Antibiotics and Alcohol: Which Ones Really Don't Mix
Medically Reviewed by Dr. Pedro Yelamo Vera, MD
Licensed Physician No. 484814280 · Official Medical College of Bizkaia (Spain)Last reviewed: 31 October 2026
Antibiotics and alcohol: which ones never mix (metronidazole, linezolid), how long to wait after, and when a drink is unlikely to matter.
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Dr. Pedro Yelamo Vera is an independent, bilingual GP licensed in Spain. Book a 15-minute video consultation in English or Spanish for €50, with a private electronic prescription issued under Spanish law when clinically appropriate.
With most antibiotics, such as amoxicillin, a small amount of alcohol is unlikely to cause harm, says the NHS. A few antibiotics do not mix with alcohol at all. Metronidazole and tinidazole can cause a nasty reaction with any drink. Linezolid reacts with tap beer and wine. Heavy drinking can make doxycycline work less well. If you are not sure, ask before you drink.
- Most common antibiotics and a moderate drink do not clash, but alcohol can slow your recovery.
- Metronidazole (Flagyl in Spain) and tinidazole: no alcohol at all, during the course and for a while after.
- Linezolid: avoid tap beer and wine, which can raise blood pressure.
- Doxycycline: best to avoid alcohol. Co-trimoxazole: sources differ, so ask.
- Hidden alcohol counts too: some mouthwashes, cough syrups and cold medicines.
Dr. Pedro Yelamo Vera is a GP licensed in Spain (Colegiado No. 484814280).
For a medical emergency, call 112 or go to the nearest local emergency department. Do not wait for a video consultation or an online reply.
Can you drink alcohol while taking antibiotics?
Usually a little is fine, but it is rarely a good idea. The NHS says moderate drinking is unlikely to cause problems with the most common antibiotics. It also says it is a good idea to avoid alcohol when you take medicine or feel unwell.
There are two reasons. First, antibiotics and alcohol share some side effects. Mayo Clinic lists upset stomach, dizziness and drowsiness. Together, they can feel worse. Second, alcohol can lower your energy and slow your recovery from the infection.
So the plain answer is this. With amoxicillin, a glass of wine with dinner is unlikely to hurt. But you will probably get better sooner without it.
Which antibiotics should never be mixed with alcohol?
A short list of antibiotics needs real care. The names in brackets are ones you may see in Spain, the UK or the US.
| Antibiotic | What to do | Why |
|---|---|---|
| Metronidazole (Flagyl in Spain and the US) | No alcohol during the course and for a time after | Can cause sickness, flushing and a racing heart |
| Tinidazole (Tricolam in Spain, Tindamax in the US) | No alcohol during the course and for 72 hours after (NHS) | Same reaction as metronidazole |
| Linezolid (Zyvoxid in Spain) | Avoid tap beer and wine | Can raise blood pressure |
| Doxycycline | Best to avoid alcohol | May work less well in heavy drinkers |
| Co-trimoxazole (Septrin in Spain and the UK, Bactrim in the US) | Safest to avoid alcohol; ask your doctor | Mayo Clinic says no alcohol at all; the NHS and the Spanish leaflet do not mention it |
In Spain, tinidazole is sold on prescription as Tricolam tablets, according to the AEMPS CIMA database. The same alcohol rule applies whatever the brand.
How long after metronidazole can I drink alcohol?
This is where the sources differ, so it is worth knowing all three.
- The Spanish Flagyl leaflet says no alcohol during treatment and for at least one day after it.
- The NHS says to wait 48 hours after the last dose.
- MedlinePlus says to wait at least three days.
The waiting time gives the medicine time to leave your body. If you want the safest choice, wait the longest of the three. Your doctor can tell you what fits your case.
It is not only tablets. Metronidazole also comes as a vaginal gel and, in Spain, as vaginal tablets. The NHS says the vaginal gel can sometimes cause the same reaction. A skin cream or gel is less likely to, as very little gets into the body.
What does the reaction feel like?
The NHS lists these effects when alcohol meets metronidazole or tinidazole:
- Feeling sick or being sick.
- Stomach pain.
- Hot flushes.
- A fast or irregular heartbeat.
- Headache, dizziness or drowsiness.
The Spanish leaflet calls it the efecto Antabus, after a medicine used to help people stop drinking. If it happens, stop drinking and drink water. See a doctor today if you keep being sick, if you cannot keep your antibiotic down, or if your heartbeat does not settle.
