Can I drink alcohol while taking metronidazole? You will regret it if you don’t read this!

Severe cases may lead to death

Metronidazole is widely used in clinical practice because of its good anti-anaerobic effect, such as the treatment of pelvic inflammatory disease, acute pericoronitis, vaginal trichomoniasis and lung infection. Clinicians pay more attention to its common adverse reactions, but do not pay attention to or understand the disulfiram (anabolic sulfamethoxazole)-like reaction caused by metronidazole. Disulfiram-like reaction is caused by drinking alcohol (including white wine, rice wine, fruit wine, beer) while using metronidazole. It manifests as facial flushing, headache, palpitations, rapid pulse, difficulty breathing, decreased blood pressure, drowsiness, and severe cases are at risk of death. These reactions are similar to alcohol poisoning and are easily misdiagnosed.

Ethanol reacts directly with metronidazole

Ethanol is metabolized very slowly in the body, and metronidazole can inhibit alcohol metabolism. Therefore, if you drink alcohol while taking metronidazole, the ethanol that enters the human body cannot be fully oxidized. Metronidazole can inhibit acetaldehyde transaminase (acetyl dehydrogenase), so that acetaldehyde cannot be converted and accumulates in large quantities, resulting in a disulfiram (Antisulfiram)-like reaction. Metronidazole will directly react with ethanol absorbed into the blood, whether it is taken orally or intravenously. Therefore, regardless of whether you are used to drinking, what kind of alcohol, or how much you drink, you may experience an Antisulfiram-like reaction while using metronidazole. If you use metronidazole after drinking, you must take the drug 12 hours after drinking.