Wellbutrin XL also helps prevent seasonal affective disorder. It’s recommended that you avoid taking MAOIs within 21 days of stopping Trintellix treatment or for 14 days before starting Trintellix. Examples of MAOIs include phenelzine (Nardil), selegiline (Emsam), and linezolid (Zyvox).
Similarly, medications that accelerate gastric emptying (e.g., the stomach medications metoclopramide Reglan® and cisapride Propulsid® and the antibiotic erythromycin) may reduce first-pass metabolism in the stomach. Many people who are being treated for chronic health problems, such as diabetes and high blood pressure (i.e., hypertension), consume alcohol, whether occasionally or regularly. As described in the main article, alcohol consumption, even at moderate levels, may interfere with the activities of many medications prescribed for such conditions. In addition, however, alcohol use may contribute to or exacerbate certain medical conditions.
Interactions with Medicines
- The articles were chosen after a search of published English language medical literature.
- CBD has the potential to affect the immunosuppressant cyclosporine’s metabolism which may result in increased cyclosporine blood levels and an increase in its toxic side effects.
- Further clinical studies in the patient populations for whom prescribing may be considered are needed to derive a better understanding of these drugs and enhance safe and optimal prescribing.
- Blood tests may be needed to check for any unwanted effects.
Alcohol metabolism by ADH generates a byproduct called reduced nicotinamide adenine dinucleotide (NADH). Excessive NADH levels can inhibit glucose production (i.e., gluconeogenesis) and breakdown (i.e., oxidation) of fat molecules as well as stimulate production of fat molecules. Alcohol that has not been eliminated by first-pass metabolism enters the systemic circulation and is distributed throughout the body water (i.e., the blood and the watery fluid surrounding and inside the cells). The proportion of body water and body fat differs between men and women and between young and old people; women and older people generally have more body fat and less body water than do men and younger people.
These effects, however, are unlikely to occur in moderate drinkers. Most studies assessing alcohol-medication interactions focus on the effects of chronic heavy drinking. Relatively limited information is available, however, on medication interactions resulting from moderate alcohol consumption (i.e., one or two standard drinks1 per day). Researchers, physicians, and pharmacists must therefore infer potential medication interactions at moderate drinking levels based on observations made with heavy drinkers. In addition, moderate alcohol consumption may directly influence some of the disease states for which medications are taken (see sidebar, pp. 52–53, for further discussion of alcohol’s influences on various disease states). Cannabidiol, a non-intoxicating phytocannabinoid, has potential therapeutic effects over a broad range of disorders.
Interaction with Wellbutrin SR and Wellbutrin XL
Acute intake of alcoholic beverages does not interfere with the PK of doxycycline to an extent that would affect its therapeutic levels. Azithromycin is listed in an NIH report on harmful interactions with alcohol (4). The basis for this recommendation is unclear, as published findings do not identify an interaction. Data are limited regarding the adverse effects of concomitant use of FQs and alcohol. One case report documents a 46-year-old male who developed erythema multiforme while receiving ciprofloxacin after consuming alcohol (25). The reaction resolved with continued ciprofloxacin use and abstention from alcohol.
However, others did not support this association (103, 117). Given the biologic plausibility, it would be prudent to avoid alcohol with pyrazinamide. One case report details a severe psychiatric reaction requiring hospital admission in a patient with heavy alcohol consumption on combination therapy with isoniazid, streptomycin, and ethionamide (115).
Health Challenges
They’ll determine whether it’s safe to take Contrave with the specific beta-blocker you’re prescribed. The chart below lists drugs that may interact with Contrave. Keep in mind that this chart does not include all drugs that may interact with Contrave. Nortriptyline comes as a capsule and an oral liquid to take by mouth. It is usually taken one to four times a day and may be taken with or without food.
The potential for the occurrence and relevance of alcohol-medication interactions in moderate drinkers may differ, however, between pharmacokinetic and pharmacodynamic interactions. Although the potential for such effects certainly exists even after low alcohol consumption, researchers have not yet demonstrated the occurrence and relevance of those tommy lee drinking effects in moderate drinkers. Conversely, pharmacodynamic interactions can occur with intermittent alcohol consumption and even after a single episode of drinking. Accordingly, those interactions clearly pertain to moderate drinkers. In people consuming alcohol only occasionally, CYP2E1 metabolizes only a small fraction of the ingested alcohol. Chronic heavy drinking, however, can increase CYP2E1 activity up to tenfold, resulting in a substantial increase in the proportion of alcohol that is metabolized by this enzyme rather than by ADH (figure 3) (Lieber 1994).
