Metformin and Alcohol

Metformin is a medication commonly prescribed to treat type 2 diabetes. It helps to lower blood sugar levels and increase insulin sensitivity in people who have insulin resistance. Even though taking metformin is a safe and effective way to lower blood sugars, there are some potential risks and side effects, especially if you drink alcohol frequently or engage in binge drinking. What is the link between metformin and alcohol, and can you drink while taking it?

Metformin and Alcohol: Why You Shouldn’t Drink Excessively When Taking Metformin

Metformin lowers blood sugar levels in several ways. One is by reducing the amount of glucose produced by the liver through a process called gluconeogenesis. When the liver produces less glucose, less enters the bloodstream to raise blood sugar levels. But under certain circumstances, this can lead to the accumulation of a compound called lactate in the blood stream.

Normally, extra lactate can be neutralized by the lung and kidneys, but in people with lung, liver, kidney and certain types of heart disease, lactate levels can build up leading to a life-threatening complication called lactic acidosis. Drinking excessive amounts of alcohol can be a trigger for lactic acidosis, a condition that can be fatal. That’s why it’s important to limit or avoid alcohol entirely while taking metformin.

It usually requires more than modest amounts of alcohol to trigger lactic acidosis, so it’s unlikely you’ll develop lactic acidosis from drinking an occasional alcoholic drink. Lactic acidosis is rare, particularly among healthy people. Most of the cases have occurred in older people with medical problems. Still, lactic acidosis is such a serious condition that it’s best to take precautions you to avoid it, which may include avoiding alcohol entirely.

Lactic acidosis is a medical emergency that can happen without warning. Signs and symptoms include rapid breathing, lightheadedness, a drop in blood pressure, vomiting abdominal pain, fainting and extreme weakness. It’s such a serious condition that quick emergency treatment and hospitalization are required to prevent death in many cases. Fortunately, this is a rare condition that happens in only about 6 per 100,000 people on metformin.

Metformin and Alcohol: What Does This Mean?

It’s best to avoid alcohol entirely if you’re taking metformin, especially if you have reduced kidney function, liver function or have a history of lung problems. If you’re otherwise healthy, an occasional drink usually won’t cause problems, but talk to your doctor before using alcohol while on this medication. Binge-drinking and frequently drinking will increase the risk of lactic acidosis. Don’t take chances with your health.