Is it safe to combine alcohol and allergy medications like Allegra? Find out the facts about the risks and how to manage allergy symptoms while drinking.

Understanding First-Generation Allergy Medications and Alcohol

When it comes to combining first-generation allergy medications like Benadryl (diphenhydramine) with alcohol, the answer is a resounding no. These medications, which also include chlorpheniramine (Chlor-Trimeton), clemastine (Tavist), and hydroxyzine (Atarax), have a primary side effect of drowsiness. Alcohol also causes drowsiness. The combination of the two can lead to severe impairment, increased risk of accidents, and even unconsciousness. Doctors strongly advise against mixing first-generation antihistamines and alcohol.

The Exception: Severe Allergic Reactions

The only exception to this rule is in the case of a severe, life-threatening allergic reaction, such as anaphylaxis from a food or insect sting. In this situation, the patient would need to take Benadryl or another first-generation antihistamine, regardless of any alcohol consumption. However, this is an emergency situation that requires immediate medical attention.

Safer Combinations: Second-Generation Allergy Medications and Alcohol

For chronic seasonal allergies, doctors are more likely to prescribe second-generation allergy medications like loratadine (Claritin), fexofenadine (Allegra), or cetirizine (Zyrtec). These have a lower risk of drowsiness and are considered a safer combination with alcohol. However, experts still recommend avoiding alcohol altogether while taking any allergy medication, as the effects are unpredictable.

Alternative Option: Nasal Corticosteroids

For those who want to enjoy the occasional alcoholic beverage while managing their allergies, nasal corticosteroids like Flonase or Nasonex may be a better option. These are used as needed and do not have a contraindication with alcohol, nor do they cause drowsiness or other systemic side effects.

The Bottom Line

While the combination of first-generation antihistamines and alcohol should be strictly avoided, second-generation allergy medications like Allegra can be a safer option for those who want to have a drink. However, the best practice is to avoid alcohol altogether when taking any type of allergy medication, as the effects can be unpredictable. Nasal corticosteroids may be a good alternative for those who want to manage their allergies without giving up their weekend social activities.

Key Takeaways

• First-generation antihistamines like Benadryl should never be combined with alcohol due to the risk of severe drowsiness and impairment.
• The exception is in the case of a severe, life-threatening allergic reaction, where Benadryl may be necessary regardless of alcohol consumption.
• Second-generation allergy medications like Allegra are considered a safer combination with alcohol, but experts still recommend avoiding alcohol altogether.
• Nasal corticosteroids like Flonase may be a good alternative for those who want to manage their allergies without giving up alcohol.

FAQs

Can I take Allegra and have a few drinks?

While Allegra (fexofenadine) is considered a safer combination with alcohol compared to first-generation antihistamines, experts still recommend avoiding alcohol altogether when taking any allergy medication. The effects can be unpredictable, and it’s best to err on the side of caution.

Is it okay to have a glass of wine with Zyrtec?

Zyrtec (cetirizine) is also a second-generation allergy medication that is generally considered safer to combine with alcohol than first-generation antihistamines. However, it’s still best to avoid alcohol completely while taking Zyrtec or any other allergy medication, as the effects can be unpredictable.

Can I drink alcohol while taking nasal corticosteroids for allergies?

Nasal corticosteroids like Flonase or Nasonex do not have a contraindication with alcohol and do not cause drowsiness or other systemic side effects. They may be a good option for those who want to manage their allergies without having to give up their occasional alcoholic beverage.

Are they a safe combination?

Seasonal allergies are as common as they are annoying. According to the Asthma and Allergy Foundation of American, allergic rhinitis (aka hay fever) affects 20 million adults in the United States each year. And millions more experience various other types of allergies—everything from insect bites and pet dander to shellfish, peanuts, and mold spores (to name a few). If your allergy is severe enough, you might carry an EpiPen or receive allergy shots from your doctor. For most people, however, over-the-counter allergy medicine is the first line of defense.

But how does taking allergy medication impact your ability to enjoy those #weekendvibes? In other words, will you still have the option to enjoy a cold beer on a hot summer night if you are taking something to combat your itchy eyes, runny nose, hives, or scratchy throat?

First-generation allergy medicines, like Benadryl, and alcohol

If your allergy med of choice is diphenhydramine, also known as Benadryl, the answer is an emphatic NO. Benadryl and alcohol should never, EVER, be combined, says David Corry, MD, a pulmonologist and professor of medicine in the immunology, allergy, and rheumatology department at Baylor College of Medicine in Houston, Texas. The same rule goes for other first-generation allergy medications such as chlorpheniramine (Chlor-Trimeton), clemastine (Tavist) and hydroxyzine (Atarax).

