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Metronidazole + Alcohol: how much is too much?

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    I'm on Metronidazole and they say to avoid alcohol at all costs, which does sounds quite menacing. Where is the line though? Is it any amount; none at all?

    I'm not going to drink any alcohol 'cause I don't want to get ill, obviously. As the title says though, how much is too much?

    If I had one unit I can imagine that'd make me ill; earlier I was going to have a risotto but it has white wine in the sauce, or stroganoff, which has brandy in the sauce but didn't 'cause I didn't want to risk it.
    Is it silly to avoid the small amounts that'd be in the sauces? Or would they still have an effect?

    It's just they say "avoid any alcohol" so I didn't want to take any chances.
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    right well basically metronidazole is a precursor (innactivated) form of a very toxic drug. The way it detects bacteria is by relying of the fact that the bacteria metronidazole are good at killing are anaerobes (dont use oxygen - good example is plain h. pylori (stomach ulcer bacterium)). Normally this is great because our cells use oxygen (are aerobic) so the bacteria are targeted and destroyed. If you drink even a modest amount of alcohol this will cause some of your cells to start respiring anaerobically - just a thing alcohol does. This means the antibiotic will target your cells too and kill them. End result you get very sick. Ive been told the effects are somewhat similar to those of people taking antabuse - basically drinking anything will make you feel nausious and potentially be sick.

    I would avoid drinking any alcohol whilst on the drug, though the amount present in sauces is likely to be so negligible that youre probably not going to notice the effects.

    *antabuse is a drug given to alcoholics to make them avoid drinking alcohol due to the unpleasant effects.
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    I was on these antibiotics and i got told the same. My sister whos a nurse told me to avoid all alcohol because it'll make you violently ill. Her friend got put on these tablets a week or so ago and she got told the same. If i was you just stay clear of like alcoholic drinks and stuff with a substancial amount of alcohol in. I'm not sure if food with alcohol in the sauce would have the same reaction but maybe stay clear of them just until you finish the course? Hope you're feeling better soon =) x
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    Yeh, No alcohol at all, I've heard Met stories about people getting sick off of their alcohol containing mouthwash. I would suggest no alcohol at all, not even a sip.

    When you've finished, go nuts
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    Thanks for the replies guys. So I better be careful with what I eat and drink.. I'll start checking all labels from now on... Luckily it's only a week long course of the antibiotics so I'll be able to do whatever as of next Friday (48 hours after taking the last tablet). How would the mouth wash work? I know it contains alcohol but you don't swallow it so just absorption through the gums? If that's the case, that's quite worrying.
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    Might be exaggerated for effect, but only tiny amounts are needed to be swallowed a for the sickness to start!
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    I was on Metronidazole for my gums once, but the dentist forgot to tell me that drinking alcohol would cause me great pain whilst on it...

    Long story short; take it from me, do not do it, at all!
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    (Original post by martin101)
    right well basically metronidazole is a precursor (innactivated) form of a very toxic drug. The way it detects bacteria is by relying of the fact that the bacteria metronidazole are good at killing are anaerobes (dont use oxygen - good example is plain h. pylori (stomach ulcer bacterium)). Normally this is great because our cells use oxygen (are aerobic) so the bacteria are targeted and destroyed. If you drink even a modest amount of alcohol this will cause some of your cells to start respiring anaerobically - just a thing alcohol does. This means the antibiotic will target your cells too and kill them. End result you get very sick. Ive been told the effects are somewhat similar to those of people taking antabuse - basically drinking anything will make you feel nausious and potentially be sick.

    I would avoid drinking any alcohol whilst on the drug, though the amount present in sauces is likely to be so negligible that youre probably not going to notice the effects.

