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 

Can You Mix Alcohol with Antihistamines?

Written by
Juhi Modi

Medically reviewed by
HaVy Ngo-Hamilton, Pharm. D.
| Jan 16, 2022

Antihistamines are medications commonly used to treat allergy symptoms like allergic rhinitis, hay fever, skin rashes, and the common cold. They are available as both prescription and over-the-counter drugs. Like all medications, antihistamines can cause side effects. To use these allergy medications safely, you should be aware of certain precautions. In particular, you should be aware of the dangers of mixing alcohol and antihistamines. 

Please continue reading to learn whether it is okay to consume alcoholic drinks while taking Claritin, Zyrtec, Benadryl, Allegra, and other commonly used antihistamines.

What are antihistamines? How do they treat allergy symptoms?

Antihistamines are drugs used to treat allergic reactions caused by food, dust, pollen, mold, pet dander, insect bites, and other common allergens. When these allergens enter the body, your immune system identifies them as dangerous intruders and releases chemicals to fight them off. One of these chemicals is called histamine. Histamine triggers symptoms like runny nose, itchy eyes, swelling, and hives to get rid of the allergen. Antihistamines work by binding to the h2 receptors, where histamine binds to produce its effects. That’s why they are also called h2 blockers. By blocking the action of histamine, antihistamines relieve allergy symptoms.

What are the different types of antihistamines?

Antihistamines are first-generation (older drugs) and second-generation (newer drugs). Some examples include:

First-generation antihistamines (H-1 blockers)

• Brompheniramine (Children’s Dimetapp Cold®).
• Clemastine (Dayhist®, Tavist®).
• Chlorpheniramine (Chlor-Trimeton®).
• Cyproheptadine (Periactin®).
• Diphenhydramine (Benadryl®).
• Dexchlorpheniramine Dimenhydrinate (Dramamine®).
• Doxylamine (Tylenol Cold and Cough Nighttime®, Vicks NyQuil®).
• Phenindamine (Nolahist®).
• Hydroxyzine (Vistaril®, Atarax®).

Second-generation antihistamines (H-1 blockers)

• Azelastine (Astelin®).
• Cetirizine (Zyrtec®).
• Loratadine (Claritin®).
• Fexofenadine (Allegra®).
• Desloratadine (Clarinex®).

Can you drink alcohol if taking antihistamines?

Whether or not it is okay to consume an alcoholic drink while taking an antihistamine depends on the type of antihistamine you are taking. You should avoid alcohol completely if you are taking a first-generation antihistamine. Mixing alcohol with a second-generation antihistamine is less likely to cause problems but is still avoidable. This is because first-generation antihistamines are more likely to cause drowsiness compared to second-generation antihistamines. The drowsiness caused by an antihistamine can be made worse when you drink alcohol. This can lead to extreme drowsiness, impairing your ability to function and increasing the chances of an injury or accident. Older adults are at an increased risk of this occurring. 

The exception to this rule is if someone has a severe allergic reaction while drinking alcohol, they should certainly be given an antihistamine. In such a situation, it may be a medical emergency, and you should call 911 or take the person to see a healthcare professional who can provide medical advice. In any case, an antihistamine like Benadryl clears from the body in four to six hours, so you don’t have to avoid alcohol forever.

Is it okay to drink alcohol with cetirizine?

Cetirizine (Zyrtec®) is a second-generation (non-drowsy) antihistamine commonly used to treat seasonal allergies. Combining cetirizine and alcohol is unlikely to cause severe drowsiness. However, cetirizine can make some people feel sleepy. Therefore it is advisable to wait and see how you feel on cetirizine before drinking alcohol. You should also avoid driving or doing anything that requires your complete concentration until you know how this antihistamine affects you.

If mixing Claritin and alcohol can be risky, what is the alternative?

Claritin is a second-generation antihistamine. Unlike first-generation antihistamines, which have a higher risk of causing problems with alcohol, it is generally safe to mix Claritin and moderate alcohol. However, if taking Claritin and alcohol together (or any other antihistamine) is a concern for you, you can talk to a health professional about using nasal corticosteroids (Nasonex®, Flonase®) as alternative treatment options for seasonal allergies. These drugs don’t cause drowsiness. Therefore, it is safe to use both alcohol and nasal corticosteroids together. However, only health professionals can decide whether nasal corticosteroids are right for you.

What about people struggling with alcohol abuse?

If you are struggling with alcohol abuse or some other mental health disorder, it’s important to seek professional medical advice from licensed medical professionals about which allergy medications are right for you. Alcohol is a central nervous system depressant. Mixing alcohol with antihistamines can lead to serious problems with thinking, judgement, and motor skills. 

What should you avoid while taking antihistamines?

Here are some precautions you should take while using an antihistamine:

• Tell your doctor about all your medical conditions, especially if you have diabetes, high blood pressure, heart disease, hyperthyroidism (overactive thyroid), glaucoma, epilepsy, or an enlarged prostate gland.
• Give your doctor a complete list of all your medications including prescription and over-the-counter drugs, vitamins, supplements, and natural or herbal products. This can help avoid dangerous drug interactions.
• Follow the instructions on your package label or prescription carefully. Don’t take more of the antihistamine than recommended.
• Don’t drive or perform any activities that require focus until you know how the antihistamine medication affects you.
• Alcohol can worsen certain side effects of antihistamines. It is best to avoid mixing alcohol with antihistamines.
• Eating grapefruit or drinking grapefruit juice, apple juice, or orange juice while taking certain antihistamines can affect how these drugs work. Ask a qualified healthcare provider for advice if this is a concern.
• Tell your doctor if you’re pregnant or breastfeeding while taking an antihistamine.
   

References:

1. https://my.clevelandclinic.org/health/drugs/21223-antihistamines
2. https://medlineplus.gov/ency/patientinstructions/000549.htm

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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.