Is It Safe to Combine Terbinafine and Alcohol?

Cindy Quarters
Cindy Quarters
Combining terbinafine and alcohol can increase the risk of liver failure.
Combining terbinafine and alcohol can increase the risk of liver failure.

Terbinafine is drug used to treat fungal infections. Since this drug can put stress on the liver, combining terbinafine and alcohol is not recommended. The combination can be especially problematic for people with autoimmune disorders such as lupus, and those who have existing liver problems.

The drug is commonly used to treat fungal infections of the fingernails, toenails and the scalp. It is also used to treat fungus that occurs on other parts of the body, such as the groin and feet. The medication is typically given in either tablet or granulated form. Terbinafine must usually be taken for at least three or four weeks before any results are seen. In some cases it may take months before patients notice relief from symptoms.

An untreated scalp fungus may produce unsightly flakes.
An untreated scalp fungus may produce unsightly flakes.

The initial length of treatment with terbinafine varies, depending on the condition being treated. The usual daily dosage for adults and for children over 75 pounds (35 kg) is 250 mg once a day. Conditions such as fungal infections of the fingernails or scalp require treatment for six weeks. If the fungus is in the toenails, treatment time is doubled to 12 weeks. Some conditions, such as fungus of the foot or ringworm infections may require as little as two weeks of treatment.

The side effects of terbinafine can include sadness and mood changes.
The side effects of terbinafine can include sadness and mood changes.

A person who chooses the combine terbinafine and alcohol may be at risk for a variety of liver problems, including the possibility of complete liver failure. Symptoms that may require emergency treatment include pale stools, stomach pain, very dark urine or yellowish skin and eyes. It is important to seek medical help immediately if any of these symptoms occur. The physician should be advised that the patient has consumed a combination of terbinafine and alcohol.

Terbinafine may be used to treat fungus of the foot.
Terbinafine may be used to treat fungus of the foot.

For persons who struggle with depression, taking terbinafine with alcohol may compound those feelings. Sadness, mood changes and generalized feelings of unhappiness can all be side effects of this drug. In many people drinking alcohol can cause similar problems. Taken together the two things may result in a person feeling overwhelmed by feelings of unhappiness and despair.

Foot and toenail fungus may be transmitted by using public showers.
Foot and toenail fungus may be transmitted by using public showers.

Terbinafine is potentially toxic to the liver, so tests to check the patient’s liver function are usually given periodically during the treatment period. The drug itself poses enough of a risk that very few doctors will allow a patient to take this medicine without a complete liver check prior to treatment. If the patient combines terbinafine and alcohol, the results can be deadly.

A History of Terbinafine

Fungal infections have been around since the beginning of humanity, but it wasn't until 1991 that the medication terbinafine was created to treat various fungal skin infections. 

Europe was the first to see terbinafine in 1991, but the medication didn't arrive in the United States until 1996. 

Adults began using this medication for fungal infections in the late 1990s. Still, in the United States, it wasn't until 2007 that the FDA approved the drug for children as young as four, even though fungal infections are prevalent in kids.

Other Things to Avoid While Taking Terbinafine

Combining alcohol and terbinafine may compounds feelings of depression.
Combining alcohol and terbinafine may compounds feelings of depression.

While people without lupus or liver disease can drink in small quantities while taking terbinafine, it's still recommended that patients avoid it to prevent liver damage. Besides alcohol, there are other things patients should avoid or avoid in excess for the duration they’re on the medication, including:

  • Soda
  • Coffee
  • Tea
  • Energy drinks
  • Other forms of caffeine
  • Prolonged sunlight

Anything with caffeine can also pose a risk to the liver while on terbinafine. While it shouldn't be a massive issue in low quantities, it's best to be aware of its potential effects on the human body. 

While everyone should be wearing sunscreen while in the sun, taking this medication requires even more careful consideration. Terbinafine can cause the skin to burn more quickly, so patients should either avoid prolonged exposure or reapply sunscreen more often than they usually would.

Potential Side Effects of Terbinafine

While the risk of depression and unhappy feelings being amplified and the risk of sustaining liver damage when drinking alcohol on terbinafine have already been discussed, there are other side effects patients should be aware of when they start this medication. Many of these are rare but still worth noting: 

  • Nausea
  • Skin rash
  • Hives
  • Flu-like symptoms
  • Difficulty breathing
  • Dry mouth
  • Coughing 

Most people who take terbinafine won't experience any of these side effects. Still, if they do occur, patients need to reach out to their doctor immediately and stop taking the medication to prevent further health issues.

Can Alcohol Cause Fungal Infections?

