Can You Drink on Macrobid? What Are the Risks?

You’ve just been prescribed Macrobid, and you’re ready to finally kick this infection. Especially because tomorrow is your friend’s birthday party — and it’s going to be lit! You’re looking forward to having a few drinks, and you’ve already preordered your Uber for the drive home.

A quick glance at the leaflet from the pharmacy says you should be okay to drink on Macrobid, so you don’t need to worry — right?

Just because we can eat all the cookies in the cookie jar doesn’t mean it’s healthy to do so. Even though there aren’t any direct interactions between alcohol and Macrobid, there can be adverse effects to mixing the two. Let’s examine these effects further; well-informed decisions require well-formed knowledge!

What Is Macrobid?

Macrobid (a.k.a., nitrofurantoin) is an antibiotic that is used to treat bacterial infections, most commonly urinary tract infections (UTIs). The antibiotic is different from other, more common antibiotics; it collects in the urine, making it a good choice for infections involving the lower urinary tract. It’s one of the most common prescriptions in the United States with roughly 4 million prescriptions per year. Macrobid only works against bacterial infections, not viral infections of the urinary tract (such as BK virus, adenovirus, or herpes simplex virus). 

The medication starts working within a couple of hours, and it is typically taken for 5-7 days. Several side effects are associated with Macrobid:

• Nausea 
• Headache
• Dizziness
• Joint or muscle pain
• Swelling
• Shortness of breath
• General discomfort (malaise)

In very rare cases, Macrobid can cause damage to lungs, liver, and nerves. However, Macrobid is regarded as generally safe to use.

Are Macrobid and Nitrofurantoin the Same Thing?

Macrobid is the brand-name version of the generic drug nitrofurantoin. Brand-name Macrobid contains nitrofurantoin in both slow-release macrocrystal form and a quick-acting liquid monohydrate form. Together, this attacks an acute UTI from two angles. (Other nitrofurantoin formulations contain only macrocrystals and are usually used as a preventative to avoid UTIs.)

Our doctor will prescribe the appropriate form of nitrofurantoin to treat our specific circumstances. The most important thing is to take it as prescribed and read all directions and warning labels.

Systemic Effects of Macrobid and Alcohol

So, can you drink alcohol while taking nitrofurantoin? The answer is complicated. Although Macrobid and alcohol don't have any direct interactions, mixing them can interfere with the drug’s effectiveness, damage our liver, and slow down our recovery from infection.

• Liver metabolization. Most drugs are metabolized by the liver — including Macrobid. Using both at the same time can stress out the liver and inhibit its ability to effectively eliminate the toxic byproducts of alcohol metabolism, possibly leaving us with a nasty hangover. Proper liver function is crucial in helping break down toxins at an appropriate rate to prevent them from causing negative effects on other organs and systems in our body.
• Decreased immune function. Our immune system’s main role is to help fight infection and keep us healthy. When recovering from a UTI, a strong immune system is critical to eliminating the infection because the Macrobid is only a boost to our body’s natural bacteria-fighting power. Alcohol dampens the function of our immune system, taking away precious resources and prolonging recovery. 

• Dehydration. Alcohol is a diuretic, meaning it makes us pee. Hydration is essential for treating a UTI because peeing regularly prevents further bacteria growth. While alcohol can cause us to urinate a lot in the short term, the result is that we’re left dehydrated and playing catchup to restore our fluid levels.
• Medication adherence. Nitrofurantoin is prescribed for 5-7 days to ensure the infection is completely eliminated. Although symptoms may start to go away before then, the entire round of antibiotics is recommended for full effectiveness. Alcohol is correlated with decreased inhibitions and impacted judgment. Research has shown that drinking may influence a patient's adherence to taking daily medication, which may increase the risk of UTI recurrence. 

Despite no acute interactions, it’s clear that alcohol can still interfere with nitrofurantoin. While the above conditions can complicate UTI treatment, there are also some ways that .

