Flagyl and Alcohol

I'm supposed to start a pulse of flagyli this week. The pharmacist told me absolutely do NOT take even the tiniest bit of alcohol with flagyl or I'll spend the day with my head in the toilet.

Yikes!

Is it really that bad? How careful do you have to be? Will the alcohol in a homeopathic remedy or cough syrup be enough to trigger a bout of nausea? He made it sound like I shouldn't even be in the same room the stuff. lol

 How many days after your last flagyl dose do you have to wait before you can get near alcohol again?

 Yes, it is that bad and worse. I was given flagyl in hospital and the nurse was giving me mouthwash to brush my teeth with. I got really really sick... buckets and buckets and buckets worth of sick.

Definatly no alcohol based homeopathics or caugh meds, no mouthwash, aftershaves, perfumes, beware of all of it trust me even a tiny exposure can cause  nausea. I even avoid the hand sanitizers in hospitals etc. Effects of minute amopunts of alcohol on flagyl can be so subtle its often hard to connect the causitive item to the reaction. Ive even been suspicious of my shampoo on ocassion.

I usually wait as long as possible, usually after about  3-4 days I stop being overly paranoid but who knows how long it takes to leave the system.. Im really not sure, maybe depends on the person.

 

CPNi pcri and antibody positive , treating MSi, CFSi, TMJ, trigeminal neuralgia, IBS neutropeniai, pus found in facial bone, Doxy 100x2, zithro 250x1 alternate days. Metroi pulses each month.

 

 

 

 

 

&nbs

 

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

An Itinerary in Light and Shadow...........Completed Stratton/Wheldon regime for aggressive secondary progressive MSi in June 2007, after nearly four years, three of which intermittent.   Still slowly improving and no exacerbation since starting. EDSSi was 7, now 2, less on a good day.

Completed Stratton/Wheldon regime for aggressive secondary progressive MSi in June 2007, after four years, three of which intermittent.   Still improving bit by bit and no relapses since finishing treatment.

I think it depends on the person and whether one is used to drink alcohol on a regular basis. I avoid alcohol while taking Flagyli but happily and without problems have my usual glass of wine after the last day of the pulse. I don't think external use of alcohol containing stuff like deos, shampoos etc has any influence whatsoever.

 Daniela

Cpni diagnosed. Monotherapy Feb08 - April 08. Then full Wheldon protocol. Feb.09 first steps toward intermittent. NACi, Vit D 2000IU, B complex

Supposedly, flagyli acts like Antabuse and causes one to become sick if alcohol is ingested while taking it. Well, by accident, because I simply forgot I was taking flagyl, I had a drink at dinner during one of my first pulses. I've done it several times since and have NEVER had a problem with a glass of wine or one drink while taking flagyl. Like Sarah, no 'sicking up'. I think it, like so many things we've discovered here, depends on the individual.

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

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

I don't drink starting 24 hours before a pulse until at least 24 hours after a pulse just to be sure.  I'm scared enough of ending up "praying to porcelain" that I wouldn't even join in the toast to a successfully completed project recently - everyone on the team just assumed I'm a recovering alcoholic.  Even so, the alcohol in sauces or liquid medications has never bothered me.  People are different so to know for sure you either have to take the risk or scrupulously avoid it altogether.

CAPi for M.S. since 8/2007. Currently: 100 mg Dox. (2 x day), 250 mg Zithi (3 x week) ceased 3/2008, restarted 5/2008, 150 mg Roxi (2 x day) starting 3/2008, ended 5/2008. Ninth pulse metronidazolei completed 6/7/2008.

CAPi for M.S. 8/2007 - 3/2009.  Twentieth pulse metronidazolei + INHi completed 3/12/2009.  Intermittent treatment thereafter until 11/20/2009.  

Thats what I found : 

 

Lack of disulfiram-like reaction with metronidazolei 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.

Blood ethanol concentrations during metronidazole therapy

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:

Blood ethanol concentrations during metronidazole therapy

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

Male 38 years (Germany),CFIDSi, IBSi, Enterovirus, Cpni and Bartonella, Dientamoeba fragilis positive. Started Capi on 02/19/08, Currently taking Bactrim, Flagyli, soon adding Malarone and Clindamycin for suspected protozooa. 

yes, i am pretty cautious with flagyli and alcohol - which is very inconvenient as i often have a real craving at the start of pulse.......aaarghhh! 

M.E./CFSi 20 years, intermittent.  Wheldon Protocol - Started NACi and supplementsi Sept 2007. Doxyi and Roxy full dose by Dec '07.  First Flagyl pulse January 2008.

M.E./CFSi 20 years, intermittent.  Wheldon Protocol - Started NACi and supplementsi Sept 2007. Doxyi and Roxy full dose by Dec '07.  First Flagyli pulse January 2008.  Changed to Tinii in December 2008.  Stopped CAPi in February 2009 at pulse 16.

I was reading comments on askapatient.com and it seems nearly everyone gets nauseated on this stuff even without going near alcohol. Sounds like good times ahead.

