Sunni, this warning is used as a precaution but some people can stomach some, whist others can't.  I used to be in the same room as the stuff every night when I was on a pulse without sicking up and eventually I braved a bit and got the same result..........Sarah

The difference between what we do and what we are capable of doing would suffice to solve most of the world’s problems. Mohandas Gandhi

Thats what I found : 

Lack of disulfiram-like reaction with metronidazole and ethanol

 BACKGROUND: Metronidazole, an effective antianaerobic agent, has been reported to have aversive properties when ingested with ethanol. This is thought to be due to the blocking of hepatic aldehyde dehydrogenase (ALDH) enzyme followed by the accumulation of acetaldehyde in the blood. However, based on animal studies and on only 10 human case reports, the existence of metronidazole-related disulfiram-like reaction has recently been questioned. OBJECTIVE: To investigate the possible disulfiram-like properties of metronidazole and ethanol in human volunteers. METHODS: Of 12 healthy male volunteers in this double-blind study, one-half received metronidazole for 5 days and the other half received placebo. All volunteers received ethanol 0.4 g/kg at the beginning of the study. Repeated blood samples were taken every 20 minutes for 4 hours, and blood acetaldehyde and ethanol concentrations were determined. Blood pressure, heart rate, and skin temperature were also measured every 20 minutes for objective signs of a possible disulfiram-like reaction. Volunteers also completed a questionnaire focusing on the subjective signs of disulfiram-like reaction. RESULTS: Metronidazole did not raise blood acetaldehyde or have any objective or subjective adverse effects when used together with ethanol. CONCLUSIONS: This study shows that metronidazole does not have an effect on blood acetaldehyde concentrations when ingested with ethanol and does not have any objective or subjective disulfiram-like properties. However, it is possible that disulfiram-like reaction can occur in some subgroups and by other mechanisms than the inhibition of hepatic ALDH.

None of the participants noted any dyspnea, flushing, vertigo, or headache during the test. Interestingly, the heart rates for the metronidazole group tended to be about 10bpm lower than the control group throughout the test. I don’t know that this is clinically significant, but it is interesting:

Final thoughts (Back to top)

So we’ve got some age-old advice that doesn’t stand up when tested properly, and we have a proposed mechanism of action that doesn’t hold up to closer scrutiny, either. Where does that leave us?

It leaves us with a couple things… Some people experience GI distress while on Flagyl. Sometimes they vomit. Sometimes they drink alcohol and vomit. Sometimes they drink alcohol and don’t vomit. That tells us that:

1. Flagyl is hard on the stomach. It’s a difficult medication to tolerate for a good percentage of folks, regardless of its effect on blood acetaldehyde levels.
2. Flagyl is not a disulfiram-like drug, and should not be referred to as such.
3. Flagyl will not absolutely cause the vomiting associated with Antabuse when consumed in conjunction with alcohol. Pharmacists should stop counseling that it will.
4. Adverse events are too often attributed to metronidazole because it is convenient, and “everyone knows” that alcohol and Flagyl are a recipe for disaster.
5. Flagyl remains an unpleasant drug to take; its side effects are real and often severe, and should not be downplayed.
6. Patients should be educated about these side effects, and how to minimize them. Avoiding alcohol is one way to do this. Taking it with food is probably more effective. Doing both is obviously better than doing just one of the two.

It is my suspicion that early researchers thought there was a link between metronidazole and alcoholism due to the medication’s side effects. Taste perversion. Smell perversion. These things will cause folks to avoid certain foods for the duration of the drug therapy. Alcohol is one of those things. It’s coincidental, and its usefulness in the real world is questionable.

Male 35 (Hamburg-Germany),CFIDSⁱ, IBSⁱ, Enterovirus, Cpnⁱ,treated Enterovirus with Inf-y,Inf-a.,Ribavirin. Started Wheldon Capⁱ on 02/19/08, Currently NACⁱ 2400, Doxyⁱ 2x100, Biaxin 2x500, Metro pulses,pyr

Cesare, your point 5: a couple of people who have finished their treatment have reported that they no longer had any unpleasant reactions to Flagylⁱ.

I suggest (very inexpertly) that unpleasantness from this drug is as a result of its action on Cpnⁱ. As many people are infected with Cpn without knowing it, it might easily be surmised I suppose that Flagyl is causing the unpleasantness.

Sarah was the first to report no ill effects with a glass of wine, but I heeded my pharmacist and all the warnings on the labels. Then, by accident, I forgot I was on flagylⁱ and had two mixed drinks at dinner one night. No problems. Did it again a couple of months later with red wine. No problem.

I think this may be one of those warnings that's there because some people have had trouble mixing the two, but by no means does it happen to everyone. If you feel the need to experiment, you might want to test it at home, near the bathroom?