Skip to main content

What are the dangers of mixing sleeping pills with alcohol?

Medically reviewed by Leigh Ann Anderson, PharmD. Last updated on Dec 13, 2023.

Introduction

Medications that are known as sedative and hypnotics are used to help people who have with trouble sleeping (insomnia). If you experience difficulty with sleep, you may have trouble getting to sleep, staying asleep, or both. Sleep medicines can be helpful in the short-term or long-term to help with sleep, but can you safely mix sleeping pills with alcohol? 

Many different classes of drugs are used to help with insomnia and get you off to sleep, including:

Some of these medications, such as the benzodiazepines, are best used only in the short-term for sleep due to risk of addiction and central nervous system side effects such as drowsiness, dizziness, and confusion. Other drugs, such as the DORAs, are used longer-term. Tell your healthcare provider if you have ever been dependent upon alcohol, opioids or other prescription medications, or recreational / illicit drugs.

There is a substantial risk for a drug interaction if you drink alcohol (ethanol) while taking a medication for sleep, and some interactions can be very dangerous or even deadly. Always review any possible drug interactions with your doctor and pharmacist.

Since you have a taken sleeping medicine, you should not drive, operate machinery or do any other hazardous activity. Some medicines can still make you feel drowsy in the morning and can still effect your driving skills or reaction time. Do not drink alcohol and drive or operate machinery at any time.

Learn More: Drug and Alcohol Interactions - What to Avoid

Benzodiazepines

Many drugs in this class are used for the short-term (7-10 days) treatment of insomnia. You should not drink alcohol while taking benzodiazepines, as this class of medication can increase the effects of alcohol. You may feel more drowsy, dizzy, or tired if you take a benzodiazepine with alcohol. You may have trouble concentrating or thinking, lose good judgment, or experience impairment to your memory or reflexes.

Benzodiazepines commonly used for sleep include:

Non-benzodiazepines

The non-benzodiazepine ("Z-drugs") class includes:

You should also avoid the use of alcohol while being treated with the non-benzodiazepine medications, (often referred to as the "Z-drugs"). Alcohol can further increase the central nervous system side effects of these drugs such as drowsiness, dizziness, and trouble concentrating. Some people may also experience impairment in thinking, judgment, memory or reflexes. Talk to your doctor or pharmacist if you have any questions or concerns.

Dual orexin 1 and 2 receptor antagonists (DORAs)

Dual orexin 1 and 2 receptor antagonists (DORAs) are a class of sleep medications that block orexin, a brain chemical involved in wakefulness and arousal. You should avoid the use of alcohol while being treated with these medicines. You also must have at least 7 hours of time to sleep before you plan on waking up after taking a dose.

DORAs are oral drugs used for the treatment of insomnia characterized by difficulties with falling asleep and/or staying asleep. Medicines in the DORA class include:

As with any medicine, do not take a higher dose than prescribed by your doctor. Use caution if driving the next day and with other activities requiring complete mental alertness. Dual orexin receptor antagonists (DORAs) should not be used in patients with narcolepsy.

Talk to your doctor about the side effects of these drugs before you use them. Serious side effects may include:

If you experience any complex sleep behaviors or other concerning side effects while taking this medicine, notify your doctor immediately.

Sleep medications and the elderly

Older patients may experience greater side effects from sleep medications. Some OTC medications such as diphenhydramine (Benadryl, Nytol QuickCaps, Tylenol PM, Aleve PM) and doxylamine (Unisom, Nytol Maximum Strength) can interact directly with alcohol as they contain sedating antihistamines.

Some drugs used for sleep have anticholinergic actions; for example, sedating antihistamines like diphenhydramine (Benadryl), doxylamine (Unisom, Nytol) and tricyclic antidepressants such as trazodone (Desyrel).

Related: Anticholinergic Drugs to Avoid in the Elderly

Barbiturates

Barbiturates were used more frequently in the past to help with insomnia. However, they can lead to addiction and dependence and can be especially toxic or deadly when mixed with alcohol due to breathing that may drastically slow down or stop altogether.

Today barbiturates are infrequently prescribed for sleep, but they still may be used in surgical procedures or for seizure control. Tell your doctor if you have a history of alcohol or drug dependence before using a barbiturate. You should not drink alcohol while taking any barbiturate; common examples include:

The barbiturates secobarbital and butabarbital have been discontinued in the U.S.

Herbal products used for sleep

Certain herbal or dietary products commonly used for sleep, for example, melatonin, valerian or chamomile can increase central nervous system side effects when used with alcohol. Dizziness, drowsiness, and difficulty concentrating, and impairment in thinking and judgment can occur.

Any herbal product or dietary supplement that leads to drowsiness or dizziness may interact with alcohol. Avoid or limit the use of alcohol while using herbal or dietary supplements for sleep, unless approved by your doctor. Always check with your pharmacist for possible drug or food interactions with herbal or dietary supplements.

Table of Common Sleep (Insomnia) Medications

Generic Name Common Brand Name
daridorexant Quviviq

diphenhydramine and ibuprofen, diphenhydramine, diphenhydramine and acetaminophen

 Aleve PM, Benadryl, Nytol, Tylenol PM
doxepin Silenor
doxylamine Unisom Sleep Tabs
eszopiclone Lunesta
lemborexant Dayvigo
lorazepam Ativan
melatonin various OTC products
ramelteon Rozerem
suvorexant Belsomra
tasimelteon Hetlioz, Hetlioz LQ
temazepam Restoril
trazodone Desyrel
triazolam Halcion
valerian various OTC products
zaleplon Sonata
zolpidem Ambien, Ambien CR, Edluar

Note: This is not a complete list of medicines that may be used to treat insomnia; 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.

For a complete list of side effects, warnings and drug interactions please refer to the individual drug monographs.

Types of Drug Interactions With Alcohol

Sources

  1. Breslow RA, Dong C, White A. Prevalence of Alcohol-Interactive Prescription Medication Use Among Current Drinkers: United States, 1999 to 2010. Alcohol Clin Exp Res. 2015; 39:371-79. Accessed Dec. 14, 2023.
  2. Weathermon R, Crabb DW. Alcohol and medication interactions. Alcohol Res. Health. 1999;23(1):40-54. Accessed Dec. 14, 2023.
  3. Alcohol Facts & Statistics. National Institute on Alcohol and Abuse and Alcoholism (NIAAA). National Institutes of Health (NIH). Accessed Dec. 14, 2023 at https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/alcohol-facts-and-statistics
  4. Salahudeen MS, Duffull SB, Nishtala PS. Anticholinergic burden quantified by anticholinergic risk scales and adverse outcomes in older people: a systematic review. BMC Geriatr. 2015 Mar 25;15:31. doi: 10.1186/s12877-015-0029-9
  5. Harmful Interactions: Mixing Alcohol with Medications. National Institute on Alcohol Abuse and Alcoholism. Accessed Dec. 14, 2023 at https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/harmful-interactions-mixing-alcohol-with-medicines

Further information

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

Medical Disclaimer