This article is from "Nankai Sun Pharmacist", which is used for medical science popularization for reference. I often take aspirin, statins, nifedipine controlled-release tablets, metformin, can I drink alcohol?
Aspirin is an antipyretic, analgesic and anti-inflammatory drug, small doses (50-100mg) of aspirin can inhibit cyclooxygenase-1 in platelets, thereby reducing the production of thromboxane A2, has obvious antiplatelet effect, can inhibit the formation of arterial thrombosis, is suitable for the prevention of transient ischemic attack, myocardial infarction, atrial fibrillation, artificial heart valve and other postoperative thrombosis, and can reduce the risk of stable and unstable angina.
Long-term use of aspirin to prevent cardiovascular and cerebrovascular diseases will lead to gastroduodenal mucosal damage, and even gastrointestinal bleeding. Aspirin can also inhibit platelets and increase the risk of bleeding, and taking aspirin after drinking alcohol can enhance the antiplatelet effect of aspirin and prolong bleeding time. Aspirin can also inhibit the metabolism of alcohol, under normal circumstances, alcohol enters the body and is first metabolized into acetaldehyde by the liver's alcohol dehydrogenase, and then converted into acetic acid by acetaldehyde dehydrogenase, and finally generated water and carbon dioxide to be excreted from the body. Therefore, alcohol should be avoided when taking aspirin.
Statins are commonly used lipid regulators in clinical practice, which can significantly reduce total cholesterol, LDL cholesterol and apolipoprotein B levels, as well as reduce triglyceride levels and slightly increase HDL cholesterol levels. In addition, statins can also stabilize, shrink or even reverse atherosclerotic plaques, which is suitable for the prevention and treatment of primary hypercholesterolemia, as well as coronary heart disease and stroke.
Although a small amount of low-strength alcohol can increase plasma HDL cholesterol levels, long-term alcohol consumption can cause alcoholic fatty liver disease, pancreatitis, hypertension, glucose and lipid metabolism disorders and even malignant tumors, so alcohol consumption is not recommended in patients with hyperlipidemia and/or coronary heart disease. In addition, statin use can cause liver damage, manifested by elevated aminotransferases, and long-term heavy alcohol consumption is the cause of statin-induced liver damage, so it is recommended that statin takers should avoid alcohol. Statins are mainly metabolized by liver enzymes (CYP3A4), and long-term heavy alcohol consumption can inhibit CYP3A4 activity, resulting in slowed statin metabolism, increased blood concentration, and increased risk of toxic reactions.
Nifedipine controlled-release tablets are commonly used first-line antihypertensive drugs in clinical practice, which have the characteristics of rapid onset, strong antihypertensive efficacy and amplitude, stable and long-lasting antihypertensive effect, no obvious effect on blood lipids and blood glucose, good medication compliance, and small individual differences. In addition, nifedipine controlled-release tablets can also improve angina, and long-term use also has anti-atherosclerotic effects, suitable for all ages, various types of hypertension, and can be used for the prevention and treatment of coronary heart disease angina.
There is a close correlation between drinking alcohol and high blood pressure, drinking a small amount of alcohol can dilate peripheral blood vessels and slightly lower blood pressure, while drinking a lot of alcohol can stimulate the sympathetic nerves, causing an increase in cardiac output and an increase in heart rate, resulting in an increase in blood pressure, therefore, the vast majority of people will first drop and then rise after drinking. The short-term effect of drinking alcohol on blood pressure is related to the amount of alcohol drunk and the tolerance of alcohol drinkers, and long-term heavy drinking of alcohol in ordinary people will definitely increase the incidence of hypertension, and heavy drinking in hypertensive patients can lead to further increase in blood pressure, significantly increasing the risk of cardiovascular and cerebrovascular events such as myocardial infarction and stroke. On the one hand, alcohol can resist the antihypertensive effect of nifedipine controlled-release tablets, resulting in a weakened antihypertensive effect. On the other hand, nifedipine controlled-release tablets are mainly eliminated by liver drug enzyme (CYP3A4) metabolism, and a small amount of alcohol has an inducing effect on CYP3A4, which accelerates the metabolism of nifedipine controlled-release tablets and reduces the efficacy, and a large amount of alcohol has an inhibitory effect on CYP3A4, slowing down the metabolism of nifedipine controlled-release tablets, resulting in accumulation, which can cause severe hypotension and arrhythmia. Therefore, hypertensive patients who are not usually Xi used to drinking alcohol are not encouraged to drink alcohol, and it is best for hypertensive patients not to drink alcohol, and they should avoid alcohol when taking nifedipine controlled-release tablets.
Metformin is the first-line and first-line and full-course drug for type 2 diabetes, reducing fasting blood glucose, postprandial blood glucose, and glycosylated hemoglobin. In addition, metformin can also reduce the weight of patients with type 2 diabetes, especially for obese patients, and can improve blood lipids, inhibit platelet aggregation and fibroblast proliferation, protect cardiovascular, and is not prone to hypoglycemia when used alone, with a wide and clear effect and good safety.
Although drinking alcohol can temporarily lower blood sugar, with the metabolism of alcohol in the body, the effect of inhibiting liver glycogen is gradually weakened, and blood sugar will rise. In addition, excessive drinking, especially on an empty stomach, inhibits glycogenolysis, and blood sugar is not replenished in time, which can easily induce hypoglycemia and even lead to hypoglycemic coma, which is life-threatening. Accumulation of metformin can cause rare but severe lactic acidosis, which can be fatal (about 50% fatality). The increased risk of lactic acidosis is related to the degree of renal function and the age of the patient, and regular monitoring of renal function and the use of the lowest effective dose significantly reduce the risk of occurrence. Alcohol increases the risk of lactic acidosis in patients taking metformin, especially in fasting or malnourished patients and in patients with hepatic insufficiency. In addition, alcohol can obscure symptoms of hypoglycemia and cause flaccid hypoglycemia. Therefore, alcohol should be avoided when taking metformin.