | Alcohol and baclofen can both cause sedation, dizziness, slowed reaction time, and impaired coordination. Human alcohol-challenge studies show... details → |
| Brimonidine | Caution | Brimonidine eye drops can cause systemic alpha-2 agonist effects in some people, including fatigue, somnolence, low blood pressure, and dizziness.... details → |
| Celecoxib | Caution | Celecoxib generally causes fewer upper GI ulcers than many nonselective NSAIDs, but alcohol can still increase GI irritation and bleeding risk. The... details → |
| Cetirizine | Caution | Cetirizine is less sedating than older antihistamines, but it is not impairment-free. Controlled alcohol studies are mixed: some found no meaningful... details → |
| Chlorthalidone | Caution | Chlorthalidone has a long duration of action and can cause volume depletion, low sodium, and low potassium. Alcohol can worsen orthostatic... details → |
| Cyclobenzaprine | Caution | Cyclobenzaprine commonly causes drowsiness, dizziness, and slowed reaction time, and alcohol can intensify those effects. Combining them can... details → |
| Diclofenac | Caution | Alcohol can increase diclofenac-related gastrointestinal bleeding risk. Diclofenac reduces protective gastric prostaglandins, and alcohol can... details → |
| Diphenhydramine | Caution | Alcohol can add to diphenhydramine's sedating and anticholinergic effects. Human testing found worse mental-performance impairment when ethanol was... details → |
| Duloxetine | Caution | Duloxetine has a known rare risk of clinically significant liver injury, and substantial alcohol use is a recognized risk factor in labeling and... details → |
| Fluconazole | Caution | Fluconazole is hepatotoxic in a dose- and duration-dependent fashion, and alcohol is one of the strongest modifiable risk factors for drug-induced... details → |
| Furosemide | Caution | Furosemide can cause volume depletion, electrolyte loss, and orthostatic symptoms. Alcohol can impair vasoconstriction during standing and can... details → |
| Gabapentin | Caution | Alcohol can make gabapentin-related dizziness, slowed reaction time, and sedation less predictable. A small human laboratory study in... details → |
| Guanfacine | Caution | Guanfacine lowers sympathetic outflow and commonly causes sedation, fatigue, dizziness, bradycardia, and lower blood pressure. Alcohol can add CNS... details → |
| Hydrochlorothiazide | Caution | Hydrochlorothiazide lowers blood pressure partly through natriuresis and reduced plasma volume. Alcohol can potentiate orthostatic hypotension, so... details → |
| Hydroxyzine | Caution | Alcohol can markedly worsen hydroxyzine-related drowsiness, slowed reaction time, and clumsiness. In a controlled crossover trial, hydroxyzine taken... details → |
| Ibuprofen | Caution | Alcohol increases the chance of stomach bleeding while taking ibuprofen. The combination is most concerning with repeated ibuprofen dosing, binge... details → |
| Isotretinoin | Caution | Isotretinoin can raise triglycerides and liver enzymes, usually modestly but occasionally to clinically important levels. Alcohol does not appear to... details → |
| Leflunomide | Caution | Leflunomide can cause clinically significant liver injury, including rare severe drug-induced liver injury. Alcohol adds hepatic stress and can make... |
| Loratadine | Caution | Loratadine is much less sedating than older antihistamines, and controlled testing did not find meaningful driving or psychomotor impairment from a... details → |
| Melatonin | Caution | Combining alcohol with melatonin can increase sedation and drowsiness, while alcohol itself disrupts the body's natural melatonin rhythm and overall... details → |
| Meloxicam | Caution | Alcohol can increase the risk of stomach bleeding while taking meloxicam. Meloxicam is somewhat COX-2 selective but still causes clinically... details → |
| Memantine | Caution | A controlled human study found that combining memantine with alcohol increased dissociation, confusion, stimulation, and impaired balance without... details → |
| Methocarbamol | Caution | Methocarbamol can cause sedation, dizziness, and impaired coordination, and alcohol can make these effects stronger. The combination can lead to... details → |
| Methotrexate | Caution | Alcohol can add to methotrexate's liver toxicity risk, especially with regular or heavy use. The risk is most important for people with rheumatoid... details → |
