Metronidazole alcohol
Pro Research Analysisby 
Searched over 200M research papers for "metronidazole alcohol"
Metronidazole and Alcohol: Interactions and Implications
Metronidazole and Alcohol Interaction
Disulfiram-like Reaction
Metronidazole has been reported to cause a disulfiram-like reaction when consumed with alcohol. This reaction includes symptoms such as flushing, nausea, and epigastric discomfort, similar to those experienced with disulfiram (Antabuse)1 4. However, recent studies have questioned the validity of this interaction. A comprehensive review of literature and adverse effect databases found no convincing evidence of a clinically relevant disulfiram-like interaction between metronidazole and alcohol6. This suggests that the warnings against combining metronidazole and alcohol may be based on anecdotal reports rather than solid scientific evidence.
Mechanism of Interaction
The mechanism behind the reported disulfiram-like reaction is not well understood. One study on rats indicated that metronidazole increases intracolonic acetaldehyde levels when combined with alcohol, likely due to changes in gut flora rather than liver enzyme inhibition8. This finding suggests that the reaction might be localized in the gut rather than being a systemic effect.
Metronidazole in Alcoholism Treatment
Reduction in Alcohol Craving
Several studies have explored the potential of metronidazole in treating alcoholism. Early observations suggested that metronidazole could reduce alcohol craving and tolerance, making it a potential adjunct in alcoholism therapy1 4. However, subsequent controlled trials have produced mixed results. Some studies reported a decrease in alcohol craving and tolerance, which was associated with treatment success in a subset of patients2 3.
Efficacy and Safety
Despite initial promising results, other studies have failed to confirm the efficacy of metronidazole in reducing alcohol consumption or producing a significant disulfiram-like reaction5 7. These studies highlight the variability in patient responses and suggest that metronidazole may not be universally effective for treating alcoholism. Additionally, the safety profile of metronidazole in patients with liver disease, such as those with alcoholic liver disease, indicates a need for dose adjustments due to altered pharmacokinetics in these patients10.
Conclusion
The interaction between metronidazole and alcohol remains a topic of debate. While early reports suggested a disulfiram-like reaction, recent evidence does not support a clinically significant interaction. Metronidazole's role in treating alcoholism is also inconclusive, with mixed results from various studies. Further research is needed to clarify these interactions and determine the potential therapeutic benefits of metronidazole in alcoholism treatment.
Sources and full results
Most relevant research papers on this topic
Metronidazole and Alcoholism
Metronidazole can decrease tolerance, diminish cravings, and produce unpleasant reactions to alcohol in alcoholic patients.
Metronidazole in the treatment of alcoholism.
Metronidazole shows a decreased desire for and tolerance for alcohol, but does not significantly improve abstinence in alcoholism patients.
The use of metronidazole in the treatment of alcoholism: a pilot study.
Metronidazole in divided doses of 500 to 750 mg. daily effectively reduces alcohol consumption within two weeks in motivated alcoholics, with a wide margin of safety.
Non-RCTLong Term Trial of Metronidazole in Male Alcoholics
Metronidazole reduces alcohol cravings, increases psychological aversion, and may induce an antabuse-like response in male alcoholics.
Metronidazole in the treatment of alcoholism: a negative report.
Metronidazole does not effectively reduce alcohol desire or produce disulfiram-like reactions in alcoholics, and its side effects are unclear.
Non-RCT[Is combining metronidazole and alcohol really hazardous?].
Recent research does not confirm a clinically relevant interaction between ethanol and metronidazole, contradicting the common warning against their combination.
Systematic ReviewMetronidazole in the Treatment of Alcohol Addiction A Controlled Trial
Metronidazole may have disulfiram-like effects and reduce cravings in alcohol addiction, but its effectiveness in treating alcoholism remains unclear.
Metronidazole increases intracolonic but not peripheral blood acetaldehyde in chronic ethanol-treated rats.
Metronidazole increases intracolonic acetaldehyde levels in chronic ethanol-treated rats, suggesting a possible mechanism in gut flora rather than the liver.
RCT
Animal StudyRandomised Double-Blind Placebo-Controlled Trial of Inulin with Metronidazole in Non-Alcoholic Fatty Liver Disease (NAFLD)
Brief metronidazole followed by inulin supplementation can further reduce ALT levels beyond those achieved after a very-low-calorie diet in patients with non-alcoholic fatty liver disease.
RCT
Very Rigorous JournalPharmacokinetics of metronidazole in patients with alcoholic liver disease
A reduced dose of metronidazole is recommended for patients with alcoholic liver disease to avoid accumulation of metronidazole and its metabolites, and monitoring of drug concentration in serum may be necessary.
Non-RCT