Metformin is a prescription medication taken to treat type 2 diabetes.
If you are an adult and take metformin for whatever diagnosis, chances are, you may occasionally desire an alcoholic drink.
However, doing so may have risks, especially if you have kidney or liver problems or your glucose levels are not in range.
Talk to your healthcare provider before consuming alcohol while taking metformin.
This article will also help you understand the possible risks.
First we’ll explore the potential interactions between metformin and alcohol.
Then we’ll discuss the precautions and risks of this combination.
We’ll also cover metformin side effects and when you should see a medical provider about drinking while on this medication.
Metformin and Alcohol: Is It Safe to Mix?
Not everyone who takes metformin needs to entirely avoid alcohol.
There are two important factors to consider:
Alcohol can worsen diabetes control. Even if your diabetes is well managed, consuming too much alcohol can lead to problems balancing glucose. Even one episode of binge drinking can worsen insulin resistance. Most alcohol is based upon carbohydrates.
Alcohol increases the risk of severe side effects. Metformin is generally safe, but in rare cases, lactic acid builds up because too much metformin stays in the body. This can lead to a life-threatening condition known as lactic acidosis. If you binge drink or regularly drink alcohol, it can increase this risk because alcohol can change the way that the liver metabolizes metformin and could increase the concentration of the drug in your body.
Drinking alcohol in moderation (no more than two drinks per day for people assigned male at birth and no more than one drink per day for people assigned female at birth) while taking metformin is likely safe as long as you do not have other risk factors.
However, excessive alcohol use should be avoided at all cost.
Medical providers will most likely screen you for your alcohol consumption prior to initially prescribing the medication.
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Alcohol Interaction Risks
Alcohol changes the way that the body breaks down most medications.
How does alcohol interact with metformin?
Metformin works to balance blood glucose levels by preventing the liver from making glucose.
As a byproduct of this, lactic acid can increase in the bloodstream.
As long as you do not have kidney or liver problems and you do not heavily drink alcohol, this is not problematic.
However, drinking alcohol also causes blood levels of lactic acid to rise.
Combining alcohol with metformin could result in too much lactic acid, causing lactic acidosis.
Beyond that, alcohol can worsen less serious side effects of metformin such as nausea, vomiting, and diarrhea.
Precaution and Risks
While metformin is generally safe and well-tolerated long term, it comes with potential complications.
The most common long-term effect of metformin is the risk of developing vitamin B12 deficiency, which can lead to anemia.
Metformin also has many possible drug interactions, including:
Other diabetes medications
Glycopyrrolate
Iodinated contrast agents
Lamotrigine
Bupropion (Wellbutrin, Aplenzin)
Carbonic anhydrase inhibitors
Cephalexin
Prothionamide
Pegvisomant
Cimetidine
Dolutegravir
Androgens
Alpha-lipoic acid
Selective serotonin reuptake inhibitors (SSRIs)
Quinolones
Ranolazine
Salicylates
Metformin may be too risky for individuals with certain health conditions such as:
Kidney problems or disorders
Metabolic acidosis
If you take metformin, you may be asked to temporarily stop taking it before procedures such as:
Surgery
Radiology tests with iodine contrast
Who is more at risk when mixing alcohol and metformin?
Some people may experience more side effects when they consume alcohol while taking metformin.
People at higher risk include:
Adults over age 65
People assigned female at birth
People who have liver problems or disorders
People who have kidney disease or kidney problems
Side effects and complications
Common side effects of metformin include:
Diarrhea
Bloating and gas
More serious complications include:
Vitamin B12 deficiency
Hypoglycemia
Lactic acidosis
Signs of lactic acidosis are a medical emergency.
If you or someone you care for takes metformin and shows the following signs, call 911 immediately:
Extreme drowsiness
Slow heart rate
Low body temperature
Flushing skin
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Refill medications and get certain necessary prescriptions.
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When to See a Medical Provider
Talk to a medical provider if you take metformin and want to know about consuming alcohol.
They can consider your health and medications to help you make an informed decision and minimize potentially harmful effects.
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