“That is a big contraindication,” Dr. Corry says.

Why? Because the primary side effect of these medications is drowsiness (case in point: Benadryl is also used to treat insomnia), which is also one of the primary side effects of alcohol consumption.

“First-generation antihistamines will cause drowsiness in just about everybody, [and] alcohol does that, too,” Dr. Corry explains. “So if you are taking alcohol and antihistamines your chances of having a double dose of that drowsiness are very, very high.”

And in the worst-case scenario, he explains, this double-dose of drowsiness can not only impair your ability to function and increase the likelihood of some sort of accident, it can also lead to unconsciousness. Meaning, that cold beer is not worth the risk.

RELATED: Diphenhydramine details | Chlorpheniramine details | Clemastine details | Hydroxyzine details 

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The only exception to this hard-and-fast rule is if someone has a severe allergic reaction to something, like food or an insect bite, in the midst of alcohol consumption.

“If you are allergic to shellfish and you had two martinis and then somebody passes you a shrimp and you are having a reaction … you would not withhold Benadryl,” says Maria Marzella Mantione, Pharm.D., director of the Doctor of Pharmacy program at St. John’s University in Queens, New York. She adds that in this scenario the patient needs professional medical care so call 911 or get them to a doctor immediately.

“These concerns [about antihistamines and drowsiness] are really outside of this particular context of severe, life-threatening situations,” Dr. Corry agrees.

Fortunately, Benadryl clears from your system in four to six hours, says Dr. Mantione. So, presuming the allergic reaction is kept at bay, you won’t be teetotaling indefinitely.

Second-generation allergy medicines, like Zyrtec, and alcohol

If you have chronic seasonal allergies it is unlikely your doctor will recommend a first-generation antihistamine, says Dr. Mantione, because these are normally used for acute reactions. Instead, she explains, you’ll likely be steered toward one of the second-generation allergy medications. Loratadine (Claritin), fexofenadine (Allegra), or cetirizine (Zyrtec) and alcohol are generally considered a slightly safer combination. These medications do not typically cause drowsiness or other side effects that are intensified by alcohol consumption.

“Most of these have a reduced, if not completely absent, side effect of sleepiness,” Dr. Corry says.

This is not to say, however, that it is okay to go on a bender while taking Claritin, Zyrtec, Xyzal, or Allegra—Dr. Corry recommends avoiding alcohol altogether while taking any medication.

But is doing so going to lead to a critical medical emergency? Probably not, explains Dr. Mantione. “It is one of those situations where, as a pharmacist, I say it is best to avoid because we don’t know how it is going to affect you, but it is not [considered] a life-threatening combination,” she says.

She also offers an alternative for those who don’t want to give up the opportunity to have a drink—nasal corticosteroids, such as Flonase or Nasonex. These are used as needed, and are safe to use regularly throughout the allergy season. They don’t have a contraindication with alcohol, and they don’t cause drowsiness or other systemic side effects, she says.

“If somebody came to me and said ‘I am on this allergy medication but I am going away on vacation and I am hoping to have Bahama Mamas every day’ I would recommend the nasal corticosteroid,” Dr. Mantione says.

RELATED: Loratadine details | Claritin details | Fexofenadine details | Allegra details | Cetirizine details | Zyrtec details | Xyzal details 

What Are the Risks of Combining Allegra and Alcohol?

Allegra and Alcohol

Allegra is a popular brand name for the anti-allergy medication fexofenadine. It belongs to a large class of anti-allergy medications known as antihistamines.^1,2,3,4

Like other medications, Allegra and other antihistamines have side effects and interactions. Included in these interactions are the hazards associated with mixing Allegra and alcohol.

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Allergies and How Allegra Works

Allergic reactions can arise from various sources, such as: 

• Food
• Dust
• Pollen
• Mold
• Pet dander
• Insect bites

When allergens enter the body, your immune system recognizes them as potential threats and releases chemicals to combat them. One such chemical is histamine, which can trigger allergic symptoms to eliminate the allergens, like: 

• Runny nose
• Itchy eyes
• Swelling
• Hives 

Allegra and other antihistamines block histamine’s action by binding to histamine-1 (h2) receptors. These are the same receptors that histamine binds to to produce its effects.^5,6,7

Depending on the condition and the person’s age, a healthcare provider can prescribe oral Allegra tablets in varying strengths:^3,8 Some examples of dosing include the following: 

• 30 mg for allergic rhinitis in children aged 6-12 years
• 120 mg for allergic rhinitis in adults
• 180 mg for chronic urticaria in adults and children aged 6-12 years

Can You Drink Alcohol with Allegra?