Risks of Drinking on Nitrofurantoin

To make more mindful decisions when drinking while on nitrofurantoin, it’s important to know what we may be getting into:

• Increased side effects. UTIs are painful and unpleasant. Alcohol can further exacerbate symptoms, increase side effects from medication, and heighten the risk of experiencing hangover symptoms — compounding the uncomfortable experience. Choosing to drink while on nitrofurantoin is like holding up a big welcome sign to usher in unpleasant symptoms such as nausea, vomiting, headache, and stomach pain.
• Decreased effectiveness. Alcohol’s impact on our immune system and hormones can affect our body’s ability to fight against infection — indirectly dampening the effectiveness of nitrofurantoin.
• Risk of liver damage. Prolonged and excessive drinking is associated with liver damage and disease. When our liver is in overdrive trying to break down alcohol and other drugs in our system, it’s less efficient at eliminating toxic substances that cause damage to our cells and organs. While on nitrofurantoin, alcohol can create the perfect storm that may lead to liver damage or disease.

We may have missed the tiny print on the back of the bottle warning us of these potential risks. If we’ve already had a drink or two while taking nitrofurantoin, should we be concerned?

What To Do If You’ve Already Consumed Alcohol With Nitrofurantoin

First of all: don’t panic! You’re going to be okay; plus, high stress levels can negatively impact recovery and lead us to make rash decisions through black-and-white thinking. 

Avoid further drinking and make sure to continue taking the medication as directed. Immediate symptoms may not show up after drinking, and it shouldn’t cause any immediate risk to health. If symptoms do arise, keep track of them and reach out to a doctor.

How Long After Taking Nitrofurantoin Can You Drink Alcohol?

Drinking while on nitrofurantoin isn’t recommended, but what about after? Similar to drinking while on the medication, drinking after finishing treatment may not cause immediate risks or direct impacts. However, it’s recommended to wait at least 48 hours after finishing nitrofurantoin to resume drinking.

Even after finishing the round of antibiotics, there’s still the chance of a lingering infection. Take it easy on alcohol — or better yet, avoid it all together — for a week or two after finishing treatment. This allows the body a better chance to fight off any infection that could still be present. Drinking immediately after finishing treatment will not cause any significant dangers (beyond the regular dangers of alcohol), but making intentional choices sets us up for the most successful and safe recovery.

Approaching Safe Consumption of Nitrofurantoin and Alcohol 

If we choose to drink, mindful practices can help minimize potential negative consequences to our recovery from infection. Actioning these four strategies can lead to safer and speedier healing:

• Practice moderation. Avoid drinking alcohol as much as possible while on nitrofurantoin. Opt for light or non-alcoholic beverages or mocktails, and set limits for yourself when you do go out. Avoiding triggers and standing up to peer pressure are other great ways to reduce overall alcohol consumption. 
• Monitor symptoms. Tracking your alcohol consumption helps you connect any dots between your drinking and symptoms, and it can help you communicate clearly with your physician. They can offer personalized advice based on your unique health needs.
• Adhere to the medication cycle. Completing the entire cycle of antibiotics is necessary to ensure the best chance of completely eliminating the infection. Always take your medication as prescribed. If you know we’ll be out for the night and may forget to take it the morning after, it’s helpful to set an alarm or designate an accountability buddy.
• Maintain nutrition and hydration. Proper nutrition and hydration are key for fighting off infections. If you’re planning to drink, prioritize eating a balanced meal that supports your liver and consider giving your liver a boost with a next-day liver detox drink. Maintain hydration by keeping a water bottle handy and supplementing with electrolytes.

Moving Forward

Macrobid and nitrofurantoin are short-term antibiotics that help to treat UTIs. Although not immediately dangerous, mixing alcohol and Macrobid puts unnecessary stress on our body and increases the possibility of unpleasant symptoms and complications.

If we choose to drink, implementing mindful drinking practices can minimize risks. Keeping these strategies in our back pocket can be helpful for practicing safe alcohol consumption in other scenarios as well. Here’s to a healthy tomorrow!