Bactrim and Alcohol: Can You Drink on Bactrim?

Written by

Jessica Guht

Jessica is a medical writer with an unquenched thirst to discover something new. She believes that medical content should be accessible to everyone and strives to write content that every single person can understand. When Jessica isn’t writing, she can usually be found reading a book with a dog cuddled in her lap. Jessica has a Masters of Engineering degree in Biomedical Engineering.

Medically reviewed by

Amy Dougherty, FNP-BC, AGAC

Amy is a Board Certified Family Health Nurse Practitioner (FNP) with over 15 years of experience working in Hospital Medicine, Urgent Care and Primary Care practices. Amy graduated Thomas Jefferson University with high distinction earning a Bachelor of Science in Nursing in 2008, a Master of Science in Nursing in 2010 and a Post Master's Certificate in Adult Gerontology Acute Care (AGAC) in 2014. She was recognized by the Elite American Nurses Association in 2013 for her dedication, achievements and leadership in the field Nursing. She served as a clinical preceptor for a number of Nurse Practitioner students and enjoys teaching the bright minds of future NPs.

Those with a bacterial infection may be prescribed Bactrim, a combination drug effective against some of the most common bacterial infections. However, a frequently asked question when taking a medicine is if it is safe to mix with alcohol, leading many to wonder if you can drink on Bactrim. 

While alcohol does not affect the efficacy of Bactrim, it can cause the potential side effects of Bactrim to occur or even worsen. Continue reading to learn more about how Bactrim and alcohol interact and if mixing these two is ever safe. 

Table of Contents

• What Is Bactrim?
• Can You Drink Alcohol While Taking Bactrim?
• What Happens if You Drink Alcohol With Bactrim?
• Risk of Mixing Bactrim and Alcohol
• How Long After Taking Bactrim Can You Drink Alcohol?
• What Else Should You Avoid on Bactrim?
• When to See a Doctor?
• Key Takeaways

What Is Bactrim?

Bactrim is a combination antibiotic drug consisting of trimethoprim and sulfamethoxazole. These two drugs are responsible for treating different bacterial infections, and combining the two into one drug increases the number of infections Bactrim can treat. When they work together, trimethoprim and sulfamethoxazole block two steps in the production of proteins and nucleic acids needed by bacteria in order to survive. 

Bactrim is effective against various bacterial infections, such as:

• urinary tract infections (UTIs)
• ear infections
• traveler’s diarrhea
• bronchitis
• pneumocystis jiroveci pneumonia
• shigellosis

However, some of the above infections may also have a viral cause, so Bactrim will only be effective if the cause is bacterial. 

Those who take Bactrim may experience some side effects, and the most common center around the stomach, such as nausea, stomach pain, and diarrhea. To help minimize nausea and vomiting, Bactrim can be taken with food. As for lessening diarrhea, try staying hydrated and avoiding greasy and spicy foods. 

In addition to these common and minimal side effects, those who take Bactrim may also notice more significant ones. For example, Bactrim can make your skin more sensitive to sunlight, increasing your chances of getting sunburn. 

Bactrim may also produce an allergic reaction in some people; signs of this can include:

• hives
• coughing
• shortness of breath
• swelling in the throat, mouth, or face
• chest pain

Severe skin reactions may also occur while taking Bactrim, including fever, sore throat, skin pain, purple or red rash with blistering and peeling skin, and burning eyes. 

If you have any severe side effects while taking Bactrim, including allergic reactions, skin reactions, or liver problems, reach out to a medical professional immediately. 

Can You Drink Alcohol While Taking Bactrim?

It is not recommended to drink alcohol while taking Bactrim because it may cause Bactrim’s side effects to be more severe. Some of these side effects that can occur while mixing alcohol and trimethoprim/sulfamethoxazole include warmth or redness of the skin, fast heartbeats, nausea, vomiting, or tingling sensations. This is considered a “disulfiram-like” reaction. 

Because of these potential side effects, it is not recommended to drink alcohol while taking Bactrim. In fact, medical professionals generally advise never to drink alcohol while taking any medication because it can reduce the medicine’s efficacy or cause unpleasant side effects to amplify or appear. 

As it stands, research into alcohol’s effects on Bactrim does not appear to show any decline in Bactrim’s efficacy. So, you can drink on sulfamethoxazole/trimethoprim, but it is still essential to be aware that mixing the two may increase side effect occurrence and severity. 

What Happens if You Drink Alcohol With Bactrim?

While alcohol will not decrease the effectiveness of Bactrim, if you choose to drink alcohol while taking Bactrim, there can be some consequences, such as keeping you sicker for longer.

Alcohol has also been shown to dehydrate the person drinking, but hydration is crucial to recovery from infection. In this regard, alcohol can inhibit your body’s ability to heal. Alcohol can also disrupt sleep in some people, and, again, rest is crucial for healing from illness. 

Beyond the more severe side effects that may occur while taking Bactrim and alcohol together, alcohol can also suppress your immune system, making your body less effective at removing the infection you have. This is critical because antibiotics work with your body’s immune system to eliminate the infection. If your immune system is not working as well as it should, it may take your body longer to fight the infection, leaving you sicker for longer. 

Additionally, by suppressing your immune system, your infection might actually get worse and may require stronger treatment, which could then come with more severe side effects. 

