Prednisone and Alcohol: Can You Mix Them?

Although prednisone and alcohol do not have a drug interaction, mixing them can be problematic.

Although alcohol and prednisone do not have a drug interaction, they share similar side effects. Taking them together may interfere with controlling the medical condition for which you take prednisone. For this reason, it is important to be aware of the risks of mixing alcohol and prednisone before you use them together. 

What Is Prednisone? 

Prednisone is a commonly prescribed steroid for many medical conditions, including but not limited to: 

• Asthma or COPD flares
• Allergic reactions
• Psoriasis
• Rheumatoid arthritis
• Ankylosing spondylitis
• Bursitis
• Gout flares
• Osteoarthritis
• Lupus
• Allergic conjunctivitis
• Multiple sclerosis flares
• Ulcerative colitis

How prednisone works depends on why you take it. It reduces inflammation, which is helpful in COPD and gout flares. However, it also helps with autoimmune disorders like multiple sclerosis and lupus since it suppresses the immune system.

Can You Drink Alcohol While Taking Prednisone? 

Alcohol is an extremely commonly used substance in the U.S., with 174.3 million people ages 12 and up reporting drinking in the last year in 2021. Whether you should drink while taking prednisone depends mainly on your medical history. In some cases, the medical condition for which you take prednisone can be worsened by drinking. As a result, you should speak with your doctor before drinking alcohol to determine whether it is safe for you to drink based on your medical conditions.

It is important to note that alcohol and prednisone do not have a drug interaction. However, the two have similar side effects, which may worsen by combining the two substances.

Side Effects of Drinking on Prednisone

No drug interaction exists between alcohol and prednisone, meaning taking one agent will not directly impact the other. However, both agents have similar side effects, suggesting these effects can be additive in some cases. These effects can include:

• A weakened immune system
• Liver damage
• High blood pressure and cardiovascular disease
• Changes in your blood sugar
• Gastrointestinal problems

In addition, prednisone can be prescribed to treat several different medical conditions; some may worsen if you drink alcohol. Speak to your doctor about whether it is safe for you to drink based on your medical history.

Potential Risks of Mixing Alcohol and Prednisone 

Although prednisone and alcohol have no drug interaction, it is important to keep their similar side effects in mind. As a result, you may experience additive side effects when taking prednisone while drinking. These side effects include:

Weakened Immune System

Steroids like prednisone can suppress the immune system, especially when taken at 20 mg daily or higher for at least 14 days. In addition, alcohol is also an immunosuppressant. Taking two substances that can suppress the immune system may therefore increase your risk of infections and other problems related to immune health.

Liver Damage

Prednisone can sometimes put a person at risk of liver injury. Further, alcohol’s damaging impact on the liver is well-known, and the substance can lead to complications like cirrhosis. Taking two separate substances with the potential for liver injury may increase your risk of developing liver damage.

High Blood Pressure

High blood pressure is a known side effect of prednisone and other steroids. The medication can also increase your risk of heart failure. Likewise, alcohol can elevate your risk for high blood pressure and heart disease. For this reason, mixing these substances may increase your risk of developing cardiovascular problems, including high blood pressure.

Blood Sugar Problems

Prednisone can cause your blood sugar to rise. In addition, alcohol can have varying effects on your blood sugar. More specifically, alcohol can lead to an initial spike in blood sugar followed by a drop in blood sugar. Unexpected swings in your blood sugar from mixing alcohol and prednisone can complicate your health, especially if you have diabetes.

Gastrointestinal Problems

Prednisone is linked to gastrointestinal problems, including peptic ulcers, pancreatitis, ulcers in the esophagus and developing a distended abdomen. It can also increase your bleeding risk. 

Alcohol is also associated with stomach bleeding and several gastrointestinal cancers, including mouth, esophagus, larynx, pharynx, liver, colon and rectal cancers. Therefore, mixing the substances may lead to stomach bleeding and other gastrointestinal issues. 

The possibility of stomach bleeding can be further compounded if you take other agents that increase your bleeding risk, like aspirin or other NSAIDs (ibuprofen, naproxen).

Reduced Effectiveness of Prednisone

No drug interaction exists between alcohol and prednisone, meaning alcohol cannot directly reduce prednisone’s effectiveness. However, in some cases, alcohol may make it harder to control the medical condition for which you are taking prednisone and can indirectly counteract prednisone. 

For example, prednisone is often prescribed to control gout flares, but alcohol can trigger a gout flare. For this reason, drinking while taking prednisone for a gout flare can be counterproductive.

When To Seek Medical Attention

If you experience severe side effects while using prednisone and alcohol, contact your doctor. These may include:

• High blood pressure
• Changes in your blood sugar control
• Stomach or abdominal pain
• Vomiting bright red blood or a substance that looks like coffee grounds
• Worsening of the medical condition that you are taking prednisone to treat

Other Medications and Drugs To Avoid on Prednisone 

Prednisone interacts with 553 medications. However, some of these interactions are mild or moderate and may not warrant concern. Further, some interacting medications are obsolete or rarely prescribed in the U.S. However, it is important to be aware of prednisone’s major drug interactions, which include:

• Adalimumab
• Baricitinib
• Bempedoic acid
• Bupropion
• Certolizumab
• Ciprofloxacin
• Cladribine
• Deferasirox
• Etanercept
• Fingolimod
• Golimumab
• Infliximab
• Leflunomide
• Levofloxacin
• Mifepristone
• Moxifloxacin
• Natalizumab
• Ozanimod
• Siponimod
• Teriflunomide
• Thalidomide
• Tofacitinib
• Ublituximab
• Upadacitinib
• Vigabatrin
• Some vaccines, including live vaccines like the measles and mumps vaccines

If you take any of these agents, you should discuss the safety of taking it alongside prednisone with your doctor or pharmacist.

How Long After Taking Prednisone Can You Drink Alcohol?

Because alcohol can interfere with the medical condition for which you are taking prednisone, you should talk with your doctor before drinking after you stop prednisone to see if it is possible to drink safely. 

That said, it takes around four hours for half of a single dose of prednisone to leave your system. Because it takes a medication five half-lives to leave your body, prednisone will be out of your system around a day after you stop taking it. If you are concerned about additive side effects between alcohol and prednisone, the risk will decrease after this time when prednisone is out of your body.

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