Is It Safe to Drink Alcohol During Chemotherapy?

Possible Risks and "Benefits" to Consider

Table of Contents
View All
Table of Contents

When it comes to alcohol and chemotherapy, the first assumption that many people make is that the two don't mix.

And, while there certainly are risks and concerns, the safety of alcohol during chemotherapy can vary from one person to the next. Different factors can influence the risk, including drug interactions, the worsening of side effects, and the depressive effects of alcohol itself.

Glass of alcohol on wooden table
Myeong Jun Baeg / EyeEm / Getty Images

This article takes a closer look at the potential risks of alcohol use during chemotherapy and whether there are any potential benefits to having the occasional drink.

Drug Interactions

Alcohol can interact with certain chemotherapy drugs as well as drugs that support cancer treatment. Some of these interactions are minor, while others may require you to skip alcohol until treatment is completed.

Interactions with Chemotherapy Drugs

Alcoholic beverages do not appear to interact with chemotherapy drugs, but there are a few exceptions:

  • Matulane (procarbazine): Drinking alcohol with Matulane (used for the treatment of stage 3 and stage 4 Hodgkin lymphoma) can increase the central nervous system side effects. This includes the loss of balance, headaches, drowsiness, or dizziness.
  • Gleostine (lomustine): Combining alcohol with Gleostine, also used for Hodgkin lymphoma and metastatic brain cancer, can lead to nausea and vomiting.

Interactions with Other Drugs

Perhaps of greater concern are the effects that alcohol has on the medications used to support cancer treatment. These include:

  • Ultram (tramadol): Used to relieve pain, Ultram can cause excessive drowsiness and confusion when mixed with alcohol. Using alcohol with Ultram can also severely suppress breath, blood pressure, and heart rate.
  • Anxiolytics (anti-anxiety drugs): When mixed with alcohol, anti-anxiety drugs like Xanax (alprazolam) and Ativan (lorazepam), can cause extreme sleepiness, difficulty concentrating, and abnormally slowed breathing. 
  • Antiemetics (anti-nausea drugs): Drugs like Zofran (ondansetron) used to treat nausea and vomiting can also cause extreme drowsiness, dizziness, and loss of coordination when combined with alcohol.

Recap

Alcohol can cause severe side effects when combined with chemotherapy drugs like Matulane (procarbazine) and Gleostine (lomustine). It can also interact with painkillers, anti-anxiety drugs, and anti-nausea medications used to support cancer treatment.

Additional Risks and Concerns

There are a number of chemotherapy-related side effects that can be worsened by drinking alcohol. Alcohol may also indirectly impact treatment and a person's ability to cope.

Some of the concerns include:

  • Dehydration: The dehydrating effect of alcohol can worsen any dehydration caused by chemotherapy (typically due to vomiting, diarrhea, or excessive urination).
  • Mouth sores: Chemotherapy-induced mouth sores are common. Alcohol can make the sores worse and increase pain.
  • Nausea and vomiting: Alcohol is irritating to the stomach and can aggravate the symptoms of chemotherapy-induced nausea.
  • Blood counts: Alcohol can interfere with the production of blood cells, potentially worsening bone marrow suppression in people undergoing chemotherapy. The risk is highest among heavy drinkers but can affect moderate drinkers as well.
  • Peripheral neuropathy: Chemotherapy-induced peripheral neuropathy causes the painful tingling of the hands and feet. Chronic alcohol use can make the condition worse.
  • Sleep disturbances: Alcohol can cause sleep problems. Sleep problems, in turn, correspond to poorer survival times in people with advanced cancer.
  • Depression: Depression is common in people with cancer. As a depressant, alcohol can worsen depression and make it harder for people to cope during chemotherapy.

Recap

Alcohol can complicate chemotherapy by making mouth sores, nausea, and vomiting worse. It can also interfere with sleep, increase the risk of depression, and promote bone marrow suppression.

Effects on Cancer Growth and Survival

It has long been theorized that alcohol use translates to worse outcomes in people with cancer. To date, there is little evidence of this.

While alcohol can increase estrogen levels and, in theory, promote the progression of estrogen-sensitive cancers (like breast cancer), there is little research to support the claims. A 2014 study involving almost 30,000 people with breast cancer found that alcohol use had no significant effect on survival times or the rate of cancer progression.

A 2017 study investigating the impact of alcohol on people with head and neck cancers found that alcohol did, in fact, decrease survival times in people who had undergone tongue cancer surgery. However, the same was not seen with other forms of head and neck cancer or for people with tongue cancer who had undergone radiation therapy.

Recap

Alcohol does not appear to promote cancer growth or affect the survival times of people with cancer.

Potential Benefits

Despite concerns about mixing alcohol and chemotherapy, there are potential "benefits" if alcohol is consumed in moderation.

Chief among these is anxiety relief. This is not to suggest that there aren't better ways to deal with anxiety, but the occasional glass of wine may help if stress levels are high. By contrast, demonizing alcohol use may only serve to drive the habit underground.

A 2021 study from the American College of Cardiology concluded that moderate alcohol use can also help the heart by calming stress signals in the brain.

Moderate drinking refers to two drinks or less per day for males and one drink or less per day for females. In the United States, one drink is usually considered to be 12 ounces of beer, 5 ounces of wine, or 1½ ounces of spirits such as gin or whiskey.

As with all facets of cancer treatment, speak with your healthcare team to decide if alcohol is safe for you to use during chemotherapy.

Recap

While debatable, moderate alcohol use may be "beneficial" in relieving high levels of stress due to cancer treatment. Speak with your doctor.

Summary

There are potential risks to mixing alcohol with chemotherapy. While alcohol does not appear to reduce the effectiveness of chemotherapy, it can lead to side effects when combined with certain chemotherapy drugs and/or drugs used to support treatment (such as painkillers and anti-nausea medications).

Alcohol can indirectly affect chemotherapy by making side effects worse, including mouth sores, nausea, and vomiting. It can also interfere with sleep and increase the risk of depression.

With that said, alcohol does not appear to affect survival times or speed the progression of cancer. If used in moderation, the occasional drink may help reduce anxiety in people undergoing chemotherapy. It is important to speak with your oncologist as to whether alcohol is safe for you.

As with all other aspects of cancer treatment, it is best to speak with your healthcare team as to whether it is safe to drink alcohol before or immediately following chemotherapy.

Was this page helpful?
5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Sawabe M, Ilo H, Oze I, et al. Heterogeneous impact of alcohol consumption according to treatment method on survival in head and neck cancer: a prospective study. Cancer Science. 2017;108(1):91-100. doi:10.1111/cas.13115

  2. RXlist: Matulane.

  3. National Institute on Alcohol Abuse and Alcoholism. Harmful interactions: mixing alcohol with medicines.

  4. Ali AM, Schmidt MK, Bolla MK, et al. Alcohol consumption and survival after a breast cancer diagnosis: a literature-based meta-analysis and collaborative analysis of data for 29,239 cases. Cancer Epidemiol Biomarkers Prev. 2014 Jun;23(6):934-45. doi:10.1158/1055-9965.EPI-13-0901

  5. American College of Cardiology. Alcohol in moderation may help the heart by calming stress signals in the brain.

Additional Reading