Risk of Mixing Bactrim and Alcohol

If you mix Bactrim and alcohol, you may experience:

• nausea and vomiting
• flushing
• headache and migraines
• respiratory problems
• palpitations

Even more, these side effects could appear within just 15 minutes of drinking alcohol. 

If you take Bactrim long-term and drink alcohol, the side effects may elevate to:

• erratic mood and behavior
• brain damage
• chronic sleep dysfunction
• depression
• reduced libido

So, if you take Bactrim long-term and continue drinking alcohol even while on this antibiotic, the side effects can be quite severe. 

Furthermore, Bactrim may cause liver problems in some people, with symptoms that can include:

• lightening stool
• darkening urine
• jaundice (yellowing of the skin or eyes)
• stomach pain

Since alcohol can also damage the liver, specifically in those with a history of alcohol abuse or long-term consumption, alcohol can further damage the liver. 

How Long After Taking Bactrim Can You Drink Alcohol?

When it comes to how long you should wait to drink alcohol after taking Bactrim, it helps to look at the half-life of Bactrim and how long it remains in your system. 

Trimethoprim has a half-life of 8-10 hours, and sulfamethoxazole’s is 10. On average, it takes a drug 5-6 half-lives until it is cleared from your system. So, Bactrim will remain in your system for 50-60 hours, or around 5 days.

This means that if you want to wait until Bactrim is entirely out of your system, you should wait at least 5 days after your last dose before drinking alcohol.

It’s important to remember, though, that these numbers are only estimates as certain factors can increase how long it takes for your body to remove Bactrim. For example, those of an older age or with a metabolic condition will not clear the medication from their body as quickly and should then wait longer to drink alcohol. 

What Else Should You Avoid on Bactrim?

In addition to alcohol, other medications may interact with Bactrim, such as:

• antidepressants
• anticonvulsants
• digoxin
• cyclosporine
• indomethacin
• anticoagulants
• blood pressure medications
• pyrimethamine
• methotrexate
• thiazide diuretics
• metformin
• medicines that induce or inhibit CYP2D6 enzymes

For a complete list, speak to your doctor and ensure they are aware of all medications you take. 

FAQs

When to See a Doctor?

If you drink alcohol while taking Bactrim and notice any unpleasant or severe side effects, contact a doctor or seek emergency medical attention. 

Watch for skin reactions such as blistering, rashes, peeling, ulcers, or sores. Anyone taking Bactrim should also monitor for allergic reactions, which have symptoms such as difficulty breathing, itching, swelling of the throat, tongue, or mouth, and chest pain. If you experience any of these symptoms, call a doctor or visit the emergency room. 

Bactrim may also cause liver problems in some people, and you should seek immediate medical attention if you have any of the following symptoms:

• lightening stool
• darkening urine
• jaundice (yellowing of the skin or eyes)
• stomach pain

Key Takeaways

Bactrim is a combination antibiotic taken to treat a range of bacterial infections. However, like most medications, it is not recommended to drink alcohol while taking it. This isn’t because alcohol makes it less effective but because mixing alcohol and Bactrim can cause more severe side effects. Additionally, alcohol generally inhibits the immune system, which may keep you sicker for longer. 

If you decide to drink alcohol while taking Bactrim, be sure to contact a doctor if you notice any skin reactions, allergic reactions, or signs of problems with the liver. If you’re ever unsure if it’s safe to take a particular medicine with alcohol, reach out to your doctor. 

Sources:

• Mergenhagen, K., Wattengel, B., Skelly, M., Clark, C., & Russo, T. (2020). Fact versus Fiction: a Review of the Evidence behind Alcohol and Antibiotic Interactions. Antimicrobial Agents And Chemotherapy, 64(3). doi: https://www.doi.org/10.1128/aac.02167-19 
• Sulfamethoxazole / Trimethoprim – Tablet, tablet (double strength) | NIH. (2023). https://clinicalinfo.hiv.gov/en/drugs/sulfamethoxazole-trimethoprim/tablet-tablet-double-strength 
• Kemnic TR, Coleman M. Trimethoprim Sulfamethoxazole. [Updated 2022 Nov 28]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK513232/ 
• Bactrim. (2013). https://www.accessdata.fda.gov/drugsatfda_docs/label/2013/017377s068s073lbl.pdf 
• Hagihara, M., Kato, H., Uchida, S., Yamashita, R., Tanaka, S., Sakanashi, D., Shiota, A., Asai, N., Koizumi, Y., Suematsu, H., Yamagishi, Y., Namiki, N., & Mikamo, H. (2019). The First Report on Pharmacokinetic/Pharmacodynamic Study of Trimethoprim/Sulfamethoxazole against Staphylococcus aureus with a Neutropenic Murine Thigh Infection Model. Chemotherapy, 64(5-6), 224–232. https://doi.org/10.1159/000507540 
• Abusin, S., & Johnson, S. (2008). Sulfamethoxazole/Trimethoprim induced liver failure: a case report. Cases Journal, 1(1). doi: https://www.doi.org/10.1186/1757-1626-1-44 
• LiverTox: Clinical and Research Information on Drug-Induced Liver Injury [Internet]. Bethesda (MD): National Institute of Diabetes and Digestive and Kidney Diseases; 2012-. Sulfamethoxazole-Trimethoprim. [Updated 2017 Dec 5]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK547937/