Can You Mix Weight Loss Drugs and Alcohol?

Medically reviewed by Leigh Ann Anderson, PharmD. Last updated on Dec 30, 2024.

Obesity or weight loss drugs may be prescribed in the short-term or the longer-term in addition to diet and exercise to treat weight gain. But even if you are losing weight with medications, you might still want to have a beer, a glass of wine or a cocktail every once in a while. So the question is - do weight loss drugs have interactions with alcohol?

The short answer is - it depends. Many weight loss drugs can interact with alcohol, but a few don't. That's why you should check for alcohol and drug interactions with your healthcare provider each time you start a new medicine or supplement.

Weight loss medications, such as the amphetamine derivatives like phentermine work in the brain (also known as the central nervous system or CNS). Adding alcohol to weight loss medications can lead to side effects with both drugs.

The effects of adding alcohol to certain weight loss medications can include:

• dizziness
• mental depression
• problems with concentration, judgement or thinking
• drowsiness, sedation or altered mental alertness which can make driving or other hazardous activities dangerous
• serious heart side effects
• seizures
• liver toxicity
• changes in blood sugar levels

Heart disease

The use of CNS stimulant weight loss drugs should be avoided with the use of alcohol, especially in patients with heart disease. When these amphetamine-like drugs are combined with alcohol, dangerous cardiovascular (heart) side effects such as rapid heart rate, chest pain, and blood pressure changes can occur.

Many weight loss or obesity drugs are also controlled substances, have addictive potential and can be misused.

Diabetes

Alcohol may affect blood glucose (blood sugar) levels in patients with diabetes. In general, moderate alcohol consumption generally does not affect blood sugar levels if your diabetes is under control. You should avoid using alcohol if your diabetes is not well controlled. 

However, both hypoglycemia (low blood sugar) and hyperglycemia (high blood sugar) may occur, based on how much you drink and how often. Avoid drinking alcohol on an empty stomach or following exercise, as it may increase the risk of hypoglycemia.

• Symptoms of low blood sugar may include: headache, sweating, tremors, feeling jittery, weakness, rapid heartbeat, anxiety, hunger, dizziness, feeling faint, blurred vision, confusion, pins and needles feeling in the lips or hands, trouble speaking, changes in behavior, seizures, loss of consciousness, and coma.
• Symptoms of hyperglycemia can include: extreme thirst, dry mouth, weakness, headache, frequent urination, blurry vision, nausea, confusion, and shortness of breath. In some cases, you may not have any symptoms at all.

Many diabetes medications may lead to hypoglycemia as well, so it's best to ask your doctor about drinking any amount of alcohol if you have diabetes. 

Seizure risk

Drinking alcohol during treatment with bupropion and naltrexone (Contrave) should be minimized or avoided altogether due to reports of adverse nervous system and liver side effects. Contrave should not be used in patients undergoing an abrupt discontinuation of alcohol. Combining alcohol with bupropion or abruptly stopping alcohol use can increase the risk of a seizure.

If you frequently or excessively consume alcohol, discuss this with your doctor before starting treatment with bupropion and naltrexone (Contrave).

Liver toxicity

Liver toxicity may be increased if you combine alcohol with naltrexone (a component of Contrave).

Signs of liver toxicity can include fever, chills, skin rash, nausea, unusual bleeding or bruising, dark-colored urine, pale (clay-colored) stools, yellowing of the skin or eyes, or stomach-area pain.

Learn More: Guide to Weight Loss Drugs

Table 1: Common Weight Loss Drugs

^{*This is not a complete list; always check with your doctor or pharmacist for drug interactions.}

Do all weight loss drugs interact with alcohol?

No, not all weight loss drugs have drug interactions with alcohol. For example, orlistat (alli, Xenical) does not list alcohol drug interactions in their product labeling. alli is a weight-loss agent available over-the-counter, while Xenical is the prescription-strength version.

Wegovy and Zepbound do not list alcohol as a potential drug-drug interaction in the labeling, but if you have type 2 diabetes, the use of alcohol might further increase your risk for low blood sugar. Be sure you can recognize the signs and symptoms of both low and high blood sugar.

Zepbound and sleep apnea

In December 2024, Zepbound was approved by the FDA for the treatment of moderate-to-severe obstructive sleep apnea in adults with obesity. Although there is not a specific drug interaction, alcohol use may worsen sleep apnea by slowing down breathing, causing disrupted sleep, making it harder to wake up and contributing to weight gain.

Learn more: How does Zepbound help treat sleep apnea?

Always check for drug interactions with your pharmacist or doctor to determine if it's safe to combine alcohol with any medicine.

This is not all the information you need to know about the safety of weight loss drugs and alcohol use and does not take the place of your doctor’s directions. Review the full product information and discuss this information and any questions you have with your doctor or other health care provider.

Related: Drugs.com Drug Interaction Checker

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Further information

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

Medical Disclaimer

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