Medicine and alcohol, like water and oil, do not mix well.
The two are mutually exclusive; one designed for merriment, leisure and ease of social of interactions, while the other helps heal organs to restore normal bodily functions.
For Kenyans on medication, the festive season can be a trying moment, as the temptation to ignore prescription and doctor’s warnings is reinforced by the human desire to throw caution to the wind and indulge in the moment.
Doctors, however, warn that mixing alcohol and medication can be harmful, as ingredients used in making intoxicants do not interact well with those in medicine, and in many instances can reduce the effectiveness of drugs.
“When you take any medicine, it immediately undergoes a process known as metabolism in the liver, and alcohol undergoes the same process after being absorbed in the stomach,” explains Geoffrey Kulabusia, an immunologist. “The only difference,” he adds, “is that it will be absorbed faster than the drug.”
This difference reduces the absorption level of the drug and inhibits it from reaching its peak levels for it to be effective.
“This greatly reduces its effectiveness, despite metabolising in the liver, as every drug has an efficacy level that reduces upon interaction with alcohol,” says Dr Kulabusia.
For instance, vaccines have an efficacy of between 60 per cent and 70 per cent, depending on the time of administration. This efficacy is greatly impacted by alcohol.
In other cases, these interactions may make drugs harmful or even toxic to the body.
Even small amounts of alcohol may worsen side effects such as nausea, vomiting, drowsiness, dizziness and cause changes in one’s blood pressure.
“Taking alcohol alongside some medication like antibiotics could be detrimental on the user’s health,” says Dorothy Aywak, a pharmacist at Kenyatta National Hospital.
She says a few antibiotics like metranidazole, tinidazole, and sulfamethoxazole may result in more severe reaction like rapid heart rate and headache, besides predisposing one to complications such as impaired breathing, depression, heart complications, and liver damage.
Likewise, women and men metabolise alcohol differently. Women are said to have fewer alcohol dehydrogenises, enzymes produced in the liver for metabolising the bulk of ethanol consumed and aiding in their elimination from the blood stream.
This is the major reason why women get higher on alcohol faster than men. They metabolite alcohol slower and thus get intoxicated faster.
This same reaction plays a role in the efficacy, side effects and potency of a wider range of medications.
While moderate alcohol intake may have health benefits, doctors warn against mixing the same with diabetes medication, antidepressants, blood pressure and erectile dysfunction medications, or even painkillers.
For those on treatment, adjusting lifestyles will be key in ensuring drugs work effectively, especially during the festive season when the temptation to take alcohol lingers.
Dr Aywak advises that those on medication consult healthcare professionals for adjustments in dosage or regimen should they feel the need to take alcohol. This will prevent adverse reactions.
This is crucial as the world battles Covid-19, with the government urging vaccine uptake.
Heavy drinking during this season, it is feared, could impair the collective immune responses of vaccination in communities.
Although there is insufficient evidence that taking alcohol can render the current Covid-19 vaccines ineffective, prolonged heavy alcohol consumption can suppress one’s immune system and interfere with response to medication.
“Vaccines also undergo metabolism upon being administered, and this process takes place in the liver, where alcohol also undergoes metabolism,” says Kulabusia.
When you take alcohol, you increase the activity of the liver and the likelihood of the vaccine being ‘masked’ and not undergoing metabolism is high. “This lowers its functionality,” says Kulabusia.
Ideally, the purpose of the vaccines is to help the immune system recognise the virus that causes Covid-19. Immunologists say it takes between eight and 12 weeks for the body to generate adequate antibodies against Covid-19 virus, and that anything that interferes with the body’s immune response would be a cause for alarm.
To minimise this risk, “you may want to go slow on the bottle, especially now when the world is grappling with the emergence of new strains of the coronavirus,” warns Kulabusia.
Taking alcohol within 24 hours after being vaccinated is not encouraged. One should avoid alcohol for at least 36 days after the jab.
Heavy drinking, along with hangovers, are also said to intensify the vaccine’s side effects such as fever, headache and body aches.
A study published in the British Journal of Nutrition in 2007 shows how alcohol may impair the movement and functioning of key immune system cells.
According to the researchers, excessive drinking can alter the immune system’s ability to produce important chemicals, like cytokines.
This excessive drinking can even make one more susceptible to infectious diseases like Covid-19.
Some studies indicate that the impacts of alcohol consumption on human health are complex and modulated by several factors such as patterns and amounts of drinking, genetics, the organ system studied, as well as the sex and age of the user.
There is also strong evidence that chronic alcohol abuse is associated with increased morbidity and mortality.
But how much is too much when it comes to alcohol consumption? Moderate drinking is defined as having no more than two drinks a day, for men, and a maximum of one drink in the same period for women.
Heavy drinking is defined as four or more drinks on any day for men and three or more for women.
According to a December 2020 Reuters report, some first concerns about alcohol and Covid-19 vaccination began circulating after a Russian health official warned that people should avoid alcohol for two weeks before getting vaccinated, and then abstain for another 42 days afterwards.
The official claimed alcohol could hamper the body’s ability to develop immunity against Covid-19.
This, however, attracted a backlash in Russia, which is considered to have one of the world’s highest drinking rates.