It’s generally safe to drink alcohol in moderation, but combining alcohol with certain medications can lead to potential risks and complications. That includes Allegra and other antihistamines, as alcohol can amplify certain side effects.⁸

What Are the Risks of Combining Allegra and Alcohol?

Both alcohol and Allegra can depress the central nervous system. When taken together, they can amplify each other’s sedative effects.

It can potentially cause the following:^{2,7,9,10,11,12}

• Extreme drowsiness
• Reduced concentration
• Inability to drive safely and perform other tasks requiring mental alertness
• Impaired motor skills and coordination
• Decreased reaction times
• Unsteady movements
• Increased risk of falls, fractures, injuries, or accidents 
• Serious health consequences (like overdose, respiratory distress, coma, or even death)

If you’re medicating with Allegra:^8,9

• Ask your medical provider first if it’s okay for you to drink alcohol. They’ll consider your unique situation, including your medical conditions and other medications you take.   
• You may be allowed to drink if you follow specific rules, like drinking in moderation or waiting a few hours after taking Allegra. 
• You’re fully aware of the effects of combining Allegra and alcohol on you. 

How Long After Taking Allegra Can I Drink Alcohol?

There’s no specific waiting period mentioned for Allegra concerning alcohol consumption. 

However, waiting for a few hours before drinking is good advice. This should allow the medication to be metabolized and eliminated from the body, reducing the risk of interactions.

For your guidance, Allegra’s effect starts to kick in after one hour, reaching maximum effect within two to three hours. However, some people can still feel the impact by up to 12 hours, which aligns with Allegra’s elimination half-life of 14.4 hours.^13,14

Can I Drink Alcohol After Taking Allegra 180 mg?

Drinking alcohol can enhance Allegra’s side effects. This is more pronounced with Allegra 180 mg, Allegra’s most potent form. Taking alcohol and Allegra 180 mg can lead to a higher level of sedation.

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What Other Things to Avoid When Taking Allegra

Aside from alcohol, there are other substances you need to avoid when taking Allegra. You should be aware of these substances to ensure the effectiveness and safety of Allegra.

Fruit Juices

Certain fruit juices can interfere with Allegra’s absorption and decrease the drug’s level in the body.

These fruit juices include:

• Apple
• Grapefruit
• Orange

Refrain from drinking large amounts of these juices or drink only water so that the body absorbs Allegra better.^2,3,15,16 

Sedating Medications

Allegra can already cause drowsiness. Combining it with sedatives and CNS (central nervous system) depressants can lead to additive sedation.

Examples of these substances include:^3,11,12,16

• Cough and cold remedies containing another antihistamine (like olopatadine intranasal)
• Tranquilizers
• Sleeping pills
• Neurotic pain medications
• Muscle relaxers
• Medicine for seizures
• Antidepressants (like isocarboxazid and tranylcypromine)
• Other sedatives and CNS depressants

Unless your doctor instructs you, you should avoid taking multiple antihistamines simultaneously or combining Allegra with other drowsy medications.

Antacids 

Avoid taking aluminum and magnesium antacids within two hours before or after taking Allegra. These medications can decrease the absorption of Allegra and reduce its effectiveness.^3,12,17

Other Medications That Interact with Allegra

Some drugs can increase the concentration of Allegra in the body, enhancing the side effects. This means you should avoid co-administration.

Examples of such drugs are:¹⁶

• Cancer drugs (like erdafitinib, leniolisib, and tepotinib)
• Migraine medications (like lasmiditan and metoclopramide intranasal)
• Trofinetide (a medication for Rett syndrome)

On the other hand, some drugs can decrease Allegra’s concentration. One known example is the lung cancer drug sotorasib. It would be best if you also avoided coadministration. But if use is unavoidable, your healthcare provider may help you with dosage modifications.¹⁶

This list of things to avoid with Allegra isn’t exhaustive. Always consult your healthcare provider or pharmacist for guidance on potential interactions and other things to avoid. They can provide personalized advice based on your medical history and medication regimen.

Can I Drink Alcohol While Taking Allergy Medicine?

Whether it’s safe to drink alcohol while taking an antihistamine relies on the specific type of antihistamine you use.  

If you take older, first-generation antihistamines, you should avoid alcohol altogether. This is because they’re more likely to cause drowsiness than second-generation antihistamines. 

