Is It Okay to Mix Antacids and Alcohol?

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Antacids are over-the-counter (OTC) or prescription medications to treat heartburn, indigestion, and acid reflux. They work by neutralizing stomach acid and are generally considered safe for short-term or occasional use. However, they may cause side effects and pose health risks when used for longer periods, especially when used with other substances like alcohol. Mixing antacids and alcohol can be harmful and has the potential to exacerbate the unwanted effects of both.^1,2

In this article:

• Why Do Antacids Interact With Alcohol?
• What are the Risks of Mixing Alcohol and Antacids?
• How to Avoid Mixing Alcohol and Antacids
• How Can I Manage Acid Reflux and Alcohol Addiction?

Why Do Antacids Interact With Alcohol?

Antacids are the oldest effective medications for treating heartburn, with chalk (calcium carbonate) being used for centuries to provide relief. Antacids come in many different types, though each serves the same purpose—to neutralize gastric acid and relieve discomfort.^1,3

Most of the antacids available on the market are a combination of aluminum and magnesium hydroxide. Others contain sodium carbonate (chalk) sodium bicarbonate, commonly known as baking soda. Some popular brands of antacids include Tums, Alka-Seltzer, and Bromaseltzer.^1,3

Proton pump inhibitors (PPIs) are another popular antacid that works by reducing the amount of stomach acid made by glands in the lining of your stomach. Unlike traditional antacids, these are also used to treat ulcers and damage to the lower esophagus caused by acid reflux. Some are available over-the-counter, while others require a prescription.⁴

Many different types and brands of PPIs are available, including:⁴

• Esomeprazole (Nexium)
• Omeprazole (Prilosec)
• Lansoprazole (Prevacid)
• Pantraprozole (Protonix)
• Rabeprazole (AcipHex)
• Dexlansoprole (Dexilant)
• Omeprazole with sodium bicarbonate (Zegerid)

Each medication will have its own unique side effects. But, some common side effects of antacids in general include:^1,4,5

• Constipation
• Diarrhea
• Headache
• Nausea
• Itching
• Kidney stones
• Calcium loss
• Osteoporosis (weak bones)

You may be wondering, can you take antacids with alcohol safely? If you are taking antacids, you can still consume alcohol in moderation. However, it may worsen your gastrointestinal symptoms or cause interactions. Alcohol increases stomach acid and is associated with a greater risk of gastroesophageal disease. Mixing antacids and alcohol regularly may worsen the side effects of both and increase your risk for long-term health problems.^2,6

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What are the Risks of Mixing Alcohol and Antacids?

While you may not notice immediate harm from the occasional mixing of antacids and alcohol, the health risks of both are increased when you combine them, especially with chronic use.

Some short-term risks of antacids include:²

• Rapid heartbeat
• Sudden changes in blood pressure
• Increased alcohol effect

Long term risks associated with antacid use include:^6,7,8

• Chronic kidney disease
• Chronic liver disease
• Fatal cardiovascular disease
• Upper gastrointestinal cancer
• Bleeding in the gastrointestinal tract

Not much is known about antacids’ effect on alcohol absorption. However, research has shown that certain antacids, such as ranitidine (Zantac), increase alcohol absorption.⁹ Ranitidine has been taken off the market after an association was found between use and gastrointestinal cancers.¹⁰

Still, many of the antacids on the market do carry risks. For example, the U.S. Food and Drug Administration warned about serious bleeding in the stomach and gastrointestinal tract that can occur from taking aspirin-containing antacids.² These include brand names like Alka-Seltzer Original and Zee-Seltzer.

Gastrointestinal bleeding risk is also associated with PPI use. Researchers have found that the risk increases with the duration of PPI use, regardless of the dosage size. The risk of bleeding is even higher if you consume more than three alcoholic drinks per day or have a history of stomach ulcers.⁷

How to Avoid Mixing Alcohol and Antacids

If you are concerned about antacids’ effect on alcohol, you can take steps to avoid mixing the two. You may be able to use both antacids and alcohol in moderation without any serious side effects.

Do Antacids Help After Drinking?

Alcohol increases gastric acid in the stomach, while antacids help to neutralize stomach acid.⁵ If you are experiencing heartburn or related symptoms after drinking, antacids may temporarily relieve your symptoms. However, antacids are meant for occasional use and do carry risks when taken in the long term, and those risks may increase when combined with alcohol.^1,2,3

What Should I Do If I Already Mixed Antacids and Alcohol?

If you have already taken antacids and alcohol, monitor yourself closely for adverse reactions. If you notice a rapid heartbeat, sudden increases in blood pressure, or other side effects, reach out to your doctor for support. Certain antacids may make the effects of alcohol stronger. Be mindful of how much you consume as you may become more intoxicated than you intended.²

What if I Have an Antacid Prescription and Want to Drink Alcohol?

If you are prescribed antacids and want to consume alcohol, you may be able to do so safely in moderation. It is best not to mix the two if possible. For example, you may consider taking your antacid in the morning and consuming alcohol in the evening. To ensure safety, talk with the doctor who prescribed your antacids and ask for their recommendation. Ask about antacids that are safe with alcohol and whether your specific antacid medication has any known interactions with alcohol.

How Can I Manage Acid Reflux and Alcohol Addiction?

It can be challenging to manage the symptoms of alcohol addiction and acid reflux when the two co-occur. Alcohol use can make acid reflux worse and increase the risks associated with antacid medications.² If you are finding it difficult to control your alcohol use despite negative consequences, you may want to consider getting a professional assessment as this is one of the clinical criteria for diagnosing alcohol use disorder.¹¹

If you are struggling with alcohol use disorder, you may benefit from professional treatment such as counseling, medications, or attending an inpatient or outpatient rehab facility. Quitting or reducing your alcohol consumption would likely lessen some of your acid reflux symptoms and would make your antacid medications safer to use.

For more information on addiction treatment options for alcohol use disorder, contact 800-948-8417 Who Answers? to find out more.

Resources

1. U.S. National Library of Medicine. (November 2020). Taking Antacids.
2. National Institute on Alcohol Abuse and Alcoholism. (2014). Harmful Interactions: Mixing Alcohol with Other Medicines.
3. International Foundation for Gastrointestinal Disorders. Antacids
4. U.S. National Library of Medicine (April 2021). Proton Pump Inhibitors.
5. Pan, J., Cen, Li., Chen, W.,, Yu, C., Li, Y. & Shen, Z. (September 2018). Alcohol Consumption and the Risk of Gastroesophageal Reflux Disease. Alcohol and Alcoholism, 54(1), 62-69.
6. U.S. Food and Drug Administration (June 2016). FDA warns about serious bleeding risk with over-the-counter antacid products containing aspirin.
7. Xie, Y., Bowe, B., Yan, Y., Xian, H, Li, T., & Al-aly, Z. (March 2019). Estimates of all cause mortality and cause specific mortality associated with proton pump inhibitors among US veterans: cohort study.
8. Buschman, H. (October 2017). Common Acid Reflux Medications Promote Chronic Liver Disease. UC San Diego Health.
9. Arora, S., Baraona, E., & Lieber, C. (January 2000). Alcohol levels are increased in social drinkers receiving ranitidine. American Journal of Gastrointestinology, 95(1), 208-213.
10. McGwin, G. (January 2021) The Association between Ranitidine Use and Gastrointestinal Cancers. Cancers,13(1), 24.
11. National Institute on Alcohol Abuse and Alcoholism. (April 2021). Understanding Alcohol Use Disorder.