Why alcohol should not be consumed when taking cephalosporins

The main principle behind avoiding alcohol consumption when taking cephalosporins is due to disulfiram reaction and disulfiram-like reaction.

1. Disulfiram Reaction: If alcohol is consumed within three days after taking cephalosporin antibiotics, it may trigger a disulfiram reaction. This reaction can cause symptoms such as facial flushing, increased heart rate, nausea, and in severe cases may even lead to palpitations, decreased blood pressure, shock, and require immediate medical attention.

2. Disulfiram-like Reaction: This reaction occurs because ingredients in cephalosporin drugs can inhibit the activity of an enzyme in the liver called aldehyde dehydrogenase, which is responsible for further metabolizing acetaldehyde, a byproduct of alcohol metabolism, into harmless substances.

Under normal circumstances, acetaldehyde is rapidly metabolized by aldehyde dehydrogenase. However, when cephalosporin antibiotics are used, the activity of aldehyde dehydrogenase is inhibited, leading to the accumulation of acetaldehyde in the body and causing a series of uncomfortable symptoms, including facial flushing, headache, nausea, vomiting, rapid heartbeat, and decreased blood pressure. In severe cases, difficulty breathing and impaired consciousness may even occur.

To avoid these adverse reactions, it is recommended to avoid alcohol consumption during treatment with cephalosporin antibiotics and for a period of time after discontinuation of the medication.