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Sleep (Insomnia) Medications and Alcohol Interactions

Written by L. Anderson, PharmD on Nov 7, 2017.

Sleep (Insomnia) Medications and Alcohol

Sedative and hypnotic types of drugs are used to help with trouble sleeping (insomnia), either getting to sleep or staying asleep. Sleep medicines are either prescription medicines or over-the-counter (OTC). Drugs classes often selected for insomnia include:

  • Benzodiazepines
  • Non-benzodiazepines
  • Antihistamines
  • Antidepressants

Many of these medications are best used only in the short-term due to risk of addiction and central nervous system side effects. Tell your healthcare provider if you have ever been dependent upon alcohol, prescription medications, or street drugs to determine your risk.

Older patients may experience greater side effects from sleep medications. Even certain OTC medications such as diphenhydramine (Benadryl, Nytol, Tylenol PM, Aleve PM) and doxylamine (Unisom) can interact with alcohol. Some drugs used for sleep have anticholinergic actions; for example, certain antihistamines like Benadryl and tricyclic antidepressants such as trazodone. Side effects in the elderly like drowsiness, dizziness, confusion, or falls may be worsened when anticholinergic drugs are combined with alcohol.

Barbiturates were used more frequently in the past to help with insomnia. However, they can lead to addiction and dependence and they can be especially toxic when mixed with alcohol. You should not drink alcohol while taking any barbiturate; for example,  phenobarbital, secobarbital, butabarbital, or pentobarbital. 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 any barbiturate.

Certain herbal products commonly used for sleep, for example, valerian, can increase the nervous system side effects when used with alcohol. Dizziness, drowsiness, and difficulty concentrating, impairment in thinking and judgment can occur. Avoid or limit the use of alcohol while being treated with valerian. Other herbal products that may act this way include chamomile, Always be sure to check for interactions with herbal and dietary supplement products like vitamins and minerals.

Learn More: Drugs To Avoid in the Elderly

Common Sleep (Insomnia) Medications

Generic Name Common Brand Names
diphenhydramine/ibuprofen, diphenhydramine, diphenhydramine/acetaminophen Aleve PM, Benadryl, Nytol, Tylenol PM
doxepin Silenor
doxylamine Unisom Sleep Tabs
eszopiclone Lunesta
lorazepam Ativan
ramelteon Rozerem
suvorexant Belsomra
temazepam Restoril
trazodone Desyrel
triazolam Halcion
valerian N/A
zaleplon Sonata
zolpidem Ambien, Ambien CR, Intermezzo, Edluar, Zolpimist

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

Types of Drug Interactions With Alcohol

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