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Cholesterol Medications and Alcohol Interactions

Medically reviewed by Leigh Ann Anderson, PharmD. Last updated on Feb 14, 2022.

Introduction

Can you drink alcohol while taking cholesterol medication? HMG-CoA reductase inhibitors, also called statins, are a widely prescribed group of medications used to lower high cholesterol and other lipids (hyperlipidemia) in addition to diet. Statins are used to help protect the heart and blood vessel system and lower the risk of heart attack or stroke.

Related: Cholesterol Testing: What Do Your Results Mean?

Statins or other cholesterol medications work by lowering LDL (low density lipoproteins, or “bad” cholesterol) and triglycerides, or by raising HDL (high density lipoprotein, or “good” cholesterol). Statins are oral medicines that are available as single agents or in combination with other medicines.

  • Alcohol and cholesterol medications known as statins: you may consider moderating your alcohol intake because statins mixed with alcohol may elevate triglyceride levels and possibly lead to liver damage. Talk to your doctor if you drink more than 1 to 2 glasses of alcohol daily.
  • Alcohol abuse is a common risk factor for statin-related myopathy. Myopathy can include muscle weakness, muscle pain or tenderness, and muscle toxicity.
  • Patients using cholesterol medications and alcohol who have liver disease due to excessive alcohol use (for example, cirrhosis) or who consume large quantities of alcohol should alert their doctor to this issue. Statins can lead to liver disease in roughly 2% of patients, and ongoing monitoring of liver function may be needed. You should NOT use statins if you have active liver disease or elevated liver enzymes. Your doctor will check your liver enzymes and assess you for liver disease before starting a statin.
  • High cholesterol and alcohol use can be linked if alcohol is consumed long-term and excessively.

Related: List of Medicines for High Cholesterol

Niacin, a B vitamin, may be used to lower cholesterol in addition to diet. Niacin may lower total cholesterol, LDL, and triglycerides and raise HDL levels.

  • Avoid alcohol at the time of niacin administration due to an increased risk of flushing (warmth, redness, or tingly feeling under your skin), itching, nausea, dizziness, and vomiting.
  • Tell your doctor if you have liver disease or consume large amounts of alcohol on a regular basis. Niacin should not be used if you have a history of or current liver disease.

Juxtapid (lomitapide) is a medication used in patients with an inherited (genetic) type of high cholesterol known as homozygous familial hypercholesterolemia.

  • There is a risk of liver toxicity with these drugs. Drinking alcohol with these drugs may increase your chance of having liver problems or make your liver problems worse.
  • It is important you limit alcohol consumption to no more than one alcohol-containing drink per day.
  • If you have symptoms of liver injury (nausea, vomiting, dark-colored urine, light-colored stools, stomach pain, fever, yellow skin or whites of the eyes, extreme tiredness, flu-like symptoms) contact your doctor immediately.

The manufacturer's labeling for Praluent (alirocumab) and Repatha (evolocumab) do not list alcohol (ethanol) as a possible drug-drug interaction. However, these agents work in the liver and Praluent has been linked with elevated liver enzymes, which may signal liver toxicity. If you have alcohol-related liver disease or other diseases of the liver, be sure to discuss this with your doctor.

Learn more: See alcohol (ethanol) drug interactions with your medication

Common Cholesterol Medications

Generic Name Brand Name
alirocumab Praluent
atorvastatin Lipitor
evolocumab Repatha
fluvastatin Lescol, Lescol XL
lomitapide Juxtapid
lovastatin Mevacor
niacin (vitamin B3) Niacor, Niaspan ER, Slo-Niacin
pitavastatin Livalo, Zypitamag
pravastatin Pravachol
simvastatin Zocor
rosuvastatin Crestor

*Note: This is not a complete list; always check with your pharmacist for possible drug-alcohol interactions. Tell your healthcare providers about all the other medications you use, including prescription, over-the-counter (OTC) drugs, vitamins, dietary supplements and herbal products.

Types of Drug Interactions With Alcohol

Sources

  1. Ramkumar S, Raghunath A, and Raghunath A. Statin Therapy: Review of Safety and Potential Side Effects. Acta Cardiol Sin. 2016 Nov; 32(6): 631–639. Accessed Dec. 10, 2019 at doi: 10.6515/ACS20160611A
  2. HDL cholesterol: How to boost your 'good' cholesterol. Mayo Clinic. Accessed Dec. 10, 2019 at https://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/in-depth/hdl-cholesterol/art-20046388
  3. Product Information. Praluent Pen (alirocumab). Sanofi-Aventis, Bridgewater, NJ.
  4. On call: Do alcohol and statins mix?. Harvard Health. Accessed Dec. 10, 2019 at https://www.health.harvard.edu/newsletter_article/do-alcohol-and-statins-mix
  5. Product Information. Repatha (evolocumab). Amgen USA, Thousand Oaks, CA.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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