Cholesterol medications (non-statins) and alcohol interaction

If you are looking for statin interactions with alcohol read here.

Examples: Alirocumab (Praluent); Evolocumab (Repatha), Fenofibrate, Gemfibrozil, Cholestyramine, Colestipol, Colesevelam, Ezetimibe, Niacin, Colestid, Lopid, Niacor, Prevalite, Questran, Slo-Niacin, Tricor, WelChol, Zetia

What happens when you take medicine after alcohol?

Medications and alcohol can react in many ways. For example, medications can increase effect of alcohol. When that happens, you can feel drunk faster. Or you can feel drunk even after drinking less alcohol. Or your hangover can stay longer. Alcohol can also increase blood levels of medications. More medicine in your blood means you can get more side effects. Read more about how alcohol reacts with medications

Can cholesterol medications increase or decrease blood levels of alcohol?

We don't know if cholesterol medications increase or decrease blood levels of alcohol. Discuss alcohol use with your doctor. Your doctor knows your medical history best. Your doctor can make recommendations about safe alcohol use.

Can alcohol increase or decrease blood levels of cholesterol medications?

We don't know if alcohol increases or decreases blood levels of cholesterol medications. Discuss alcohol use with your doctor. Your doctor knows your medical history best. Your doctor can make recommendations about safe alcohol use.

Can alcohol react with cholesterol medications in other ways?

Yes. Alcohol can react with cholesterol medications in many other ways. You might not get these reactions but be aware these can happen.

First off, you need to take cholesterol medication every day. You might forget to take medication after drinking. If you do not take your cholesterol medication, the amount of medication in your system goes below effective range. That means the medication might not completely control your cholesterol level.

Cholesterol medications such as ezetimibe (Zetia), fenofibrate (Tricor), and gemfibrozil (Lopid) can cause muscle problems (weakness, tenderness, muscle pain). If you drink alcohol, you have more risk of muscle problems.

Gemfibrozil (Lopid) can lower your blood sugar. Alcohol can also can lower your blood sugar. When your blood sugar is low, you might feel tired and sleepy. You might have trouble focusing. Be careful if you want to drive or work on machines. Diabetes medications and insulin can also lower your blood sugar. Be very careful if you take gemfibrozil and diabetes medications and drink alcohol.

Niacin causes flushing (warm feeling, skin redness, itching, tingling). Alcohol can make your flushing worse. If you drink before or after taking niacin, you might feel dizzy, nauseous, sweaty. Your heart might beat too fast.

If you take niacin and heart medicine or blood pressure medicine, be very careful. Mixup of flushing, alcohol, and heart medicine can be serious.

Ezetimibe (Zetia), fenofibrate (Tricor), gemfibrozil (Lopid) and niacin can hurt your liver. Regular drinking hurts your liver. If you keep drinking alcohol and keep taking these medications, you might hurt your liver.

Repatha and Praluent injection side effects can happen many days after injection. Wait a few days after injection. Avoid alcohol. Make sure your body is adjusting okay to injection.

Cholestyramine, colestipol, and colesevelam cause headache, upset stomach, gas in tummy, indigestion, heartburn, nausea, vomiting, and diarrhea. Alcohol can make these worse.

Cholestyramine, colestipol, and colesevelam can lower absorption of vitamin K and vitamin A from your intestines. Regular drinkers need to be careful. Because alcohol can also lower absorption of vitamins.

Cholesterol medications (pills and capsules) can irritate your esophagus and stomach. Alcohol can also irritate your esophagus and stomach. You might feel heartburn, nausea, gas in tummy. People with heartburn, GERD, stomach acidity, ulcers need to be very careful. Fried and spicy food with alcohol can make heartburn worse.

Special precautions

The risk of serious reaction can be even higher on days when you are tired, dehydrated, had a long day at work, didn't have enough sleep (read more about dangerous situations to avoid).

Older people need to be extra careful if they take medications and before they drink. Read more why older people have higher risk of medication-alcohol interactions).

Did you just start taking a cholesterol medication? Or did the doctor just change your dose? Your body still might be adjusting to the medication. Avoid alcohol till you know how the medication is affecting you.

Frequent questions

Can alcohol make cholesterol medications ineffective?

No. Alcohol does not make cholesterol medications ineffective.

Can alcohol make cholesterol medications toxic?

No. Alcohol does not make cholesterol medications toxic.

I want to drink a lot of alcohol. Can I skip my cholesterol medication today?

Remember: Skipping your medication does not mean the effect of the medication is gone. Your body gets rid of medications slowly. If you have been regularly taking a medication and if you stop for one day, little bit of medication remains in your system. So even if you don't take your medication today, little bit of medication might still be in your system (or the effect of the medication might still be there). You can get a serious reaction with alcohol. Do not skip your medications and do not drink too much. Read more why skipping medications is a bad idea.

I have been drinking for several months (or years). My doctor just prescribed cholesterol medication. What precautions I should take?

Regular drinking hurts your liver. Some cholesterol medications also can hurt your liver. If you keep drinking alcohol and keep taking cholesterol medication, you might hurt your liver.

It is also possible that your liver might have become weaker due to regular drinking. That means your liver might not be able to metabolize (get rid of) cholesterol medications. You can get more side effects from cholesterol medications.

Tell your doctor about your drinking. Your doctor can test your liver. Then your doctor can choose the best cholesterol medication for you. Or your doctor might give you a lower dose of cholesterol medication.

Page last updated: 12-September-2019