Can you drink alcohol while taking clonidine?

In this article:

• Clonidine and alcohol
• Risks of clonidine and alcohol
• Who is at risk?
• Alcohol withdrawal
• Interactions
• Alternatives
• The bottom line

In this article

• Clonidine and alcohol
• Risks of clonidine and alcohol
• Who is at risk?
• Alcohol withdrawal
• Interactions
• Alternatives
• The bottom line

Clonidine is a generic medication that treats hypertension (high blood pressure). Because clonidine works differently than other blood pressure medications, it also has several off-label uses—including anxiety, insomnia, attention deficit hyperactivity disorder (ADHD), and alcohol withdrawal. Clonidine, also sold under the brand name Catapres, is available as a tablet and once-a-week skin patch.

Because hypertension is a chronic condition, you’ll likely take clonidine long-term. So, is it safe to have a glass of wine or a cocktail while taking this medication? Usually, no, as doing so may increase your risk of dangerous side effects and worsen your blood pressure.

Mixing clonidine and alcohol

Because it works on the central nervous system (CNS), side effects of clonidine use include dizziness and drowsiness. Alcohol use can cause similar side effects. Therefore, combining clonidine and alcohol can amplify your risk of these adverse effects. This can be particularly dangerous if you’re engaging in activities that require concentration, such as driving. Due to this risk, healthcare providers usually recommend limiting or avoiding alcohol while taking clonidine.

Dangers of mixing clonidine and alcohol

There are a few reasons why it’s not recommended to drink alcohol while taking clonidine. First, clonidine and alcohol share some similar side effects. When taken together, the risk of these adverse events can increase. In addition, alcohol can increase your blood pressure. This can make clonidine less effective at managing your condition.

Increased risk of side effects

Alcohol is a CNS depressant, which means it slows down brain activity, leading to side effects such as slowed breathing, drowsiness, and dizziness. Clonidine is a centrally-acting alpha agonist. According to its prescribing information, it works to lower blood pressure by attaching to certain receptors (proteins) in the brain. This blocks the release of chemicals in the body that tighten blood vessels. Blocking these chemicals helps reduce your blood pressure. It may also lead to common side effects such as drowsiness and dizziness. Therefore, combining clonidine and alcohol can increase the risk of sedative effects. Extreme drowsiness can be dangerous if you’re driving or operating machinery.

In rare cases, clonidine can cause liver problems, such as hepatitis and increased liver enzymes, according to its prescribing information. Alcohol’s negative effects on the liver are well-documented. Alcoholic liver disease may occur in people who drink excessively over a long period or those who binge drink. Thus, mixing alcohol and clonidine may increase the potential for liver problems. The risk may be even higher in those with a history of liver problems.

Interference with blood pressure management

Alcohol can also affect blood pressure. Studies have shown that large amounts of alcohol initially cause a decrease in blood pressure, followed by an increase about 12 hours later. 

This means combining alcohol with clonidine can raise your risk of hypotension (low blood pressure) initially. Hypotension can cause serious side effects, such as dizziness, lightheadedness, fainting, falls, and even shock.

The American Heart Association also found a link between increases in systolic blood pressure and the number of alcoholic drinks consumed per day. Additionally, binge drinking over and over can cause long-term increases in blood pressure. Due to these risks, mixing clonidine with alcohol can potentially make the drug less effective at managing your blood pressure.

Are certain people at greater risk of side effects?

Yes, some people may be at higher risk of side effects from clonidine. If you take other drugs that cause drowsiness, combining clonidine and alcohol can significantly raise the risk of sedation. Examples include benzodiazepines, opioids, certain antihistamines, and sleep aids. Similarly, mixing alcohol and clonidine with other drugs known to cause liver-related side effects is also not recommended. These include Tylenol (acetaminophen), nonsteroidal anti-inflammatory drugs (NSAIDs), and certain antibiotics, such as Augmentin (amoxicillin/clavulanate).

Alcohol and clonidine can both cause liver problems. For those with existing liver conditions, this combination can be risky. For this reason, it’s best to consult a healthcare provider before consuming alcohol alongside clonidine.

Other populations that may be at higher risk of problems when mixing alcohol and clonidine include older adults and women.

Does clonidine help with alcohol withdrawal?

One of clonidine’s off-label uses is alcohol withdrawal syndrome (AWS)—symptoms that occur when a person stops or greatly reduces their alcohol consumption after long-term alcohol abuse. According to Cleveland Clinic, AWS can cause withdrawal symptoms for a period of time, from 6 to 24 hours after the last drink. Alcohol withdrawal symptoms include anxiety, jumpiness, rapid heart rate, increased blood pressure, and tremor. In severe cases of AWS, confusion, seizures, hallucinations, and delirium can occur.

Benzodiazepines are considered first-line treatment for AWS that requires drug therapy, according to U.S. Pharmacist. This is because benzodiazepines can relieve symptoms of AWS, including seizures, and help prevent symptoms from worsening. Several other drugs may be used in combination with benzodiazepines to manage AWS, including clonidine. Clonidine can help manage withdrawal symptoms like high blood pressure, fast heart rate, and tremors associated with AWS. However, it’s important to note that clonidine should not be taken alone to treat alcohol withdrawal or outside of a treatment program under the supervision of a healthcare provider.

Medication interactions with clonidine

It’s important to note that clonidine may have interactions with other medications that increase the risk of side effects. These include:

• Beta blockers: When taken with clonidine, they can increase the risk of bradycardia (slow heart rate) and hypotension (low blood pressure).
• Opioids: Medications such as hydrocodone and oxycodone can increase the sedative effects of clonidine. In severe cases, this can lead to respiratory depression.
• Other medications: Certain medications, such as barbiturates and phenothiazines, can also interact with clonidine, increasing the risk of adverse effects.

These interactions are worse when alcohol is involved. It’s vital to inform your healthcare provider about all medications you are taking, including over-the-counter drugs and supplements, to minimize the risk of adverse interactions with clonidine.

Which blood pressure medications are not affected by alcohol?

While clonidine is FDA approved to treat high blood pressure, it’s not considered a first-line treatment option. While several clonidine alternatives are available, there are risks when combining alcohol with many prescription drugs, including most blood pressure medications. These include angiotensin II receptor blockers (ARBs), angiotensin-converting enzyme (ACE) inhibitors, beta blockers, alpha blockers, and diuretics.

Blood pressure medications cause side effects such as dizziness, lightheadedness, and fainting. Because alcohol can cause these side effects as well, mixing alcohol and any blood pressure medication raises the risk of these side effects and can cause even more serious side effects like heart rhythm problems. And just as alcohol does with clonidine, mixing alcohol with other antihypertensives can make them less effective at reducing your blood pressure.

Although alcohol isn’t recommended with any blood pressure medication, certain drugs can cause serious side effects when mixed with alcohol. For example, consuming alcohol while taking alpha blockers, such as Cardura (doxazosin) and Hytrin (terazosin), can lead to significantly low blood pressure. Mixing alcohol with certain calcium channel blockers, including Calan (verapamil) and Cardizem (diltiazem), can strengthen and prolong the effects of alcohol.

The bottom line

It’s generally not recommended to mix alcohol and clonidine. Doing so can increase the risk of side effects, such as drowsiness, lightheadedness, and dizziness. In rare cases, combining alcohol and clonidine can make you more likely to experience liver problems or even heart rhythm problems. Because alcohol can affect blood pressure, mixing it with clonidine can decrease the drug’s effectiveness. To avoid problems while taking this medication, be open and honest about your substance use with your healthcare provider.