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Herbal Supplements and Alcohol Interactions

Medically reviewed by Leigh Ann Anderson, PharmD. Last updated on Nov 16, 2019.

Herbal products, vitamins and dietary supplements are widely used. Many people believe these "natural products" are safe to use without restrictions, but this is not always the case. For example, certain herbs like St. John's Wort may interact with alcohol (ethanol). You may be at risk for additive drowsiness, liver damage, impaired breathing, or other side effects, depending upon the dietary supplement. Well designed trials evaluating interactions between dietary supplements and alcohol use are often lacking.

Learn More: 18 Herbal Supplements with Risky Drug Interactions

Drowsiness, Central Nervous System (CNS) Depression

Use caution if combining alcohol with any over-the-counter herbal or dietary supplement that causes drowsiness. Review the label on the bottle and speak with your pharmacist or doctor if you plan on mixing an herbal dietary supplement and alcohol. Do not drive until you are aware of the effects of the two agents.

These herbal drugs have been known to lead to drowsiness in some patients, which may be increased when combined with alcohol:

Panax ginseng (ginseng) has been reported to reduced the blood concentrations of alcohol (ethanol) in one case report.

Liver Damage

Some herbal products may lead to liver damage as well. Chronic alcohol abuse and alcoholism can lead to liver disease such as cirrhosis. The effects may be additive when combined with liver-toxic herbs or other dietary supplements.

Examples of herbal products that may cause liver toxicity include:

Related: Top 9 Ways to Prevent a Deadly Drug Interaction

The fat soluble vitamins A, D, E and K are usually consumed from your diet and play an important role in your health. However, if you take supplements, it is important not to exceed recommended doses of these vitamins as high supplemental doses may lead to liver damage. Alcohol combined with high doses of these vitamins may theoretically lead to or worsen liver damage.

Low Blood Pressure

Rauwolfia serpentina and alcohol may have additive effects in lowering your blood pressure (hypotension). Side effects might include headache, dizziness, lightheadedness, fainting, or changes in heart rate. These side effects are most likely to be seen when you start treatment, if your dose is increased, or if treatment is restarted after you have stopped therapy.

*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. Weathermon R, Crabb DW. Alcohol and medication interactions. Alcohol Res Health. 1999;23(1):40–54. Accessed Nov. 16, 2019 at PMID: 10890797.
  2. Miller L. Herbal Medicinals: Selected Clinical Considerations Focusing on Known or Potential Drug-Herb Interactions. Arch Intern Med. 1998;158(20):2200-2211. Accessed Nov. 16, 2019 at doi:10.1001/archinte.158.20.2200
  3. Ekors M. The growing use of herbal medicines: issues relating to adverse reactions and challenges in monitoring safety. Front Pharmacol. 2013; 4: 177. Accessed Nov. 16, 2019 at doi: 10.3389/fphar.2013.00177.
  4. Lee FC, Ko JH, Park JK, et al. Effects of Panax ginseng on blood alcohol clearance in man. Clin Exp Pharmacol Physiol 1987; 14(6): 543–6
  5. Jamieson DD, Duffield PH. Positive interaction of ethanol and kava resin in mice. Clin Exp Pharmacol Physiol 1990; 17: 509–14

Further information

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