The New Complete Book of Food
Disulfiram (Antabuse). Taken with alcohol, disulfiram causes flushing, nausea, low blood
pressure, faintness, respiratory problems, and confusion. The severity of the reaction gener-
ally depends on how much alcohol you drink, how much disulfiram is in your body, and
how long ago you took it. Disulfiram is used to help recovering alcoholics avoid alcohol. (If
taken with alcohol, metronidazole [Flagyl], procarbazine [Matulane], quinacrine [Atabrine],
chlorpropamide (Diabinase), and some species of mushrooms may produce a mild disulfi-
ramlike reaction.)
Anticoagulants. Alcohol slows the body’s metabolism of anticoagulants (blood thinners)
such as warfarin (Coumadin), intensifying the effect of the drugs and increasing the risk of
side effects such as spontaneous nosebleeds.
Antidepressants. Alcohol may increase the sedative effects of antidepressants. Drinking
alcohol while you are taking a monoamine oxidase (MAO) inhibitor is especially hazard-
ous. MAO inhibitors inactivate naturally occurring enzymes in your body that metabolize
tyramine, a substance found in many fermented or aged foods. Tyramine constricts blood
vessels and increases blood pressure. If you eat a food containing tyramine while you are
taking an MAO inhibitor, you cannot effectively eliminate the tyramine from your body.
The result may be a hypertensive crisis. Ordinarily, fermentation of beer and ale does not
produce tyramine, but some patients have reported tyramine reactions after drinking some
imported beers. Beer and ale are usually prohibited to those using MAO inhibitors.
Aspirin, ibuprofen, ketoprofen, naproxen, and nonsteroidal anti-inflammatory drugs. Like
alcohol, these analgesics irritate the lining of the stomach and may cause gastric bleeding.
Combining the two intensifies the effect.
Insulin and oral hypoglycemics. Alcohol lowers blood sugar and interferes with the metabo-
lism of oral antidiabetics; the combination may cause severe hypoglycemia.
Sedatives and other central nervous system depressants (tranquilizers, sleeping pills, antidepres-
sants, sinus and cold remedies, analgesics, and medication for motion sickness). Alcohol inten-
sifies sedation and, depending on the dose, may cause drowsiness, respiratory depression,
coma, or death.