Alcohol and Allergy Medicine: To Mix or Not To Mix?

Alcohol and antihistamines can interact with each other and result in exacerbated side effects from the allergy medication. This can be life-threatening with antihistamines that cause drowsiness, and alcohol can also cause drowsiness. Other potential side effects include dizziness, headaches, and nausea when combining alcohol and allergy medications. To avoid experiencing these potentially dangerous side effects, alcohol consumption and taking allergy medications should not be mixed.

Common Allergy Medications

Allergy medications, also known as antihistamines, are taken to counteract allergy symptoms such as runny nose, itchy and watery eyes, sneezing, and hives.

Allergy medicines are categorized as [1]

First Generation:

• Benadryl (Diphenhydramine)
• Dramamine (Dimenhydrinate)
• Vistaril, Atarax (Hydroxyzine)

Second Generation:

• Claritin (Loratadine)
• Clarinex (Desloratadine)
• Xyxal (Levocetirizine)
• Zyrtec (Cetirizine)
• Allegra (Fexofenadine)

First-generation allergy medications typically have more side effects than second- or third-generation antihistamines. First-generation antihistamines cross the blood-brain barrier. [2]

They cause sedation, drowsiness, fatigue, impaired alertness, concentration, memory, and multitasking. As a result, they can impair learning and test performance in children and the safe operation of machinery and vehicles in adults. First-generation antihistamines should be avoided during pregnancy.

Second—and third-generation antihistamines are safer as they cause less drowsiness, are longer-acting, have fewer medication interactions, and have lower risks of overdose and death compared to first-generation antihistamines. [3]  However, taking Zyrtec and alcohol or mixing alcohol with any other allergy medication is not recommended.

Common Side Effects of Antihistamines

First-generation antihistamine side effects include: [4]

• Drowsiness
• Reduced coordination and reaction speed
• Dry mouth and dry eyes
• Blurred or double vision
• Dizziness
• Headaches
• Difficulty urinating and constipation
• Low blood pressure
• Mucous thickening in airways

Second and Third-Generation antihistamine side effects include: [5]

• Headaches
• Cough
• Sore throat
• Abdominal pain
• Nausea or vomiting
• Drowsiness, if taken in high doses

Antihistamine Overdose

The potential for overdose varies by medication, but first-generation antihistamines are more likely to result in overdose due to their sedative effects.

Antihistamine overdoses can happen if [6]

• You take too much antihistamine medication.
• You take antihistamine medication with another medication that is contraindicated.
• You take it with another medication or drug that is hypnotic or sedative (such as sleeping pills or alcohol).
• You are a child or over the age of sixty-five, which increases one’s risk for an accidental overdose.

Symptoms of antihistamine overdose include [7]

• Extreme drowsiness or sleepiness
• Hallucinations
• Agitation and irritability
• Blurred or double vision
• Fast heart rate
• Seizures

Antihistamine overdoses can be fatal. If you or a loved one has any of the above symptoms, call 911 and seek emergency medical attention immediately.

Alcohol and Allergy Medicine Interactions

Mixing Alcohol and allergy medications can cause significant side effects. The most common and potentially life-threatening is that of increased drowsiness. Antihistamine overdose symptoms can be worsened when taken with alcohol.

Drowsiness and Dizziness

First-generation antihistamines, such as Benadryl, are central nervous system (CNS) depressants, which is why they have side effects such as drowsiness, dizziness, and loss of coordination. Alcohol is also a central nervous system depressant with side effects of drowsiness, dizziness, and loss of coordination. Combining these two drugs can exacerbate their side effects and result in life-threatening symptoms.

While second and third-generation antihistamines are less likely to interact with alcohol, it can still happen. All antihistamines have the potential side effect of drowsiness, and that will be exacerbated if taken with alcohol. Headaches, nausea, and dizziness are also common side effects of all-generation antihistamines that can be worsened with alcohol.

Dehydration

Antihistamines can cause dehydration; alcohol is a diuretic, increasing urination and increasing the risk of dehydration. Once again, there can be a compounding effect that worsens a side effect, as both alcohol and antihistamines can result in dehydration. Dehydration symptoms include [8]

• Extreme thirst
• Less frequent urination
• Dark-colored urine
• Fatigue
• Dizziness
• Confusion

Mild to moderate dehydration can be treated at home by increasing water and electrolyte intake. Moderate to severe dehydration requires medical attention. It can become a life-threatening medical emergency.

Certain Demographics

Certain groups of people are more likely to have side effects and interactions with antihistamines and alcohol. These include

Females: Women’s bodies produce fewer enzymes that break down alcohol in the body. Women typically have higher body fat and lower body water levels (fat retains alcohol while water eliminates alcohol). This results in women having an increased physiological response to alcohol compared to men. [9] Adding in an antihistamine could result in an increased risk of experiencing adverse reactions with a smaller dose of alcohol.

Older Adults: For many people, as they age, their body’s tolerance for alcohol decreases.[10]

Older adults can feel the effects of alcohol more quickly than when they were younger. This can increase one’s risk for falls and vehicle accidents. Older adults are also more sensitive to antihistamines and experience their side effects more often. Combining alcohol and antihistamines as one age becomes more dangerous, as the body is more susceptible to side effects.

Awareness of the Dangers of Mixing Alcohol and Antihistamines

Antihistamines can be safe and effective when used as directed to treat allergy symptoms. They can have life-threatening results if taken in higher than recommended doses or when combined with alcohol or other drugs. Even moderate alcohol consumption is not safe. If you believe you or a loved one is misusing antihistamines and alcohol, talk with your healthcare provider and consider alcohol rehab. They can provide you with direction as to what treatment options are available. This could range from simply changing the antihistamine being taken to recommending a substance use treatment program.

Treatment programs can include detox, inpatient, or outpatient treatment. The goal is to find a program that meets your needs and supports you throughout your recovery process.

Over-the-counter medication misuse and alcohol misuse are two common issues. Talking about it with your loved ones and healthcare professionals is the first step towards improving your health and wellness.

Frequently Asked Questions About Alcohol And Allergy Medicine