Metformin and Alcohol: Side Effects, Interactions & Risks

Drinking alcohol while on metformin can be harmful and increase your risk of low blood sugar and dangerous conditions like lactic acidosis.

When you have diabetes, eating nutritious foods to help control your condition is important, especially if your diabetes requires a medication like metformin. This can make some people wonder if it is safe to drink alcohol while taking metformin. However, due to the chances of serious side effects, you should understand the risks before you combine metformin and alcohol.

What Is Metformin? 

Metformin is sold under brand names like Fortamet, Glumetza and Riomet) and prescribed to treat Type 2 Diabetes and Polycystic Ovary Syndrome (PCOS). It lowers sugar levels by preventing your liver from making sugar and helping your body use it more efficiently in your bloodstream.

Can You Drink With Metformin? 

It is best to avoid drinking if you have diabetes due to the risk of low blood sugar. In addition, you should avoid excessive alcohol use with metformin due to the risk of developing a potentially dangerous condition called lactic acidosis. The FDA has a Boxed Warning for the risk of lactic acidosis, which can increase with alcohol use. If you consume alcohol while taking metformin, you should drink sparingly.

Metformin Side Effects With Alcohol

When you drink while taking metformin, you risk low blood sugar, especially if you drink excessively or on an empty stomach. Conversely, if you drink sugary alcoholic beverages, you may first experience a spike in your blood sugar before it drops. Symptoms of low blood sugar include:

• Rapid heartbeat
• Hunger
• Shaking
• Sweating
• Nervousness or anxiety
• Irritability 
• Confusion
• Dizziness

In addition, drinking heavily on metformin can cause low vitamin B12 levels, which can lead to nerve and neurological damage.

The FDA has a Boxed Warning on metformin because drinking while you are on metformin can increase your risk of developing a dangerous and potentially fatal condition called lactic acidosis. In lactic acidosis, the chemical lactic acid builds up in your body, causing damage. Symptoms of lactic acidosis include:

• Fatigue
• Weakness
• Excessive drowsiness
• Muscle pain
• Abdominal pain 
• Slow or irregular heartbeat
• Problems breathing 
• Chills

Who Is Most at Risk When Mixing Alcohol and Metformin?

Those who struggle with alcohol are at the highest risk for low blood sugar when mixing alcohol and metformin. Those at the highest risk for lactic acidosis include those with liver damage and those taking other substances, like cocaine, alcohol and certain other medications.

How Long After Taking Metformin Can I Drink Alcohol?

Metformin is prescribed to last all day and night to fight diabetes, so there is never a good time to drink after taking the drug. Because your risk of low blood sugar after drinking is due to your underlying diabetes, you should drink only moderately, if at all, if you have a diabetes diagnosis. Your doctor can provide more information on the risks of drinking with diabetes based on your specific medical history.

Alcohol and Diabetes

Alcohol should be avoided or used in moderation if you have diabetes. This is due to the risk of low blood sugar, especially if you drink heavily or on an empty stomach. If you drink sugary drinks, your blood sugar may temporarily rise before dropping to potentially dangerous levels. Working with a dietitian to help you make nutritious food choices and keep your blood sugar in a safe range is important if you have diabetes.

Alcohol Addiction Treatment

If you struggle with moderating your drinking when you have diabetes, you may show signs of alcohol addiction. Alcoholism can seem overwhelming, but help is available. At the Recovery Village Ridgefield, we can help you medically detox from alcohol in a safe, supervised environment, followed by rehab to help keep you sober. Don’t wait: contact a Recovery Advocate today.