Runny nose. Sore throat. Chills. Getting the flu is the worst.
And one of the first things we do is run to the local CVS to pick up some over-the-counter flu medicine. There, we’re given a bunch of options from drugs like Tamiflu, NyQuil, or Coricidin – all promising to give us some relief from our mounting headache and sore throat.
What’s not well-known is how dangerous these easily-obtained medicines can be when combined with alcohol. And I’m not even talking about people with a full-blown case of alcoholism. These drugs have been known to cause severe side-effects even for the casual drinker.
A lot of that has to do with how your body processes the medicine and how alcohol prevents your body from breaking down these drugs.
So, are you really at risk if you drink on your flu meds? Or is this all over-hyped nonsense? We’ll examine how flu meds and alcohol work, the potential dangers of mixing the two, and if flu medicine will provide you any relief in the fight against coronavirus in the following article.
But, don’t think you have to be a science whiz to follow along! We broke down the biochemistry behind these drug-to-drug interactions into a more readable manner in hopes that you’ll be able to follow along and learn something new.
Don’t Chase Your Tamiflu with Tequila
Tamiflu, also known by its scientific name oseltamivir, is an antiviral medication use to treat influenza A and B. And it’s actually one of the few flu medicines that are recommended for pregnant women due to its limited side effects. But its wide-spread use doesn’t mean it’s risk-free – especially for those who mix it with alcohol.
To understand this better, we need to dive deeper into how it really works.
In general, oseltamivir is hydrolyzed by CES1, an enzyme in your gut that metabolizes a wide range of clinical drugs, narcotics, and chemical nerve agents. Some common drugs that interact with this enzyme include methylphenidate (Ritalin), ACE inhibitors like lisinopril, and even cocaine so to say it plays an important role in how drugs work is an understatement.
In a study approved by the University of Tennessee Health Science Center, researchers found that alcohol inhibited this enzyme from working and prevented the hydrolysis of oseltamivir into its metabolite, oseltamivir carboxylate. In layman’s terms, patients who drank while on Tamiflu had a more difficult time breaking down the flu medicine.
Meds like Tamiflu work best when they’re converted into their more active form by enzymes like CES1. But alcohol holds this entire process hostage. So, even though you took the recommended dosage, you might not feel any relief if you wash it down with a cold one.
In fact, to help your body metabolize the drug, Tamiflu was designed to have something called an ester-containing prodrug, which is a biomolecular modification that helps improve oral absorption. Without these modifications, it would take Tamiflu hours to start working – if at all.
Unfortunately, alcohol prevents these gut-boosting enhancements from working and can actually lead to a build-up of the parent drug in your body. This accumulation not only decreases the therapeutic effects of Tamiflu, but also exposes you to its toxic side-effects, some of which are listed below:
The scary thing is that the scientists conducting this study observed these negative effects after a single drink. That means that these results could be drastically understated – especially for people abuse alcohol while on a Tamiflu regimen.
So, if you really want your Tamiflu to work best, I’d recommend not washing it down with Tequila or any other alcoholic drink for that matter. Doing so messes with your enzymes and could leave you feeling heck of a lot worse than before.
NyQuil & a Nightcap
If you’re one to cap off your night with a soothing drink followed by a swig of the well-known flu medicine, Nyquil, then you’re one for thrill. Although the combo may knock you out, it can lead to some ugly consequences for the over-the-counter mixologist.
A lot of the potential dangers of mixing Nyquil and alcohol stem from how your body breaks down acetaminophen (APAP), a pain reliever and one of the drug’s main ingredients. In fact, research suggests that combining the two can more than double the risk of kidney disease.
That’s because alcohol stops your liver from synthesizing the compound’s active – yet dangerous – metabolite, N-acetyl-p-benzoquinone imine (NAPQI).
To understand this better, think of your liver like a sponge that filters out any harmful material before it reaches the heart. Under normal circumstances, your liver is able to eliminate toxic materials like NAPQI just fine, leaving you to feel the pan-relieving effects of drugs like NyQuil.
However, when alcohol is introduced, the sponge becomes saturated and enzymes like alcohol dehydrogenase (ADH) work overtime to stop your nightcap from damaging your body. Being preoccupied with metabolizing your whiskey-sprite, your body has no way to break down harmful substances like NAPQI, and they float around your body doing nothing but damage.
The result is something called hepatotoxicity, a fancy word for chemical-driven liver damage. This can have lasting effects on the liver and lead to expensive or invasive interventions – one of the more serious being a liver transplant. To know if you might have acetaminophen-induced hepatotoxicity, be aware of the following symptoms:
- Right-upper quadrant pain
- Nausea & vomiting
- Encephalopathy (i.e. brain damage as evidenced by confusion or an altered mental state)
- Loss of appetite
- Muscle weakness or convulsions
NyQuil’s other ingredients also interact negatively with alcohol. For instance, dextromethorphan, the component used to treat your cough, is a central nervous system (CNS) depressant that causes feelings of sleepiness and relaxation. But alcohol is a depressant too. And combining depressants is extremely dangerous!
By doing so, you may suffer respiratory depression or slowed breathing, feelings of dissociation which can lead to panic attacks, as well as brain lesions, epilepsy, and permanent psychosis.
So, yes, this combo will definitely have you sawing logs, but is it worth jeopardizing your health over? I don’t think so.
