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Is It Safe to Combine Phenytoin and Alcohol?

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  • Written By: Mary McMahon
  • Edited By: Shereen Skola
  • Last Modified Date: 21 May 2019
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    Conjecture Corporation
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Combining phenytoin and alcohol is not recommended, although an occasional drink now and then is not a serious risk. Also known by the brand name Dilantin®, this medication may be recommended to control seizures in a patient with epilepsy. Mixing it with alcohol can increase the intensity of side effects and compromise the medication’s ability to work effectively. Patients who drink heavily may want to discuss this before starting therapy with the medication; they may not be able to stop drinking abruptly as this could put them at risk of complications, and they may need treatment to help them address the issue.

In the short term, the concern with acute drinking, where people consume several strong drinks in a short period of time, is that it can increase the availability of phenytoin in the blood. The combination of phenytoin and alcohol can make side effects worse, and may make the patient feel the effects of alcohol more acutely. Neither of these outcomes are particularly desirable, as they can put the patient at risk. A single beer or glass of wine consumed slowly over the course of a meal generally isn’t a cause for concern, because the body has time to metabolize it safely.

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Chronic heavy drinking can cause a different problem. Instead of increasing the amount of phenytoin in the blood, it can decrease the availability of the medication. This means the patient receives less protection from seizures. People who combine phenytoin and alcohol may not be getting a dose high enough to compensate for this, and could be at risk of more seizure activity. In this situation, the patient may think the drug isn’t working, when the drinking is actually the root of the problem.

People with alcoholism or a chronic drinking habit can be at risk of health problems if they stop suddenly. While it is not safe to mix phenytoin and alcohol, it is also usually not a good idea to suddenly embark on a drinking cessation program. Patients can discuss the situation with a medical provider to determine how to safely stop drinking while on the medication. This may include slowly reducing the amount of alcohol consumed, attending therapy, or considering structured treatment in a facility dedicated to dependence and addiction.

The mixture of phenytoin and alcohol can be unpredictable. People who have just started taking the medication may want to wait to adjust to it and see how they feel before trying a moderate drink in a safe environment. If they react badly, this is an indicator that they shouldn’t drink at all while on the drug. In cases where there are no adverse effects, drinking moderately on occasion may not be dangerous, although the patient’s medical provider may have a different recommendation.

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Discuss this Article

ysmina
Post 3

I also agree that it's a bad idea to combine phenytoin and alcohol. There is no clear cut rule on it but I think the logical thing to do is to avoid it.

Did anyone know that phenytoin is also used for those suffering from seizures due to alcohol withdrawal? If alcohol use and withdrawal can lead to seizures, it doesn't really make sense to drink while taking a seizure medication.

bluedolphin
Post 2

@donasmrs-- I'm not a doctor and obviously, it's best to take your own doctor's recommendation on this topic.

I have read however that alcohol can reduce the threshold for seizures. Although phenytoin helps prevent seizures, I think that combining it with alcohol may actually increase the likelihood of a seizure. So you might be more likely to have a seizure when you drink then when you don't while on this medication.

My sister is on this medication as well and she never drinks. I asked her about it once and she told me that she doesn't want to take any risks. She often tells me how a seizure is the scariest thing one could experience. It's probably best for people on this medication to do everything in their power to prevent seizures. Drinking alcohol certainly won't help.

donasmrs
Post 1

I'm on phenytoin and although I don't drink on a regular basis, I can't deny having a drink here and there. I usually reserve these for holidays or special occasions. Thankfully, I've not experienced negative side effects from this combination. I'm very careful about how much I drink however. I usually only have one drink and I make sure that it's not hard liquor.

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