Mixing alcohol with a second-generation antihistamine is less likely to result in complications. However, that doesn’t mean it’s okay to do so. Experts still recommend refraining from drinking when on medication.

First-Generation Antihistamines

First-generation h2 antihistamines can cross the blood-brain barrier and are more likely to make you sleepy and impair your cognitive and psychomotor functions. Their combination with alcohol can produce a higher level of sedation than second-generation antihistamines.^5,7,18,19 

First-generation antihistamines include:^11,12,18

• Brompheniramine (Dimetapp, Bromfed)
• Chlorpheniramine (Chlor-Trimeton, Aller-Chlor)
• Dimethindene (Fenistil)
• Triprolidine (Actifed, Histex)
• Cyclizine (Bonine, Marezine)
• Hydroxyzine (Vistaril, Atarax)
• Meclizine (Bonine, Dramamine Less Drowsy)
• Azatadine (Optimine)
• Cyproheptadine (Periactin)
• Ketotifen (Zaditor, Alaway)
• Carbinoxamine (Palgic, Histex CT)
• Clemastine (Tavist, Dayhist)
• Dimenhydrinate (Dramamine)
• Diphenhydramine (Benadryl)
• Doxylamine (Tylenol Cold and Cough Nighttime, Vicks NyQuil, Unisom, Nighttime Sleep Aid)
• Antazoline (Vasocon-A)
• Promethazine (Phenergan)
• Doxepin (Silenor)
• Cinnarizine (Stugeron, Joy-Travel)

Second-Generation Antihistamines

Compared to their older counterparts, second-generation h2 antihistamines don’t penetrate the blood-brain barrier or do so in a lesser manner.  

Second-generation antihistamines are sometimes called “non-sedating” or “non-drowsy” antihistamines. However, they can still make you sleepy to a lesser extent. It’s still best to avoid drinking alcohol when taking a dose unless your healthcare provider permits it.^{5,7,12,18,19,20}

Second-generation antihistamines include:^7,18

• Fexofenadine (Allegra)
• Cetirizine (Zyrtec)
• Levocetirizine (Xyzal)
• Desloratadine (Clarinex)
• Loratadine (Claritin)
• Olopatadine (Pataday, Patanol)
• Azelastine (Astelin, Astepro)
• Emedastine (Emadine)
• Epinastine (Elestat)
• Ebastine 
• Acrivastine (Semprex)

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What Allergy Medicine is Best with Alcohol?

There are no guidelines for determining the best allergy medications with alcohol. However, antihistamines with zero or fewer sedative effects are generally safer with alcohol. This makes second-generation antihistamines already ahead of their first-generation counterparts. 

However, not all second-generation antihistamines are automatically good picks. There are still variations between these drugs regarding how much they disrupt cognitive and psychomotor functions.⁵

Criteria for Allergy Medicine’s Sedative Potential

Researchers used sedative parameters — like proportional impairment ratio (PIR) and brain h2 receptor occupancy (h2RO) — as an indirect gauge. 

Coincidentally, the Consensus Group on New Generation Antihistamines (CONGA) has set criteria for defining a “non-sedating” antihistamines:^5,6,20

1. There should be no “incidence of subjective sleepiness.”
2. There should be no impairment of “objective and psychomotor functions.” Several studies used PIR as a measure of this criterion. The higher the PIR, the higher the drug’s impairment tendency.
3. There shouldn’t be a significant amount of h2RO. It’s a helpful index for measuring a drug’s blood-brain permeability and sedative potential, categorizing antihistamines as follows:

• Less than 20% h2RO: non-sedating
• 20% to 50% h2RO: moderate or less sedating
• More than 50% h2RO: sedating

Fexofenadine (Allegra)

A statistical analysis of several studies supports fexofenadine (Allegra) as the least drowsy among second-generation antihistamines.^7,21 Such a claim makes an excellent argument to declare Allegra as the best allergy medication with alcohol.

One study reported -0.1% h2RO for 120 mg fexofenadine, classifying the drug as “non-sedating.” This finding supports that fexofenadine doesn’t cross the blood-brain barrier very much, if not at all.^6,11,22 

In the same study, fexofenadine didn’t show significant differences from the placebo regarding subjective sleepiness and objective psychomotor tests. ^6,11 

In another study comparing the PIR of several antihistamines, fexofenadine scored the lowest score of 0.00. This means it has the least potential to cause impairments.^5,6

Lastly, in a review of multiple studies involving multiple dosages, fexofenadine is the only drug that showed no sedation, even at higher doses. (Note that these are controlled studies.) The other second-generation antihistamines—cetirizine, loratadine, and desloratadine—showed no sedation at lower doses but had low to moderate sedation at higher doses.^7,23

Ebastine

Like fexofenadine, ebastine has less than 20% h2RO at 10 mg and is classified as “non-sedating.”¹¹ This finding makes a good case for ebastine as a safe antihistamine with alcohol.

