Alcohol and Nitrofurantoin: No Significant Interaction
You can drink alcohol while taking nitrofurantoin, as there is no clinically significant interaction between the two. However, moderation is advisable as alcohol may theoretically worsen minor side effects.
Evidence Base
The interaction between nitrofurantoin and alcohol has been specifically investigated and found to be unfounded:
- Reports of interactions between nitrofurantoin and alcohol are anecdotal and not clinically substantiated 1
- A comprehensive analysis of 921 adverse reaction reports to nitrofurantoin over a 10-year period did not identify alcohol as a contributing factor to any adverse events 2
- Systematic reviews of nitrofurantoin's safety profile spanning over 60 years of use have not documented clinically significant alcohol interactions 3
Practical Considerations
While no formal contraindication exists, consider these points:
- One guideline suggests that alcohol may worsen side effects of certain antimicrobials, though this was stated in the context of ivermectin, not nitrofurantoin specifically 4
- Common nitrofurantoin side effects include nausea and gastrointestinal upset, which alcohol could theoretically exacerbate 3
- The serious adverse effects of nitrofurantoin (pulmonary toxicity at 0.001% and hepatic toxicity at 0.0003%) are not related to alcohol consumption 5
Clinical Bottom Line
There is no medical reason to avoid alcohol while taking nitrofurantoin for a urinary tract infection. This differs from certain other antibiotics (like metronidazole) where alcohol avoidance is mandatory. Patients can be reassured that moderate alcohol consumption will not interfere with nitrofurantoin's efficacy or significantly increase toxicity risk 1.
The only reasonable precaution is to drink in moderation, as alcohol may worsen minor gastrointestinal side effects that can occur with nitrofurantoin 3.