Drug & supplement interaction

Beer + Metronidazole

Metronidazole brand names: Flagyl, Protostat, Metronidazole, Nidazol, Trikacide, and others.

Moderate Interaction
The bottom line Moderate

Beer has a moderate interaction with Metronidazole. Concomitant use may cause a disulfiram-like reaction.

Read the full interaction report
SeverityModerate
LikelihoodPossible
EvidenceC
What do Severity, Likelihood & Evidence mean?
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Interaction report

Beer and Metronidazole

Here is the interaction we found between these two, with the evidence behind it.

Moderate

METRONIDAZOLE (Flagyl)

Concomitant use may cause a disulfiram-like reaction.
Although there is some disagreement over the likelihood of a disulfiram-like reaction with concomitant use of alcohol and metronidazole, prescribing materials recommend discontinuing alcohol intake during the use of metronidazole. In the US, it is recommended to discontinue alcohol during and for at least three days after therapy with metronidazole; in Canada, it is recommended to discontinue alcohol during and for at least 1 day after therapy with metronidazole.
Severity Moderate Likelihood Possible Evidence C

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

This is the classic one we warn about. While you're on metronidazole (Flagyl), drinking beer can trigger what's called a disulfiram-like reaction. The medicine appears to block an enzyme your body uses to clear alcohol, so a toxic byproduct (acetaldehyde) builds up. That can leave you feeling pretty miserable: flushing, a pounding headache, nausea and vomiting, a racing heart, and stomach cramps.

Experts don't fully agree on how often it happens, but it's not worth the gamble. The standard advice is to skip alcohol completely while taking metronidazole and for a few days after your last dose (about 3 days in the US). That includes beer, wine, and even some cough syrups or mouthwashes that contain alcohol. If you have questions about timing, check with your pharmacist or doctor.

References
  1. Flagyl (metronidazole) prescribing information. Pfizer Labs. New York, NY, December 2021. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2021/012623s069lbl.pdf
  2. Workowski KA, Bachmann LH, Chan PA, et al. Sexually transmitted infections treatment guidelines, 2021. MMWR Recomm Rep. 2021;70(4):1-187. PubMed
  3. Flagyl (metronidazole) prescribing information [CANADA]. Odan Labs. Pointe-Claire, QC H9R 2Y6. January 2018. Available at: https://pdf.hres.ca/dpd_pm/00044072.PDF

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Beer Also Interacts With Other Medications

Beer has 654 major, 271 moderate known drug interactions in our database — the Metronidazole one above is one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Beer

Covers the 2,830 medications we’ve checked against Beer. Pick one to open its full report.

From our Q&A

Questions About Beer or Metronidazole

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Beer or Metronidazole, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Metronidazole

This page covers Beer only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Metronidazole page lists 83 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), American Hellebore (major), Arsenic (major), Cesium (major) and Ephedra (major).

By severity: 7 major · 63 moderate · 13 minor.

From our pharmacist’s overview on the Metronidazole page

“Metronidazole (Flagyl) can stretch the heart's QT interval on its own, and most of the seven major-rated interactions among its 83 flagged supplement ingredients do the same thing, so I read this list with more wariness than most antibiotics earn. Grapefruit and ephedra stand out for adding to that heart-rhythm risk, while activated ch…”

Reviewed by 2 · Jul 18, 2026

Open the Metronidazole interaction page

How much people look this up

Where Beer and Metronidazole Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Beer
Top 25%

#314 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Metronidazole
Top 25%

#610 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Beer

What is Beer?

Beer
  • Social and recreational drinking
  • Relaxation
  • Heart health (popular belief)
  • Bone health (popular belief)
  • Source of antioxidants and B vitamins

Beer is an alcoholic beverage that contains some minerals, B vitamins, and plant compounds from hops and grain, but it is not a health supplement. Any possible benefits come only from light-to-moderate intake, and they are easily outweighed by the well-known harms of alcohol. The safest amount of alcohol for health is none, and beer should be avoided in pregnancy and breastfeeding.

Read the full Beer monograph & all interactions
Medication

About Metronidazole

What Is Metronidazole Used For?

Brand names: Flagyl, Protostat, Metronidazole, Nidazol, Trikacide, MetroGel, Flagyl IV, Metronidazole Redi-Infusion, Flagyl IV RTU, Metro IV, Anabact, Metrosa, Metrotop, Noritate, Rozex Cream, Rozex Gel, Zyomet, Likmez

Metronidazole treats three main types of infections. It's used for trichomoniasis (a sexually transmitted parasitic infection), amebiasis (an intestinal or liver infection caused by a parasite), and serious anaerobic bacterial infections — infections caused by bacteria that thrive without oxygen, which can affect the abdomen, skin, bones, lungs, and other areas.

Because sexual partners can pass trichomoniasis back and forth, both partners are typically treated at the same time, even if one has no symptoms.

See full Metronidazole drug information
Keep checking

Other Drugs & Beer

Browse every other medication we’ve checked against Beer — both the ones with a known interaction and the ones without. Select any drug for the full detail.

654Major
271Moderate
0Minor
1,904No known interaction
Major

654 interactions

Showing 60 of 654 major interactions — see all 654 on the Beer page.

Moderate

271 interactions

Showing 60 of 271 moderate interactions — see all 271 on the Beer page.

No interaction 1,904 drugs checked — show the list
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

Keep exploring
Pharmacist Counseling Corner

Taking Beer and Metronidazole Together: Common Questions

Can you take Beer with Metronidazole?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Beer and Metronidazole interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Metronidazole and Beer?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.