Evidence shows that drinking alcohol can cause bacteria and fungus to grow faster in the gut. So while people don't take terbinafine to treat an overgrowth of fungi in the stomach, it's interesting to know alcohol's relationship to fungus, because this drug treats fungus. 

Because most people take terbinafine for toenail fungal infections or prolonged ringworm, alcohol can cause the current condition to last longer than it would without it. If patients continue to drink in excess while taking terbinafine to treat ringworm, it can take longer to heal, and it may even flare up. Ringworm flare-ups due to alcohol are rare, but they can happen.

Can Terbinafine Be Combined With Other Medications?

When starting a new medication, ensuring it's safe to take with any other medicines a patient may be taking is essential to their health and well-being. Of course, it's always best to consult a physician, but here are some of the most common medications people take and whether terbinafine will cause problems when combining them. 

Birth Control

Patients on a birth control pill (progestogen-only or combined hormone) shouldn't have any issues taking terbinafine for their fungal infection. No specific drug interactions make the pill or terbinafine less effective. Still, if terbinafine causes patients to have diarrhea or vomiting and the contraceptive pill hasn't had time to digest, the medication can cause the pill to fail. 

For those consuming alcohol while taking terbinafine, drinking too much or on an empty stomach can cause vomiting and make their birth control fail. These patients will need to consider other forms of birth control.

Warfarin 

Warfarin or other blood thinners cause patients to bleed more easily. Taking terbinafine can increase the likelihood of bleeding if patients cut themselves, and adding alcohol to the mix makes this much more likely. Therefore, it's best to avoid drinking alcohol while taking terbinafine, especially if patients take it with warfarin.

Beta-Blockers

Beta-blockers for high blood pressure must be considered when taking terbinafine and consuming alcohol. Alcohol raises blood pressure, and terbinafine can also increase blood pressure. So if patients on beta-blockers need to take terbinafine, it's more important than ever to limit or altogether avoid alcohol, at least while on terbinafine.

Discussion Comments

anon1006798

I drank one night after being on terbinafine for 15 days drank about 9 drinks over 10 hours. I didn’t know I was not supposed to be drinking alcohol. The next day I had the most severe pain in my lower right abdomen that I could barely get up out of bed. This is day two and I'm not much better. Yes, I'm going to the doctor's office right now. Do not drink alcohol while taking this medication.

anon1006535

Does that include red wine too?

anon1001002

I started my treatment of terbinafine 2 weeks ago. Also, I've been alcohol free. I will try to post an update in 1-2 weeks. Thanks, M-Bandit.

SteamLouis

Aside from the risks that terbinafine and alcohol pose in regards to the liver, there is also an argument that alcohol reduces the effectiveness of some drugs.

The idea behind this argument is that alcohol is a toxin that the body aims to eliminate soon after consumption. So if there is also medication in the bloodstream, the liver may delay the processing and metabolism of the medication to get rid of the alcohol first. Some people believe that this reduces the effectiveness of the medication basically making it useless.

I'm not sure if there is any truth to this, but I wouldn't want to take the risk because I want this fungal infection gone!

SarahGen

@literally45-- Oops. I'm on terbinafine and I drank a few times after starting my treatment. Thanks for the warning, I'll be sure to avoid alcohol from now on.

literally45

Combining terbinafine with alcohol can cause liver problems in even a person in perfect health because the terbinafine is so very hard on the liver as the article said. This is the major downside of anti-fungal medications in general.

Many people suffer from decreased liver function after using anti-fungal medications for some time. It happened to me and I did not drink any alcohol during my treatment. I'm sure that if I drank, things would have been much worse. My liver function is finally back to normal but it took several months for it to recover after quitting anti-fungal medications.

Those of you on terbinafine, do yourself a favor and skip the alcohol. We only have one liver.

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    • Combining terbinafine and alcohol can increase the risk of liver failure.
      By: orcea david
      Combining terbinafine and alcohol can increase the risk of liver failure.
    • An untreated scalp fungus may produce unsightly flakes.
      By: Jasmin Merdan
      An untreated scalp fungus may produce unsightly flakes.
    • The side effects of terbinafine can include sadness and mood changes.
      By: ArenaCreative
      The side effects of terbinafine can include sadness and mood changes.
    • Terbinafine may be used to treat fungus of the foot.
      By: roblan
      Terbinafine may be used to treat fungus of the foot.
    • Foot and toenail fungus may be transmitted by using public showers.
      By: Andreas Schindl
      Foot and toenail fungus may be transmitted by using public showers.
    • Combining alcohol and terbinafine may compounds feelings of depression.
      By: ambrozinio
      Combining alcohol and terbinafine may compounds feelings of depression.