Bear in mind, no one who has little reaction to flagyl is posting, because they have no complaints about it. So, a thousand people might take it and ten might post with their complaints. That doesn't mean everyone has trouble with it; it means ten did and nine hundred ninety didn't, but nine hundred ninety had nothing to post about, so they didn't. Sites like that are skewed from the beginning, to reflect the most negative of responses.

 

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

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.

Michèle (UK) GFAi: Wheldon CAPi 1st May 2006. Daily Doxyi, Azi MWF, metroi pulse.

Hi Michele! It was not my own post . Just something I found on google on the interactions off flagyl with alcohol.
By the way I don t drink also alcohol while on flagyl. I m scared of unpleasent side effects....

Male 38 years (Germany),CFIDSi, IBSi, Enterovirus, Cpni and Bartonella, Dientamoeba fragilis positive. Started Capi on 02/19/08, Currently taking Bactrim, Flagyli, soon adding Malarone and Clindamycin for suspected protozooa. 
I've been on Flagyli for two months now. I referred to this site before going out tonight. Regardless I had 1 litre (1.5 bottles) of wine with no ill effects. Enjoy !
I haven't taken it, but I know about the complaint ......Smile

In pursuit of ABX

Don't Allow What You Know To Get In The Way Of What Might Be

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?

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

The only thing that would make me "sick up" (to please Mac) was taking doxyi on an empty stomach then not sitting still for half an hour.  David as a microbiologist, says it is a warning given to cover all eventualities: some people can and some can't.  He always could, so, not wanting to miss out, after a while I thought I would try............Sarah

An Itinerary in Light and Shadow

Completed Stratton/Wheldon regime for aggressive secondary progressive MSi in June 2007, after four years, three of which intermittent.   Still improving bit by bit and no relapses since finishing treatment.
All I can say is that I stay away from it for at least three days after a pulse. I had a drink 24 hours after finishing a pulse (celebrating mom's birthday) The next morning I was sicking up and had the runs. Pepto Bismol did help but now I will not risk it. Better to wait a few days. Raven

Feeling 98% well-going for 100. Very low test for Cpni. CAPi since 8-05 for Cpn/Mycoplasma P.,Lyme, Bartonella, Mold exposure,NACi,BHRT, MethyB12 FIRi Sauna. 1-18-11 begin new treatment plan with naturopath

It would be interesting if Jim or Mac could set up a survey and see how many people here get a reaction to alcohol when pusling with flagyli and how many people do not.  My impression is that more people do then don't, but I have nothing but my impression to go on and I would be interested in actual data.  And by the way, it makes me sicker then a dog, lol!

edit:  I just went up the thread and saw some data posted from a study but would be interested in what people here see too

best, John

RRMSi/EDSSi was 4.5, 5, 6, 6.5, 6.9999, 6.5 on Wheldon/Stratton Protocol beginning 04/12/2006
naci 4x600 mg/day
doxycycline 2x100mg/day
azithromycin 3x250mg/day MWF
metronidazolei 3x400mg/day then 3x500mg/day

I've had both experiences: no ill effects from a glass of wine during a tinii pulse, then once forgot I was in a pulse and had a beer and was quite nauseous from it. This is one of those "disregard at your own risk" kind of things.

 

CAPi for Cpni 11/04. Dxi: 25+yrs CFSi & FMSi. Currently: 250 aithromycin mwf, doxycycline 100mg BIDi, restarted Tinii pulses; Vit D2000 units, T4 & T3, 6mg Iodoral

Someone just sent me a link to this clip, and somehow it made me think of this thread:

http://www.youtube.com/watch?v=83JDXXKzOXg

One of you all above didn't get all loaded up with flagyli and red wine and then crank-call Ellen, did you?   Sarah,   Mac?   Wink

 

 

Treatment for Rosaceai

  • CAPi:  01/06-07/07
  • High-Dose Vit D3, NACi:  07/07-11/08
  • Intermtnt CAP, HDose Vit D3:  11/08-01/09
  • HDose Vit D3, Mg, Zn: 01/09-
I used to drink once or twice a week. but I dont think its helping me when im on the abxi. whether im on a flagyli pulse or not. Since I stopped drinking Ive been getting better quicker. Its best to stay away from it period. It was hard for me at first becuase I like to drink but I had to make a choice.

Fibro, CFSi,  Myco, CPNi, Stratton protocol, Zithro 500mg M/W/F/S, Doxyi 100mg 2x day, NACi 1200mg 2x day, Flagyli and INHi 2 week pulses 400 mg 3x day, Rifampin, 300mg 2x day,  Still cant shake it but improving.

I took Flagyli recently, and received the standard warning about alcohol.  A few days into the treatment, I used some Listerine.  Even though I spit it out, I know I swallowed a tiny amount.  About 5 minutes later, I was hit by a wave of nausea.  I didn't get sick, and the nausea only lasted about 15 minutes, but it let me know how serious this warning is.  I wanted no part of anything with alcohol in it after that.  It's been 24 hours since I took my last dose, and I would love to have a beer tonight, but I'm going to wait another 24 hours before I try it.  If a minute amount of mouthwash can have that effect, I don't want to know what a beer or glass of wine will do!!!  I'm not chancing it.

I had 3 cocktails and nada, not one symptom. So its weird to me for those writing saying they just used mouth wash and were in bad shape- guess to each their own

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