Can You Mix Prednisone and Alcohol? The Risks of Drinking on Steroids

Corticosteroids (“steroids”) — such as prednisone — treat a variety of health conditions. They’re powerful medications that help relieve inflammation and swelling. They can also treat autoimmune disorders, such as rheumatoid arthritis (RA), by suppressing the immune system. This can help calm down symptoms, especially during flare-ups.

Some people only take steroids for a few days, while others take them long term. No matter how long you’re taking a steroid, it’s important to know about possible interactions. This includes whether or not you can drink alcohol.

Can you drink while taking prednisone?

Drinking alcohol isn’t recommended if you’re taking prednisone or other oral steroids. Alcohol can increase your chances of experiencing side effects. It may also worsen the condition you’re treating.

Even for a special occasion, it’s best to talk to your healthcare team first before pouring yourself a glass of wine or ordering a cocktail. They can help you determine if an occasional drink might be safe for you.

How does alcohol interact with prednisone and other corticosteroids?

Alcohol doesn’t change how prednisone is absorbed or works in the body. But combining alcohol and prednisone can have several negative effects.

Alcohol can worsen some of prednisone’s side effects, such as:

• Headache

• Heartburn

• Mood changes

• Stomach irritation

• Weight gain

• Sleep issues

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Drinking alcohol with prednisone may also make infections more likely. It can also make it harder for you to recover from them. This is especially true if you’re taking steroids long term. Steroids suppress the immune system, making it harder for the body to fight off an infection. Alcohol can have that effect as well. Even occasional binge drinking can disrupt the immune system and make it easier for germs to cause infections.

Finally, alcohol can worsen some health conditions that are often treated with steroids, such as RA or chronic obstructive pulmonary disease (COPD).

Are there any serious side effects or risks?

There are a couple of rare, but serious, risks to consider when combining alcohol with prednisone or other oral steroids. Keep in mind the risk of these side effects is greater if you’re taking high doses of steroids or taking steroids long term.

Stomach bleeding

Even a short course of steroids can raise your risk of stomach ulcers and bleeding. This risk goes up if you combine them with other things that irritate the stomach, like alcohol. On its own, alcohol can cause stomach ulcers and bleeding, especially when consumed in high amounts.

Stomach bleeding is serious. If you notice bloody or black stools, or there’s blood in your vomit, get medical attention immediately.

Bone fractures

Taking steroids long term can lower your bone mineral density — a marker of bone health. Over time, this can raise your risk for osteoporosis and bone fractures (broken bones).

Drinking higher amounts of alcohol (3 drinks or more per day) is also associated with a higher risk of broken bones from osteoporosis. To limit bone complications while taking steroids, it’s recommended to limit the amount of alcohol you drink. This is especially important if you’re taking prednisone long term.

Are certain people more at risk when combining alcohol and prednisone?

Yes, some people may be more likely to experience negative effects from alcohol at lower amounts. This can increase your risk of problems when combining alcohol and prednisone.

Be sure that your prescriber is aware of all your current health conditions and medications. As mentioned, alcohol can worsen certain conditions. Even if an occasional drink was OK for you in the past, talk to your healthcare team before drinking while taking prednisone or other steroids. They can help you weigh the potential risks for your specific situation.

Women

Compared to men, women may be more easily affected by alcohol. Women tend to have less water in their bodies and make less of the enzymes that break down alcohol than men do. This can make blood alcohol levels rise faster in women than in men.

Because of this, women may be at higher risk of negative effects from drinking — making the combination of alcohol and prednisone potentially more harmful.

Older adults

Adults ages 60 years or older may also be more easily affected by alcohol. Alcohol affects us differently as we grow older, and it usually takes less alcohol to affect an older adult compared to a younger adult. This means that older adults may be at higher risk for side effects if they drink alcohol while taking prednisone.

When can you start drinking alcohol after taking prednisone or other steroids?

There are a number of factors that can help determine when it’s safe to have a drink. This includes what condition you’re treating, the length of prednisone treatment, and the presence of other risk factors. Even if you only take prednisone for a few days, it’s still best to ask your healthcare team when it’s safe for you to have a drink.

If you’re taking steroids long term, you may have to wait longer before drinking alcohol. Steroids like prednisone affect your body’s ability to regulate inflammation and stress on its own. Depending on how long you’ve been taking the medication, it may be several weeks or even months before this goes back to normal. Your prescriber will help you slowly lower your dose over time (called tapering) and tell you when it might be safe to drink alcohol.

Are there any corticosteroids that aren’t affected by alcohol?

Local steroids are applied directly to the area you’re treating. They tend to have a lower risk of interacting with alcohol. This is because less medication gets absorbed into the rest of your body, so there’s less chance of body-wide side effects.

Examples of local steroids include:

• Topical creams, lotions, and ointments

• Eye drops

• Joint injections

• Inhaled steroids

• Steroid nasal sprays

Even though there’s less risk when combining alcohol and local steroids, you should still speak to your healthcare team to make sure it’s safe. Remember, alcohol can worsen symptoms of other health conditions. So there’s more than just medication interactions to consider when having a drink.

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Written by:

Tegan Smedley, PharmD, APh

Tegan Smedley, PharmD, APh, has 10 years of experience as a pharmacist. She has worked in a variety of settings, including retail, hospital, and ambulatory care.

Edited by:

Stacia Woodcock, PharmD

Stacia Woodcock, PharmD, is a pharmacy editor for GoodRx. She earned her Doctor of Pharmacy degree from the University of Kentucky and is licensed in New York and Massachusetts.

Reviewed by:

Joshua Murdock, PharmD, BCBBS

Joshua Murdock, PharmD, BCBBS, is a licensed pharmacist in Arizona, Colorado, and Rhode Island. He has worked in the pharmacy industry for more than 10 years and currently serves as a pharmacy editor for GoodRx.

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