However, the limited range of doses where ebastine was studied hinders it from being proclaimed as good as fexofenadine. The range only went up to three times of a single ebastine dose; with fexofenadine, it’s six times.⁵

Cetirizine (Zyrtec)

Cetirizine (Zyrtec) is potentially safe but only at low doses. It has less than 20% h2RO at 10 mg and is classified as “non-sedating” at this dose.¹¹One thing that works against cetirizine is its dose-dependent sedation and impairment.

In the study where 120 mg fexofenadine showed -0.1% h2RO, 20 mg cetirizine showed a 26.0% h2RO. At this point, cetirizine is now “less sedating.”⁶

Moreover, cetirizine have low sedation at recommended doses but moderate sedation at higher doses.^2,5,23

Remaining Second-Generation Antihistamines

Like cetirizine, loratadine (Claritin) showed dose-ranging impairment. It showed no sedation at recommended doses but had low sedation at higher doses.^5,7,23

For desloratadine (Clarinex) and levocetirizine (Xyzal), the lack of dose-ranging studies excludes them from being classified as “non-sedating. ”⁵

Olopatadine, azelastine, mequitazine, and epinastine have shown h2RO numbers enough to be classified as either “non-sedating” or “less sedating.” However, we need more studies to support or debunk their positions.¹

Summary

Combining alcohol and Allegra (fexofenadine) can present potential risks and complications. The interaction between Allegra and alcohol may cause increased drowsiness, impaired coordination, and other adverse effects. If you choose to drink, consider doing so in moderation or wait a few hours after taking medication.

Drinking alcohol while taking Allegra isn’t the only precaution you should consider. Grapefruit juice, sedating medications, antacids, and other medications can interact with Allegra differently.

The risks can vary when you consume alcohol with other allergy medicines. Second-generation antihistamines are generally safer due to their lesser sedative effects.  

Interestingly, based on studies, Allegra emerged as the safest antihistamine to take with alcohol. However, that doesn’t mean alcohol intake is automatically acceptable when on medication. 

Ultimately, prioritizing your health and well-being is crucial over alcohol consumption. The general guideline is to avoid drinking alcohol while taking medications. We recommend you always seek guidance from a healthcare professional before taking fexofenadine with alcoholic beverages.

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Alcohol and drugs. Compatibility

01/29/2020

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Is it possible to drink alcohol together with drugs and how will this affect your well-being? From this article you will learn about the compatibility of alcoholic beverages with many drugs.

Often a situation arises when a big celebration is ahead, and a person is undergoing treatment for some kind of disease. And here the question arises – is it possible to drink alcohol and how will it affect your well-being?

How can alcohol interact with drugs? Instructions for use do not always contain information about the inadmissibility of drinking alcohol during treatment with a specific drug. But this does not mean at all that such a combination will pass without a trace.

Such interaction may manifest itself in the following:

• Antagonism. This is a complete incompatibility of the active substance and alcohol.
• Intoxication. The body produces toxic substances that have a strong toxic effect.
• Decreased therapeutic functions of the drug. In the case of the simultaneous use of alcohol and drugs, a violation of the metabolism and absorption of the drug occurs.
• Influence on side effects. Almost every drug has some side effects, and alcoholic beverages can significantly increase them, thereby leading to the development of new diseases.

Based on this, we can conclude that drugs, together with alcohol, can nullify the entire course of treatment or cause serious health problems. Moreover, each drug affects the body in its own way.

When prescribing antibiotics, the patient is usually warned to abstain from alcohol. Otherwise, the treatment will not be effective – this is at best. And often this combination leads to serious disturbances in the functioning of the body.

The use of alcohol in the treatment of any disorders of the central nervous system is strictly prohibited. Its combination with sedatives or sleeping pills drugs can lead to death.

Antihistamines with alcohol can cause severe depression and CNS depression. It is very dangerous to drink alcohol with antidepressants , even a minimal dose of alcohol can lead to a hypertensive crisis.

How long should the drug and alcohol take? To answer this question, you need to know that alcohol is excreted from the body within 48 hours, and many drugs are in the blood for a week.