Multiple sclerosis medications and alcohol interaction

Examples: Dimethyl fumarate (Tecfidera); Glatiramer acetate (Copaxone, Glatopa); Interferon beta-1a (Avonex); Interferon beta-1a (Rebif); Teriflunomide (Aubagio); Alemtuzumab (Lemtrada); Fingolimod (Gilenya); Interferon beta-1b (Betaseron, Extavia); methylprednisolone (Solu-Medrol); Natalizumab (Tysabri); Ocrelizumab (Ocrevus); Peginterferon beta-1a (Plegridy); Rituximab (Rituxan); Siponimod (Mayzent)

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 MS medications increase or decrease blood levels of alcohol?

We don't know if MS 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 MS medications?

We don't know if alcohol increases or decreases blood levels of MS 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 MS medications in other ways? Can alcohol affect MS?

Yes alcohol can affect your MS symptoms. And alcohol can react with your MS medications in many other ways. You might not get these reactions but be aware these can happen.

The biggest risk is that alcohol can make your MS symptoms worse. The more you drink, the more is the risk of having a reaction. The risk 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).

Alcohol can make your balance worse. You have a risk of falls. Falls are dangerous for people with MS.

Interferons (e.g. Avonex, Rebif, Plegridy) can cause depression. It can be very serious. Alcohol can make your depression worse. You can feel suicidal. Get help if you feel depressed.

Alcohol can make you dehydrated. When you are dehydrated, you might feel tired. This can add to your MS symptoms. You might have trouble doing your work and other daily things

Alcohol can give you hangover (headache, nausea, vomiting, feeling tired). Hangover can add to your MS symptoms. You might have trouble doing your work and other daily things. Hangover can stay for few hours or few days.

If you are taking MS medications, you might become more sensitive to alcohol. You might feel drunk faster. Or you might have a hangover (headache, nausea, vomiting, feeling tired)

Oral MS medications (tablets and capsules) can irritate your esophagus and stomach. Alcohol can also can irritate your esophagus and stomach. Taking them together can add up. You might feel heartburn and tummy pain. People with heartburn, GERD, stomach acidity, ulcers need to be very careful. Fried and spicy food with alcohol can make heartburn worse

MS medications have many other side effects on your gastrointestinal system. MS medications can cause diarrhea, nausea, abdominal pain. Alcohol can make these problems 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).

With biologics (such as Rebif, Avonex), be extra careful. You can have reactions after your injection is over. Your injection might be fine. But you might come home and get a reaction.

Also, clinic might give you pain medications and fever medications before biologic injection. These pain and fever medications can also react with alcohol.

So after biologic injection, wait a few days after injection. Avoid alcohol. Make sure your body is adjusting okay to injection.

Did you just start taking MS 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 MS medications ineffective?

No. Alcohol does not make MS medications ineffective.

Can alcohol make MS medications toxic?

No. Alcohol does not make MS medications toxic.

I want to drink a lot of alcohol. Can I skip my MS 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 MS medication. What precautions I should take?

Tell your doctor about your drinking. Regular use of alcohol affects many body functions. For example, if you have been drinking for several years, your liver might have become weaker. That means your liver might not be able to metabolize (get rid of) MS medications. Your doctor can test your liver. Then your doctor can choose the best MS medication for you. Or your doctor might give you a lower dose of MS medication.

I get fever and body pain after injection of my MS medication. How long should I wait before drinking?

You should talk to your doctor at clinic about this. Your doctor can give you best advice. Fever and pain can last for many days. Avoid alcohol till you are feeling normal after injection

I am a regular drinker. I have been drinking for several months (or years). My doctor just prescribed MS medication. What precautions I should take?

Read here for patient comments about how alcohol can worsen MS symptoms

Page last updated: 24-November-2019