There is a persistent myth that you can’t possibly drink alcohol if you are taking antibiotics so does this spread to non alcoholic and alcohol free ciders as well? Can you drink non alcoholic cider on antibiotics?
In this article i will be exploring the actual science behind the myth and hopefully let you enjoy some delicious non alcoholic and even alcoholic cider if you feel up to it, on your antibiotics.
Can you drink non alcoholic cider on antibiotics?
You can drink non alcoholic cider with most antibiotics and you can drink alcohol free cider with all antibiotics. There is a small subsection of antibiotics which you might choose to be more cautious of when considering drinking non alcoholic cider.
However the amount of alcohol in non alcoholic cider is similar to that found in many common foods, which you would not consider higher risk with antibiotics or any drugs.
Why can you not drink alcohol on some antibiotics?
The common myth is “you can’t drink any alcohol on antibiotics”. Where does this come from and is it actually true? What can happen to you if you drink alcohol on an antibiotic, what are the negative side effects?
The main thing you need to know about is… the disulfiram-like reaction. Now, what on earth is that?
Disulfiram-like reaction
This is the key reaction to think about and understand.
Disulfiram goes by the trade name Antabuse. To cut a long story short, it is designed to make you feel unwell when you drink alcohol so you therefore don’t drink alcohol!
Disulfiram causes a host of symptoms from nausea and vomiting to flushing, headache, abdominal pain and general hangover symptoms. You basically don’t feel well at all.
A disulfiram-like drug therefore, is one which mimics disulfiram itself due to its make up. When you drink alcohol with a disulfiram-like drug you get all the same symptoms. These are the antibiotics to avoid with alcohol in the main.
Which antibiotics cause a reaction with alcohol?
Ok, so which antibiotics are disulfiram-like and which others should be avoided for a different reason?
Metronidazole (Flagyl)
Disulfiram-like antibiotic. You should definitely avoid alcohol when taking this antibiotic
Tinidazole (Tindamax)
Disulfiram-like antibiotic. You should definitely avoid alcohol when taking this antibiotic
Disulfiram-like antibiotic. You should definitely avoid alcohol when taking this antibiotic
Sulfamethoxazole and trimethoprim (Bactrim)
Disulfiram-like antibiotic. You should definitely avoid alcohol when taking this antibiotic
Linezolid (Zyvox)
Can cause a hypertensive (high blood pressure) crisis. You should avoid beer containing lots of tyramine, like tap beer.
Doxycycline (Acticlate, Doryx, Vibramycin)
If you are a chronic drinker, doxycycline levels might not get up to where you want them. There is the possibility you could need a higher dose if drinking lots of alcohol.
Rifampin (Rifadin)
Rifampin can combine with alcohol to cause liver damage. The recommendation is not to drink any alcohol with rifampin
Iisoniazid (Nydrazid)
Can combine with alcohol to cause liver issues. You should avoid alcohol whilst taking it.
Disulfiram-like antibiotic. You should definitely avoid alcohol when taking this antibiotic
Cycloserine (Seromycin)
Combined with alcohol can cause nasty central nervous system issues from drowsiness to seizure. You should avoid alcohol whilst taking it
Erythromycin ethylsuccinate (E.E.S.)
Alcohol can cause erythromycin to stay in the stomach longer meaning less is absorbed and it is less effective. You should avoid alcohol when taking this medication.
Nifurtimox (Lampit)
Disulfiram-like antibiotic. You should definitely avoid alcohol when taking this antibiotic
Which antibiotics don’t cause a reaction with alcohol?
If you exclude the above antibiotics, that leaves the vast majority which should not have any interaction with alcohol in moderation.
The would mean nearly all the common antibiotics you would be on for chest, urine, kidney or skin infections would be fine to take with alcohol.
This would include the penicillins such as amoxicillin, benzylpenicillin or flucloxacillin.
Is there a difference between alcohol free cider and non alcoholic cider?
There are many differences between non alcoholic and alcohol free cider, i explore a lot of the brewing and PR differences here (article is based on beer). However, the chief difference is in how much alcohol they contain.
Unfortunately the labels on “non alcoholic cider” can be confusing.
“Non alcoholic cider” is used as a generic term for all 0.0-0.5% ABV beers but it should be specifically applied to ciders with an ABV 0.05-0.5%. Alcohol free ciders therefore have an ABV of <0.05%. In many countries the labelling laws state this must be the case but not in all jurisdictions, like the EU for example.
For a full overview of the labelling of non alcoholic and alcohol free ciders, you can read my dedicated article on it here.
For the remainder of this article…
Non alcoholic cider is cider with an ABV of 0.05%-0.5%
Alcohol free cider is cider with an ABV of <0.05%
Can you drink alcohol free beer on antibiotics?
By definition, alcohol free ciders will have no alcohol (except possibly a tiny trace amount).
This means that alcohol free ciders can be drank both with the majority of antibiotics which do not react with alcohol and the select few which do cause a reaction with alcohol.
Can you drink non alcoholic beer on antibiotics?
Non alcoholic ciders can be slightly more tricky to consider. They can have up to 0.5% alcohol by volume so not much but a bit more than a negligible trace.
I have compared the alcohol in non alcoholic ciders to many common foods here. Fruit juices can have more alcohol than a non alcoholic beer and even some breads can. In general, you would not worry about eating and drinking these foods on antibiotics.
You can certainly drink non alcoholic ciders on the vast majority of antibiotics, as they cause no reaction with alcohol. The only ones i would be slightly cautious of are the disulfiram-like antibiotics. If you wanted to be cautious, i would avoid non alcoholic beers when taking these type of antibiotics.
Can you drink non alcoholic beer on metronidazole (flagyl)?
Metronidazole (Flagyl) is probably the main antibiotic you will be prescribed which has a strong interaction with alcohol so i it worth just reiterating it.
Non alcoholic cider has the same alcohol content as orange juice, if not less and you would not be worried about drinking that on Flagyl but to be cautious and avoid any possible reaction, i would avoid non alcoholic cider when taking Flagy.
You can drink alcohol free beer with an ABV of 0.0% without risk of reaction.
