Is It Safe to Drink Alcohol During Chemotherapy?

Possible Risks to Consider

The safety of alcohol during chemotherapy can vary based on the treatment regimen. Different factors can influence the risk, including drug interactions, the worsening of side effects, and the effects of alcohol itself. 

Some specific chemotherapy medications interact with alcohol causing or worsening side effects such as dizziness, drowsiness, nausea, vomiting, and more.

This article reviews which chemotherapy and other medications used during cancer treatment interact with alcohol, additional risks and concerns, and the effects on cancer growth and survival.

Glass of alcohol on wooden table
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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.

Chemotherapy Drugs

Chemotherapy drugs and alcohol are both processed by the liver. Alcohol can cause liver inflammation which can interfere with the chemo doing its job. Alcohol also interacts with the following chemo drugs:

  • 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.

Other Medications

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 several 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 also affect moderate drinkers.
  • 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 leads to worse outcomes in cancer patients. To date, the research addressing this is minimal. 

Some studies show that those who regularly drink moderate amounts of alcohol often have decreased immune systems. Most cancer treatments work best when the immune system works properly. When alcohol harms the immune system this can lead to poor outcomes. 

Alcohol can increase estrogen levels which increases the risk of estrogen-receptor-positive breast cancer. A 2014 study found that alcohol use had no significant effect on survival times or the rate of breast cancer progression. However, more recent studies show a higher risk of recurrence for women taking hormone therapy for estrogen-receptor breast cancer. 

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.

Summary

While not all chemotherapy medications interact with alcohol, both are processed by the liver. Drinking alcohol with chemotherapy could cause liver inflammation which can interfere with the effectiveness of chemotherapy.

Alcohol can also lead to side effects when combined with certain chemotherapy drugs and drugs used to support treatment (such as painkillers and anti-nausea medications).

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

There is not enough research to state that alcohol affects survival times for all cancers. However, there are some, such as head and neck cancer, where alcohol can decrease survival times. It can also be a risk factor for recurrence in cancers such as estrogen-receptor-positive breast cancer.

A Word From Verywell

We know it can be frustrating to have more limitations placed on you while taking chemotherapy. If you are wondering if you should limit alcohol, talk with your healthcare team. They can tell you if it is safe to drink alcohol before or immediately following you specific chemotherapy.

Frequently Asked Questions

  • Is it safe to drink wine during chemotherapy?

    In general, it’s best to avoid wine and other alcoholic beverages while taking chemotherapy. Some chemotherapy medications interact with alcohol, worsening side effects. Alcohol can also cause liver inflammation which can decrease the effectiveness of chemo.

    It’s best to speak with your healthcare team to determine if your specific chemo interacts with alcohol. 

  • When can you start drinking after taking chemo medications?

    This varies depending on the type of chemotherapy treatment. Other factors include the type of cancer you have, your immune system, side effects you are still experiencing, and other medications you take.

    Your healthcare team is the best source as they can help determine if alcohol interacts with any medication in your treatment plan.

  • How much can I drink after chemo?

    How much you can drink after chemo depends on your treatment plan. Some chemo drugs interact with any amount of alcohol, which can increase your risk of side effects.

    If you are taking other medicines to manage side effects, including antidepressants, antianxiety, pain, or sleep medications, it’s best to avoid alcohol. Your healthcare team can help you determine if alcohol interacts with any medicines in your treatment plan.

  • Can you drink alcohol during radiation treatment?

    In general, it’s best to avoid alcohol while undergoing any cancer treatment, including radiation. This is because it can decrease your immune system, cause liver inflammation, and worsen the side effects of treatment.

    Alcohol can also cause more irritation to areas undergoing radiation. This includes the throat, esophagus, stomach, bladder, and more.

12 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.
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Additional Reading

By Brandi Jones, MSN-ED RN-BC
Brandi is a nurse and the owner of Brandi Jones LLC. She specializes in health and wellness writing including blogs, articles, and education.

Originally written by Lisa Fayed