Can I drink cephalexin 24 hours after drinking alcohol?

The answer is: absolutely not!

1, It's not just after 24 hours of drinking. It's strictly a week, if not half a month, after drinking alcohol that requires no cephalosporins.

2, half a month after drinking, not only can not drink cephalosporin, injection cephalosporin drugs. And, also can not drink, or injection, in addition to cephalosporins, other dangerous drugs. For example, levofloxacin and so on.

3, Drinking alcohol + cephalosporin = disulfide awakening-like reaction, which can be life-threatening in severe cases.

4, case: a recently retired teachers, at noon, accompanied by friends, drank a lot of white wine. In the afternoon, take a nap, do not want to "cold". In the evening, near home, a tertiary hospital, outpatient infusion of "ceftriaxone", "viral azole", anti-infective, anti-viral treatment. Unexpectedly appeared disulfiram-like reaction ------ facial flushing, headache, abdominal pain, sweating, palpitations, dyspnea and so on. Because of the failure of rescue, clinical death.

Articles about not drinking alcohol after applying cephalosporins have appeared in a large number of various media, and people have become more familiar with their dangers. When I first saw this topic, I didn't want to answer, but after reading carefully, I realized that the topic asked whether cephalosporin can be taken 24 hours after drinking alcohol, which is different from taking the drug first and then drinking alcohol. So I checked some relevant drug instructions and disulfiram-related professional literature, and I will share some of the information I found with you below.Click on the upper right to pay attention to "Liu pharmacist words medication", more rational use of knowledge to share with you!

Mechanism of the disulfiram reaction between cephalosporins and ethanol

There are three steps in the metabolism of ethanol, firstly, under the action of ethanol dehydrogenase, it breaks down into acetaldehyde, then further breaks down into acetic acid under the action of acetaldehyde dehydrogenase, and finally, acetic acid oxidizes to produce carbon dioxide and water. Cephalosporin can inhibit the enzyme of acetaldehyde dehydrogenase, so that the metabolism of acetaldehyde is blocked, resulting in headache, dizziness, facial flushing, chest tightness and other uncomfortable symptoms.

Drug first, alcohol second intervals

Because cephalosporins inhibit the exertion of acetaldehyde dehydrogenase activity, it takes approximately 4-5 days after discontinuation of the drug for acetaldehyde dehydrogenase to regain enzyme activity. Therefore, alcohol consumption is generally prohibited for 5 days after discontinuation of the drug. The drug insert for cefoperazone sulbactam, the most disulfiram-prone of the cephalosporins, talks about drug interactions in which the patient's consumption of alcohol during the use of cefoperazone and for 5 days after discontinuation of the drug can cause characteristic reactions such as flushing, sweating, headache and tachycardia. Some literature recommends avoiding alcohol for 7 days after discontinuation. Therefore, avoid alcohol for at least 5 days after taking cephalosporins.

Drinking alcohol first, then taking medication at intervals

Theoretically, the possibility of disulfiram reaction is high when cephalosporins are applied for a short period of time after drinking alcohol. In the clinic, we have seen cases of acute gastroenteritis after drinking alcohol to the hospital infusion of cephalosporin occurred, the occurrence of disulfiram reaction led to the death of the patient. However, if the amount of alcohol consumption is not much, the interval is longer, most of the metabolism of ethanol is completed, the possibility of disulfiram in the application of cephalosporin is relatively small. Therefore, the instructions of some drugs that are prone to disulfiram reactions only suggest avoiding alcohol consumption during the administration of the drug and within 5 days after stopping the drug, and do not mention how long it takes to consume alcohol before the drug can not be used. In the literature, disulfiram reactions to cephalosporins have been reported even after 3 days of alcohol consumption. However, if the interval is more than 3 days or more, the incidence is very low.

Therefore, to be on the safe side, try to apply cephalosporins at intervals of more than 3 days after drinking alcohol.

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How long exactly should I take cephalosporins after drinking alcohol? There is no exact answer to this question. However, you should not take cephalosporins 24 hours after drinking alcohol, and it is generally required that alcohol consumption is prohibited for a week after drinking.

As we all know, taking cephalosporin after drinking alcohol will produce serious disulfiram-like reaction, manifested as chest tightness, shortness of breath, laryngeal edema, facial flushing, increased heart rate, sweating, headache, dyspnea, limb fatigue, drop in blood pressure, hallucinations, trance, drowsiness, dizziness, nausea, vomiting, and severe may be a rapid drop in blood pressure and lead to coma. So, how alcohol and drugs in the body "meet", and when "meet" and produce a reaction.

In fact, drugs do not directly interact with alcohol in the body to cause severe allergic reactions. First, let's look at how alcohol is metabolized and excreted from the body after it is consumed. After alcohol enters the body, it is absorbed into the bloodstream and metabolized and broken down mainly in the liver. The metabolism of alcohol relies on two enzymes, one is ethanol dehydrogenase and the other is acetaldehyde dehydrogenase. The first step of alcohol metabolism is through the action of ethanol dehydrogenase, dehydrogenation and oxidation to generate acetaldehyde, the second step for acetaldehyde in the action of acetaldehyde dehydrogenase, continue to dehydrogenation and complete decomposition of carbon dioxide and water, and finally eliminated from the body through the body circulation. Cephalosporins affect the enzyme acetaldehyde dehydrogenase when it enters the body, inhibiting its activity and thus stopping the metabolism of alcohol in the body at the first step, leading to a buildup of acetaldehyde in the body. Acetaldehyde is the immediate substance that can cause severe allergic reactions.

Therefore, the amount of time it takes for alcohol to be fully metabolized and excreted from the body depends on the two enzymes in the body that alcohol metabolism depends on. Most people have comparable levels of the enzyme ethanol dehydrogenase, while the level of acetaldehyde dehydrogenase varies from person to person, ranging from high to low. This is why some people "can drink" and some "can't drink", and some people have no problem drinking the next day, while others can't fully sober up for several days after drinking. Even for those who are fast metabolizers of alcohol, it cannot be completely metabolized from the body 24 hours after drinking, so it is not possible to take cephalosporin.

To be on the safe side, cephalosporins and other drugs that produce a disulfiram-like reaction are forbidden for a week after drinking.

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