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Diabetes Medications and Alcohol Interactions

Medically reviewed by L. Anderson, PharmD Last updated on Mar 11, 2019.

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 excess alcohol consumption can also mimic the signs of low blood sugar, which might include:

  • Drowsiness
  • Confusion
  • Dizziness
  • Headaches
  • Stupor or unconsciousness

If you have type 1 diabetes or type 2 diabetes, have a frank 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 and always wear a diabetes medical I.D.

  • Drug interactions with certain diabetes medications can be serious. Consuming alcohol with some medications can lead to dangerously low blood sugar because the alcohol interferes with the liver’s ability to regulate blood sugar (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.

Common diabetes drug classes and groups:

Common Diabetes Medications*

Generic Name Common Brand Names
canagliflozin Invokana
dapagliflozin Farxiga
dulaglutide Trulicity
empagliflozin Jardiance
exenatide Byetta, Bydureon
glimepiride Amaryl
glipizide Glucotrol, Glucotrol XL
glyburide Diabeta, Glynase
insulins Lantus, Humalog, Novolog, Apidra, other brand names
linagliptin Tradjenta
liraglutide Victoza
metformin Glucophage, Fortamet
nateglinide Starlix
pioglitazone Actos
pramlintide Symlin
repaglinide Prandin
saxagliptin Onglyza
sitagliptin Januvia

*Note: This is not a complete list; always check with your pharmacist for possible drug-alcohol interactions.

Types of Drug Interactions With Alcohol

Further information

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