Pairing your Campari with Some Coricidin Will Make You Drowsy
If you don’t know what a Campari is then you might not be Italian. The Campari is a red-colored spirit blended with herbs and spices and has a strong bitter flavor. It’s enjoyed throughout the world but is mainly consumed just before dinner as an ingredient in cocktails like the Negroni or the Americano.
Coricidin, on the other hand, is a cough suppressant and antihistamine used to treat cold and flu symptoms. It can be found in any CVS under brand names Coricidin HBP, which is intended for people with high blood pressure, or Coricidin D, which is marketed for those wanting to get rid of that annoying nose stuffiness and congestion.
The flu medicine is made up of three ingredients: acetaminophen, chlorpheniramine, and phenylephrine. Although we discussed the dangers of drinking on acetaminophen, here, we’ll focus on the risks associated with chlorpheniramine, a well-known antihistamine.
Even in small amounts, alcohol may intensify the side effects of antihistamines like chlorpheniramine based on how it interacts with your central nervous system (CNS). Although alcohol typically causes nausea, vomiting, and headaches, the most common symptom you’ll experience when drinking on Coricidin is dizziness or drowsiness – especially if your above 60 years old!
This means that drinking on Coricidin may make you more apt to fall down, fall asleep at the wheel, or experience some type of impairment in thinking or judgment. So, if you need your wits about you that night, I’d recommend not taking those two substances in tandem.
What’s scary is that most cold and flu drugs are available over-the-counter (OTC) and that makes them more prone to abuse. While it can be argued that there are more dangerous drugs to be worried about, abuse of OTC antihistamines like Coricidin is increasing.
For instance, in one California survey, one in six respondents admitted to abusing OTC medicines. And this is of particular concern for adolescents, who are starting to abuse cold medicines like cough syrup in larger rates than before. Some patients have even needed detox in order to withdrawal safely from the sleep-inducing medicines.
But whatever the case, it’s important that you abide by the dosage instructions on the back of the box as any deviations from these could lead to unwanted side-effects.
COVID-19 and Flu Meds
The flu and COVID-19 are both infectious respiratory illnesses, yet despite them looking similar, they are caused by two different viruses. So, it’s hard to say whether flu meds will provide any relief for coronavirus-related symptoms.
According to Johns Hopkins, neither is treatable with antibiotics, and we’re still awaiting guidance from the CDC on the matter. Best guess is that flu meds won’t aid in treating the novel coronavirus seeing as it attacks the body in a way never seen before, but scientists are still looking for answers.
This past week, a new study published by researchers at the University of Texas at Austin says flu medicines like Xofluza may help in stopping viruses from replicating, which may have some important implications for how we treat coronavirus.
Xofluza, also known as baloxavir, reduced the length of time that an infected person was contagious, cut down on viral load, and helped limited the spread of the flu from person to person. This finding could help “prevent millions of infections and save thousands of lives during a typical influezna season,” says Robert Krug, a professor of molecular biosciences in a writing published shortly after the study was disseminated.
The success of Xofluza in treating influenza is causing scientists to re-think what type of drugs they need to develop for COVID-19 and who to target. Instead of focusing on critically ill populations in nursing homes, for instance, scientists may now target seemingly healthy individuals in order to block mass transmission.
Baloxavir is an antiviral drug approved by the FDA to treat acute, uncomplicated flu within 2 days of onset in individuals. And it performed much better than OTC meds like Tamiflu in the UT Austin study. Unfortunately, you can’t get antiviral drugs like baloxavir over-the-counter so you’ll need a prescription from your health care provider.
As well, no antiviral flu medicines for coronavirus are available to patients, but researchers are becoming more optimistic that they’ll develop one soon.
Cough Syrups May Increase Coronavirus Infection
Whatever the case, be cautious taking flu medicines like NyQuil and Robitussin during this time. One of the active ingredients dextromethorphan, used to treat cough symptoms, has been shown to increase the rate at which COVID-19 grows in certain lab tests.
These results haven’t been confirmed in humans and the mechanism underlying them is still being learned. But whatever the case, I’d think twice about reaching for one of these drugs if you’re concerned about contracting coronavirus.
But when it comes to other flu medicine ingredients like acetaminophen, the results are a little less grim.
Meds that treat inflammation might actually help your body fight off the virus. Unfortunately, a false article was circulating on social media that drugs like Tylenol and Advil should be avoided when sick with coronavirus. In fact, health authorities around the world are advocating for the use of anti-inflammatories to help mitigate symptoms.
If You’re Struggling with Antihistamine Addiction or Alcoholism, Give Us a Call
Just because popular flu meds like NyQuil are available over-the-counter doesn’t mean they’re not abused. And if you find yourself taking them in tandem with alcohol, give us a call.
Our 125+ acre inpatient drug rehab for men and women is located just outside of Fort Worth, Texas. We offer individual and group therapy, 12-Step programming, as well as equine therapy and ropes course activities in a gender-separate, faith-based atmosphere.
Our Admissions Coordinators are available to take your call at (817) 993-9733 or chat with you via email at firstname.lastname@example.org in order to help you overcome your drug and alcohol addiction.
Until then, stay safe!
John Eckelbarger is a Business Development Representative for Stonegate Center. With a BSA in Chemistry from the University of Texas at Austin, he has an interest in the neurobiology of addiction as well as the pharmacology of drugs. He hopes to bolster Stonegate Center’s status at the forefront of addiction medicine through bold, innovative content creation. He is currently pursuing his MBA in Finance from Texas Christian University.