Can I Drink Alcohol If I Have Rhabdomyolysis?

A 19-year-old consumed two liters of red wine. Six hours later, he entered the emergency room intoxicated, uneasy, and sore. He hadn’t taken any medications or other substances, and his medical history was completely unremarkable. After running numerous tests, however, the doctors spotted muscle damage and concluded he had alcohol-induced rhabdomyolysis. 

Fortunately, he was diagnosed and treated quickly and was able to make a full recovery. But what happens the next time his friends invite him out for drinks? Is it safe to drink alcohol after a rhabdo diagnosis? 

What Is Rhabdo?

Rhabdomyolysis, nicknamed “rhabdo,” is a rare, rapid breakdown of damaged muscle tissue. When our muscles are injured, they deteriorate, releasing a slew of proteins and electrolytes into the bloodstream. This can worsen kidney function and alter the body’s electrolyte balance. If left untreated, rhabdomyolysis can even lead to organ failure.

Any form of muscle damage may cause rhabdo. The most common culprits are physical overexertion, traumatic injury, and excessive heat exposure. More rarely, muscle breakdown occurs due to drug and alcohol use, certain medications, or illnesses.

If left untreated, rhabdo can be deadly. Knowing the signs of this condition helps us seek medical care before it’s too late.

What Are the Symptoms of Rhabdomyolysis?

Clinicians identify rhabdomyolysis through a triad of symptoms: myalgia, myoglobinuria, and asthenia. For those of us who aren’t doctors, that translates to muscle pain, tea-colored urine, and weakness.

It’s important to note that experiencing all of these symptoms at once is a bit rare; fewer than 10% of us will have all three. Instead, we’ll probably just notice one common symptom — the dark, discolored urine emblematic of rhabdomyolysis.

The following symptoms are also associated with rhabdo:

• Muscle swelling, especially in one specific area
• Persistent cramping sensations
• Dehydration
• Nausea
• Infrequent urination
• Fainting

Regardless of how your muscle damage manifests, prompt medical care is crucial. If you experience extreme muscle pain, dark urine, swelling, or any of the other symptoms outlined above, head to the hospital. This condition can be life-threatening.

What Happens If You Have Rhabdomyolysis?

When we have rhabdo, our deteriorating muscles dump a ton of potassium, phosphate, creatine kinase (CK), urate, and myoglobin into our bloodstream. All that gunk eventually reaches our kidneys, which may struggle to filter out those unexpected hemoglobinic pollutants. That’s a fast track to kidney failure and a whole host of other issues.

The consequences of rhabdo are serious. If left untreated, this condition can cause big problems:

• Nausea and vomiting
• Kidney damage and failure
• Electrolyte imbalance
• Cardiac arrhythmia (abnormal heartbeat)
• Seizures
• Metabolic acidosis (acid buildup)
• Compartment syndrome (poor circulation and necrosis caused by swelling)
• Disability
• Death

Because rhabdomyolysis threatens our lives, we want to take every possible measure to avoid it. In addition to avoiding triggers like prolonged heat exposure and heavy exercise, we may want to consider one other lifestyle change — cutting back on our alcohol intake. 

Alcohol and Rhabdomyolysis

Alcohol is one of the lesser-known causes of rhabdo. Some patients develop this condition after episodes of intoxication or alcohol-induced comas (acute alcoholic myopathy). Others only exhibit symptoms after years of heavy drinking, which we call chronic alcoholic myopathy.

When we consume large amounts of alcohol, we become dehydrated and uninhibited. Both of these changes contribute to our risk of rhabdo. For example, our impaired judgment may lead us to make decisions we usually wouldn’t, resulting in muscle injury from falls or overexertion. These short-term risks may cause us to develop rhabdo.

There’s another facet to alcohol-induced rhabdomyolysis: drinking accelerates the muscle breakdown associated with rhabdo. When our liver metabolizes the ethanol found in beer, wine, or cocktails, it produces carcinogenic acetaldehyde. This substance triggers the formation of free radicals — unstable, reactive molecules that destroy the protective membranes of our cells. Over time, this damage adds up, meaning that those of us who drink heavily in the long term may experience muscle breakdown, weakness, and (you guessed it) rhabdo.

So, what can we do if we have this condition? If your urine is tea-colored after drinking or you notice out-of-control muscle aches, you may need to go to the hospital.

How Do You Treat Alcohol-Induced Rhabdomyolysis?

Seek medical care immediately if you experience any symptoms of rhabdo. This potentially fatal condition isn’t one we can treat on our own — it requires expert clinical care.

As in most medical emergencies, prompt intervention for rhabdomyolysis is key. The sooner we get to the hospital, the better our outcome will be. Our medical team will strive to promote muscle healing, stop further muscle damage, and protect our kidney function.

