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Diabetes Medications and Alcohol Interactions

Medically reviewed by Leigh Ann Anderson, PharmD. Last updated on Dec 28, 2019.

Introduction

Alcohol can affect blood sugar levels in patients with diabetes. Both low blood sugar (hypoglycemia) and high blood sugar (hyperglycemia) may occur, depending on how much and how often you drink. Combining alcohol with medications that also lower blood sugar can result in serious interactions due to an additive effect. It is important to know what to expect and recognize the symptoms of low blood sugar if you choose to drink. If your diabetes is not well controlled, you should avoid the use of alcohol.

Drinking, due to the intoxicating effect, may lead to a lack of awareness of low blood sugar signals.

Symptoms of low blood sugar include:

  • Drowsiness
  • Confusion
  • Dizziness
  • Shakiness or lightheadedness
  • Headaches
  • Fast heart rate or heart palpitations
  • Stupor or unconsciousness
  • Anxiety

Drinking alcohol and diabetes

If you have type 1 diabetes or type 2 diabetes, have a discussion with your healthcare provider about drinking alcohol and its impact on your health condition. If you drink, do so only in moderation. Moderate alcohol consumption generally does not affect blood glucose levels if your diabetes is under control. You should not have high triglycerides, neuropathy (nerve damage), or pancreatitis. Follow these guidelines for moderate alcohol consumption:

  • One drink a day for women of all ages and men older than 65
  • Up to two drinks a day for men age 65 and younger
  • One drink = 5 oz wine, 12 oz beer, or 1.5 oz distilled spirits
  • Don’t drink on an empty stomach.

Remember to include the carbohydrates from any alcohol you drink in your daily carbohydrate count, monitor your blood sugar before, during, and after drinking alcohol, and check your blood sugar levels before going to bed. Do not drink on any empty stomach or after exercising as this may also lower blood sugar levels. Always wear a diabetes medical I.D. tag to help identify your medical condition if needed for emergency personnel.

Alcohol drug interactions with diabetes medications

Drug interactions with certain diabetes medications can be serious. Consuming alcohol with some types of medications can lead to dangerously low blood sugar because the alcohol interferes with the liver’s ability to regulate blood sugar (called hepatic gluconeogenesis). Many type 2 diabetes medications are available in combination, increasing the risk for multiple drug-alcohol interactions.

  • The mix of alcohol with metformin can increase the risk of a rare but dangerous condition called lactic acidosis. Get emergency medical help if you have any of these symptoms of lactic acidosis: weakness, increasing sleepiness, slow heart rate, cold feeling, muscle pain, shortness of breath, stomach pain.
  • When alcohol is combined with insulin, the glucose lowering effect of insulin may be increased or decreased. Both hypoglycemia (low blood sugar) and hyperglycemia (high blood sugar) may occur, depending on how much and how often you drink.
  • A disulfiram-like reaction to alcohol (symptoms include flushing, headache, and nausea) has been reported with the use of chlorpropamide (Diabinese) and very rarely with other drugs in the sulfonylurea class

Common diabetes drug classes and groups:

Common Diabetes Medications

*Brand discontinued

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. Product Information. Glucophage (metformin). Bristol-Myers Squibb, Princeton, NJ.
  2. Hartling SG, Faber OK, Wegmann ML, et al. Interaction of ethanol and glipizide in humans. Diabetes Care.1987:10;683-6.
  3. Jerntorp P, Almer L. Chlorpropamide-alcohol flushing in relation to macroangiopathy and peripheral neuropathy in non-insulin dependent diabetes. Acta Med Scand. 1981:656;33-6.
  4. Product Information. Glucotrol (glipizide). Pfizer US Pharmaceuticals, New York, NY.

Further information

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