Stomach / Heartburn Medications and Alcohol Interactions

Medically reviewed by Leigh Ann Anderson, PharmD. Last updated on Feb 23, 2022.

Introduction

We all have an upset stomach every now and then. But many medicines used for stomach issues, like heartburn, irritable bowel syndrome (IBS), diarrhea or nausea and vomiting, can have drug interactions with alcohol (ethanol). What do you need to know?

Reviewing for drug interactions with alcohol is especially important with over-the-counter (OTC) products where your medication use may not be reviewed by your doctor or pharmacist.
Be sure to screen all medications you take with your health care provider to look for drug interactions with prescription medications, OTC products and herbal or vitamin agents.

Stomach Drugs That Can Interact with Alcohol

Heartburn / GERD

Cimetidine (Tagamet HB) is an over-the-counter acid blocker used to treat heartburn and gastroesophageal reflux disease (GERD). Talk to your doctor before consuming alcohol while taking cimetidine. Using cimetidine and alcohol together may increase the effects of alcohol, leading to increased drowsiness and dizziness.

Cimetidine may inhibit an enzyme needed to break down alcohol (alcohol dehydrogenase), but the clinical significance of this interaction is limited. Chronic alcohol may worsen gastric ulcer disease, as well.
Other H2 blockers such as famotidine (Pepcid, Zantac 360) have minimal interactions with alcohol.

More importantly, if you have digestive tract disease, you may need to avoid alcohol to prevent worsening of your disease or bleeding. Talk with your healthcare provider.

Metoclopramide (Reglan) increases the motility of the upper gastrointestinal tract and may block dopamine receptors. Metoclopramide is an agent used for gastroesophageal reflux disease (GERD), diabetic gastroparesis, and nausea and vomiting linked with cancer treatment, or after surgery, among other uses.

Additive sedative effects can occur when metoclopramide is given with alcohol. Check with your doctor before using alcohol with metoclopramide and use caution when performing activities that require mental alertness, such as driving or operating machinery.

Irritable Bowel Syndrome (IBS)

Dicyclomine (Bentyl) is an anticholinergic and antispasmodic agent used to help with stomach spasms and intestinal problems such as irritable bowel syndrome (IBS).

Check with your doctor before combining alcohol and dicyclomine. Alcohol may lead to additive drowsiness or dizziness when combined with dicyclomine.
Avoid activities requiring mental alertness such as driving or operating machinery while using dicyclomine.

Eluxadoline (Viberzi) is used to treat irritable bowel symptoms such as pain and diarrhea in patients without constipation.

Avoid excessive alcohol use during treatment with Viberzi.
Drinking more than 3 alcoholic beverages per day while taking eluxadoline may increase the risk of pancreatitis, or inflammation of the pancreas.
Contact your doctor right away if you have symptoms of pancreatitis such as: persistent nausea, vomiting, stomach pain, especially that which is made worse after eating or radiates to the back or shoulders.

Diarrhea

Loperamide (Imodium A-D) is an oral medication usually bought over-the-counter (OTC) to treat mild and short-term diarrhea. Loperamide works by slowing digestion so that your small intestines have more time to absorb fluid and nutrients from the food you eat.

Combining alcohol with loperamide can increase the nervous system side effects of loperamide such as confusion, dizziness, drowsiness, and difficulty concentrating.
Some people may also experience impairment in thinking and judgment.
In general, it is best to avoid the use of alcohol while being treated with loperamide. Because of its effects in the nervous system, avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you.
If you have diarrhea, it may be best to avoid alcohol as it can further irritate your stomach and intestines. Talk to your health care provider if you have any questions or concerns.

Motion Sickness, Nausea, Vomiting

Drugs such as dimenhydrinate (Dramamine), meclizine (Antivert, Bonine, Dramamine Less Drowsy), and scopolamine transdermal (Transderm Scop) are medications used for motion sickness.

Dimenhydrinate or meclizine are frequently bought over-the-counter (OTC). Scopolamine is a patch worn behind the ear. They are used to help prevent nausea and vomiting from travel, such as in a car, boat or plane. They can cause drowsiness, sedation or dizziness.
Use caution when performing activities that require mental alertness, such as driving or operating machinery.
Because these medications are commonly used while on a vacation or holiday, the risk for drug interactions with alcohol may be of concern.

Promethazine (Phenergan) or trimethobenzamide (Tigan) are prescription treatments that might also be used to help control nausea and vomiting. They could be used for nausea or vomiting linked with surgery or with certain illnesses.

These medications work in the brain and can interact with alcohol. For example, mixing alcohol with these types of drugs can increase the risk of drowsiness, dizziness, and affect your mental alertness.
With promethazine, a phenothiazine drug, uncontrollable movements, agitation, seizures, severe dizziness or fainting, coma, deep sedation, irregular heartbeats, and changes in body temperature can occur. Do not drink alcohol if you are taking promethazine.

Driving or other activities can become hazardous. In general, avoid motion sickness medication while you are drinking alcohol to prevent these side effects. Definitely do not drink and drive.

*Note: The lists presented in this article do not include all the medicines that may interact harmfully with alcohol. To more closely examine specific interactions, visit the Drugs.com Interaction Checker and speak with your doctor or pharmacist.

Types of Drug Interactions With Alcohol

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Sources

Alcohol Facts & Statistics. National Institute on Alcohol and Abuse and Alcoholism (NIAAA). National Institutes of Health (NIH). Accessed Feb. 23, 2022 at https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/alcohol-facts-and-statistics
Alcohol Facts & Statistics. National Institute on Alcohol and Abuse and Alcoholism (NIAAA). National Institutes of Health (NIH). Harmful Interactions. Accessed Feb. 23, 2022 at https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/harmful-interactions-mixing-alcohol-with-medicines
Hansten PD Effects of H2-receptor antagonists on blood alcohol levels. JAMA 267 (1992): 2469.
Feely J, Wood AJ Effects of cimetidine on the elimination and actions of ethanol. JAMA 247 (1982): 2819-21.

Further information

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