| Methylphenidate | Caution | Alcohol changes methylphenidate handling and can form ethylphenidate, an active transesterification metabolite. Ethanol can increase early... details → |
| Milk Thistle | Caution | Milk thistle (silymarin) is often taken for liver support during alcohol use, but evidence does not show it prevents alcohol-related liver damage,... |
| Naproxen | Caution | Alcohol can compound naproxen's gastrointestinal bleeding risk. Naproxen is among the NSAIDs more strongly associated with upper GI complications,... details → |
| Nortriptyline | Caution | Nortriptyline is less sedating than amitriptyline for some patients, but it is still a tricyclic antidepressant that can impair alertness,... details → |
| Olanzapine | Caution | Alcohol can add to olanzapine-related sedation, slowed reaction time, dizziness, and impaired coordination. Olanzapine can already cause sleepiness... details → |
| Pregabalin | Caution | Pregabalin can cause dizziness, blurred vision, slowed thinking, ataxia, and sedation, and alcohol can intensify these effects. Product pharmacology... details → |
| Promethazine | Caution | Alcohol can add to promethazine's sedating, anticholinergic, and coordination-impairing effects. Human studies show promethazine impairs psychomotor... details → |
| Quetiapine | Caution | Alcohol can markedly increase quetiapine-related sleepiness, dizziness, slowed reactions, and poor coordination. Quetiapine's antihistamine and... details → |
| Risperidone | Caution | Alcohol can increase risperidone-related drowsiness, slowed thinking, dizziness, and impaired coordination. Even when risperidone is less sedating... details → |
| Suvorexant | Caution | Alcohol can add to suvorexant-related sleepiness and impaired alertness. A clinical alcohol coadministration study found additive negative effects... details → |
| Tamsulosin | Caution | Tamsulosin can cause orthostatic hypotension, particularly when treatment is started or restarted. Alcohol also worsens orthostatic blood pressure... details → |
| Terbinafine | Caution | Terbinafine is associated with idiosyncratic hepatotoxicity, including cholestatic hepatitis and rare cases of liver failure requiring transplant.... details → |
| Timolol Ophthalmic | Caution | Timolol eye drops can be systemically absorbed and produce beta-blocker effects such as slower heart rate, lower blood pressure, dizziness, or... details → |
| Tizanidine | Caution | Alcohol can add to tizanidine's sedation, dizziness, low blood pressure, and fainting risk. A published case report describes syncope after... details → |
| Trazodone | Caution | Trazodone produces strong sedation through histamine H1 and 5-HT2A blockade. Alcohol is a CNS depressant. Combined use produces marked additive... details → |
| Valproic Acid | Caution | Alcohol can add to valproic acid's dizziness, sleepiness, and impaired coordination, and it may increase concern for liver injury. A case-control... details → |
| Pregnenolone | Timing Sensitive | Pregnenolone is a neurosteroid that directly opposes GABA-A signaling, yet the body converts much of it into allopregnanolone, which strongly... |
Go deeper
The full alcohol profile.
Benefits, dosing by goal, forms, and the cited evidence for this supplement.
FAQ
Common alcohol questions.
Quick answers drawn from the table above.
What interacts with Alcohol?
In the NutriStack database, Alcohol has 65 documented interactions with other supplements and medications. The most notable include Acitretin, Alprazolam, Clonazepam, Cocaine, and Diazepam.
What should you not take with Alcohol?
Alcohol is flagged against 20 substances in the database, including Acitretin, Alprazolam, Clonazepam, Cocaine, Diazepam, and Eszopiclone. Review these with a clinician before combining, especially alongside prescription medications.
Can you take Alcohol with Acitretin?
NutriStack classifies the Alcohol and Acitretin pairing as contraindicated: Alcohol can convert acitretin back into etretinate, a much more lipophilic retinoid with a very long elimination time. This is especially dangerous for anyone who could... Do not drink alcohol while taking acitretin. If pregnancy is possible, avoid alcohol during treatment and for at least 2 months after stopping...
Check your whole stack
See how alcohol fits your routine.
NutriStack screens your full stack for interactions and timing conflicts, and updates the moment you change it.