All types of rhabdo, including alcohol-induced rhabdomyolysis, are treated with fluid management. Mild cases may resolve with a combo of rest and lots of water. In moderate to severe instances, we might require “aggressive repletion” in the form of intravenous fluids administered at the hospital. Those typically include saline or a solution of glucose and sodium bicarbonate (commonly known as baking soda). The purpose of this approach is to flush out the muscle proteins that cause arrhythmia and kidney damage.

Research: New Treatments for Rhabdo

Because rhabdo is such a dangerous condition, scientists continue searching for more (and better) ways to treat it. At present, there is no standardized second-line treatment for those whose conditions aren’t improved by fluids. Fortunately, it seems like that’s changing.

Researchers from Tulane University found that corticosteroids dramatically improved the condition of an alcohol-induced rhabdomyolysis patient who didn’t respond to fluid management. These drugs have a low toxicity profile, making them potentials option for those who don’t respond to aggressive repletion.

Additionally, medical experts have begun looking into ways to prevent recurrent episodes of rhabdomyolysis.

Preventing Rhabdo Recurrence

While we can’t completely eliminate the risk of rhabdo, we can make lifestyle changes that reduce it:


• Learn the warning signs. Keep an eye out for warning signs of rhabdo — especially alcoholic rhabdomyolysis symptoms. Remember, you may not experience dark urine, weakness, and muscle pain all at once, but any one of these is cause for medical attention.

• Take it easy. Overexertion causes most cases of rhabdo — especially if we’re jumping into heavy, prolonged physical activity after a long break. Be mindful of this and consider setting limits on exercise or hard labor whenever possible. Your health comes first!

• Hydrate. Drinking enough water is crucial for rhabdo prevention. The average woman needs 2.7 liters of fluid each day, while men need a full liter more (3.7). You also may want to stay away from caffeine, alcohol, and other dehydrating substances.

• Stay cool. Heat exposure drastically increases our chances of developing rhabdomyolysis. If you must stay outside in high temperatures, take breaks, stick to the shade, and head indoors from time to time. Know your limits and take care of yourself!

• Rule out health conditions. Discovering what’s behind your rhabdo can help you fend off future flare-ups. Have a conversation with your primary care physician after receiving treatment for muscle damage. They can order diagnostic tests to identify any underlying conditions that predispose you to rhabdomyolysis, such as autoimmune myositis.

• Eat well (and consistently). Fresh fruits and veggies provide the antioxidant boost we need to keep rhabdo at bay. Eat well and avoid long periods of fasting, especially before strenuous workouts or long days in the heat.

• Abstain from alcohol. At best, drinking may counteract the efforts you’ve made to repair your muscles post-rhabdo. At worst, it can trigger another episode or contribute to lasting organ damage. Consider cutting back on booze (or cutting it out entirely) — especially if you have alcohol rhabdomyolysis.

Any small change you make in the right direction will help you avoid rhabdo and improve your overall health.

How Long After Rhabdo Can I Drink Alcohol?

Rhabdomyolysis and alcohol don’t mix, but can you drink at all after rhabdo? If so, how long should you wait? Is it okay to drink during treatment? Below is a quick reference guide answering the question, “How long after rhabdo can I drink alcohol?”


• If you currently have rhabdo: If you’re in the middle of treatment for rhabdo, do not drink any alcohol at all. Drinking puts a ton of additional stress on your internal organs, including your kidneys, which are currently doing their best to recover from rhabdomyolysis. Alcohol also contributes to dehydration, which can prolong your symptoms and counteract the fluid therapy you’re currently receiving.

• If your rhabdo has resolved and was not caused by alcohol: Talk to your medical team if you’re hoping to have a few cocktails post-treatment. Their recommendation should take priority over any advice you see online. They’ll probably ask you to wait anywhere from several weeks to a few months for your kidney function and muscles to return to normal. Once your doctor has given you the okay, you may begin slowly reincorporating alcohol into your life. Just make sure you have the go-ahead, and don’t go overboard! Moderating your intake is a good idea to prevent future episodes.

• If your rhabdo has resolved and was caused by alcohol: If your doctor determined that you had alcohol-induced rhabdomyolysis, they may advise you to quit drinking (or at least drink less). They can offer you resources and support for navigating this major lifestyle shift. If your provider says it’s all right to drink in moderation, consider tracking your alcohol intake with Reframe. If they ask you to quit entirely, Reframe can help you do that, too.


Abstaining from alcohol entirely is the safest option, but your doctor will have the best recommendations for your particular case. 

Avoid Alcohol Rhabdomyolysis

The connection between alcohol and rhabdomyolysis is complex. Drinking contributes to muscle damage and weakens our immune system — a recipe for rhabdo recurrence. Our best bet is to enjoy some non-alcoholic alternatives while putting our well-being first.

If you start developing health conditions due to drinking, you may want to reevaluate your relationship with alcohol. Reframe offers a framework to help you do just that. Our one-of-a-kind app provides daily inspiration and valuable information, whether you’re quitting or cutting back. You can also enjoy peer support in our 24/7 Forum or regular Zoom meetings. We’re with you every step of the way. Visit the App Store or Google Play today for more information.