Call 112 if you have chest pain, faint, or struggle to breathe. Also call 112 if your face, lips or throat swell after a dose, as that can be an allergy.
What about linezolid, beer and wine?
Linezolid is a strong antibiotic, often started in hospital. The Spanish Zyvoxid leaflet says to avoid large amounts of cheese, yeast extract and soy extract. It also says to avoid alcohol, especially tap beer and wine. These contain a substance called tyramine. With linezolid, tyramine can raise your blood pressure.
Where can alcohol hide?
If your antibiotic must not meet alcohol, check other products too. Mayo Clinic warns that some cold medicines and mouthwashes contain alcohol. MedlinePlus adds products with propylene glycol for metronidazole. In Spain, look for etanol or alcohol in the list of ingredients in the leaflet. Your pharmacist can check for you.
On antibiotics and not sure what is safe?
You can book a video visit with a GP licensed in Spain, in English or Spanish. He checks your infection, your medicines and what you can safely eat and drink.
Does alcohol stop antibiotics working?
For most antibiotics, no. Mayo Clinic says modest drinking does not affect most of them. The main exception is doxycycline. The NHS says alcohol can affect it, and it may work less well in people with a history of heavy drinking.
Even so, your body fights the infection, not just the pill. Rest, fluids and sleep help. Alcohol works against all three.
Should you skip a dose to have a drink?
No. Do not skip a dose, or stop early, to make room for a night out. Take the antibiotic as your prescription and leaflet say. If a wedding or a holiday falls during the course, tell your doctor. Sometimes another antibiotic fits better, but only your doctor can decide that.
Talking it through with a doctor by video
Dr. Yelamo is a GP licensed in Spain. He sees adults, children and pregnant patients by video, every day from 07:30 to 20:30 (Spain time). In the visit he will:
- Ask about your infection and how you feel now.
- Check which antibiotic you take and your other medicines.
- Explain whether alcohol is safe with it, and for how long to wait.
- Tell you which signs mean you need to be seen in person.
He does not promise any test or prescription before the visit. Where clinically appropriate, following a genuine evaluation. Treatment and prescriptions are issued solely at the doctor's discretion based on evidence-based clinical guidelines.
A prescription is never guaranteed: it is issued only where clinically appropriate after a genuine evaluation, as a private electronic prescription under Spanish law. This service is for urgent, non-emergency care. In an emergency, call 112.
See how the Urgent Care video visit works. It lasts 15 minutes and costs €50.
This guide is general information. It does not replace the package leaflet or the advice of your doctor or pharmacist.
Frequently asked questions
Can I have one drink with amoxicillin?
The NHS says moderate drinking is unlikely to cause problems with the most common antibiotics, such as amoxicillin. Still, alcohol can add to nausea and tiredness, so it is wiser to wait until you feel well.
How long after metronidazole can I drink alcohol?
Sources differ. The Spanish Flagyl leaflet says at least one day after the last dose, the NHS says 48 hours and MedlinePlus says at least three days. If in doubt, wait the longest time or ask your doctor.
What happens if you drink on metronidazole?
You may feel or be sick, get stomach pain, hot flushes, a fast or irregular heartbeat, a headache, dizziness or drowsiness. The Spanish leaflet calls this the Antabus effect.
Is tinidazole sold in Spain?
Yes. The AEMPS CIMA database lists it as Tricolam tablets, which need a prescription. The NHS says to avoid alcohol during the course and for 72 hours after it.
Can I drink alcohol with doxycycline?
It is best to avoid it. The NHS says alcohol can affect doxycycline, and it may work less well in people with a history of heavy drinking.
Does alcohol stop antibiotics working?
For most antibiotics, moderate drinking does not change how they work, says Mayo Clinic. But alcohol can sap your energy and slow your recovery, and doxycycline is an exception.
Should I skip a dose so I can drink at a party?
No. Do not skip or stop an antibiotic to make room for a drink. Take it as your prescription says, and ask your doctor or pharmacist if you are unsure.
Sources
- NHS: Taking antibiotics with other medicines and alcohol
- Mayo Clinic: Is it harmful to drink alcohol while taking antibiotics?
- MedlinePlus: Metronidazole
- AEMPS CIMA: Flagyl package leaflet (Spanish)
- AEMPS CIMA: Zyvoxid package leaflet (Spanish)
Related guides
Medical Citations & Sources
This content is written and reviewed by a licensed physician with reference to the following official health authorities.