    *antabuse is a drug given to alcoholics to make them avoid drinking alcohol due to the unpleasant effects.
    So just out of interest, if it's about anaerobic cells that are destroyed by the drug, does that mean strenuous exercise would have the same effect? If someone on Metronidazole went for a sprint or a run, they'd get just as ill?
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    (Original post by helraizer)
    So just out of interest, if it's about anaerobic cells that are destroyed by the drug, does that mean strenuous exercise would have the same effect? If someone on Metronidazole went for a sprint or a run, they'd get just as ill?
    An interesting point. I would rather hesitantly say no. If you exercise to your anaerobic threshold your still going to get some aerobic respiration going on. The anaerobic component is due to the hypoxia in the tissues due to higher demand and not enough supply, as opposed to actively inhibiting aerobic respiration as occurs with alcohol intake. I may well be wrong, its been a while since I did biochem!
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    (Original post by martin101)
    An interesting point. I would rather hesitantly say no. If you exercise to your anaerobic threshold your still going to get some aerobic respiration going on. The anaerobic component is due to the hypoxia in the tissues due to higher demand and not enough supply, as opposed to actively inhibiting aerobic respiration as occurs with alcohol intake. I may well be wrong, its been a while since I did biochem!
    I thought Metronidazole reacted with alcohol because it inhibited alcohol dehydrogenase like Disulfuram does so that alcohol rapidly accumulates and causes the sickness.
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    (Original post by dob86)
    I thought Metronidazole reacted with alcohol because it inhibited alcohol dehydrogenase like Disulfuram does so that alcohol rapidly accumulates and causes the sickness.
    That would make a lot more sense because otherwise you'd get sick from anaerobic exercise.. Which if you're unfit (luckily I'm not too unfit) could be running up the stairs.
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    (Original post by dob86)
    I thought Metronidazole reacted with alcohol because it inhibited alcohol dehydrogenase like Disulfuram does so that alcohol rapidly accumulates and causes the sickness.
    I'm not sure how that can be right, otherwise it wouldn't cause you to be sick until you'd had at least a couple of pints.
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    (Original post by Renal)
    I'm not sure how that can be right, otherwise it wouldn't cause you to be sick until you'd had at least a couple of pints.
    I think it's acetealdehyde dehydrogenase that is blocked and not Alcohol Dehydrogenase. As Acetealdehyde is a lot more toxic than alcohol, only a small amount is need for toxic effects.
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    Metronidazole is prescibed far too readily as a "cure all",especially by dentists. Its a potent drug which disrupts the lives of the majority of users to some extent from mild stomach upsets to fainting,fits and commonly nausea. Using alcohol with the drug is always going to lead to problems.Interestingly in some countries Metronidazole is rarely prescribed except as a 'last resort' and certainly not for abcess or gum diseases.The thing is it is very cheap to produce so the drug companies push it.It does the job but you have to accept a week or more of feeling absolutely crap.
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    (Original post by agosant)
    Metronidazole is prescibed far too readily as a "cure all",especially by dentists. Its a potent drug which disrupts the lives of the majority of users to some extent from mild stomach upsets to fainting,fits and commonly nausea. Using alcohol with the drug is always going to lead to problems.Interestingly in some countries Metronidazole is rarely prescribed except as a 'last resort' and certainly not for abcess or gum diseases.The thing is it is very cheap to produce so the drug companies push it.It does the job but you have to accept a week or more of feeling absolutely crap.
    metronidazole is the best antibiotics for dental infections and GI infections.
    thats why it is prescribed.

    if you are such a boozer as to not be able to go teetotal for your medical treatment then you aught to tell the doctor/dentist.
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    It may very well be that these anti-biotics have a similar effect to Antibuse, in which case even the slightest bit of alcohol will make you feel very very ill. This has happened to me before. I had about half a pint and suddenly passed out/was vomiting/felt i couldnt breathe. As much of a pain as it is these warnings are there for a reason
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    Jamie it's not about being a 'boozer'. It's about the fact that it is a dangerous drug! I've been on Metronidazole twice now for a dental infection and for helicobacter Pylori (which I'm currently still taking it for). I've felt nauseous all week. I've also had other side effects which I should probably stop taking the drug for but I'm desperate to get rid of the h.Pylori which has been plaguing me for 4 years now. So don't get up on your high horse and accuse people of being boozers! Although this was the reason which I was researching this as I am going out on Saturday night (I couldn't rememer how long you had to be off it -doctor should've told me though -it isn't even in the PIL!) but I'll have to stick to the diet coke! (Suppose I probably should've hoked out my BNF but it's under the stairs and I couldn't be arsed!) If you've ever been on this drug you would understand! I feel so sick right now!
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    I've been on metronidazole twice in the last two months, for a week each time, and count myself fortunate in that I've had no real side effects (except perhaps a slight dryness of the mouth). I was also scrupulous in avoiding any alcoholic drink or any foodstuff or product with alcohol in. However I'm still anxious to know how the minimum safe interval between taking the last dose and ingesting any alcohol. It's just that I'm rather partial to the Italian dessert tiramisu, which has wine among its ingredients. As well as being insatiably curious about the physiology and biochemistry involved in the drug interaction.
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    (Original post by Goonakampf)
    I've been on metronidazole twice in the last two months, for a week each time, and count myself fortunate in that I've had no real side effects (except perhaps a slight dryness of the mouth). I was also scrupulous in avoiding any alcoholic drink or any foodstuff or product with alcohol in. However I'm still anxious to know how the minimum safe interval between taking the last dose and ingesting any alcohol. It's just that I'm rather partial to the Italian dessert tiramisu, which has wine among its ingredients. As well as being insatiably curious about the physiology and biochemistry involved in the drug interaction.
    The half life is about 7 hours, provided your liver function is normal it should be metabolised or excreted within 2 days.

    Met has interesting pharamacokinetics; roughly a third of it is metabolised to a hydroxyl compound in the liver and excreted through the kidneys, a third of it is filtered out at the kidneys direct and nobody really knows what happens to the rest.

    http://www.medsafe.govt.nz/profs/dat...agyltabsus.htm
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    Your all a big bunch of student f@nnies, I'm on Metronidazole for a gum infection and I went out last night and got so drunk I don't even remember going home, at no point in the evening did I get ANY of your supposed side effects and I felt so fine this morning I made it to my work (unlike some others!!!) so stuff your advice up your @rse because you CAN drink alcohol with these tablets, in any quantity you like!
Updated: March 14, 2010
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