Can Metformin And Alcohol Kill You [Know the Risks of Using Together]

Many people with diabetes are prescribed metformin, a medication that helps regulate blood sugar levels. However, questions often arise about the safety of consuming alcohol while taking metformin. 

Can this combination be lethal? In this blog post, we’ll delve into the potential risks and consequences of mixing metformin and alcohol.

Metformin is generally considered safe when used as directed, but when combined with alcohol, it can lead to serious complications, including lactic acidosis and hypoglycemia. 

Lactic acidosis is a rare but life-threatening condition characterized by the buildup of lactic acid in the body, while hypoglycemia is dangerously low blood sugar. 

Understanding these risks and knowing how to mitigate them is crucial for those on metformin.

We’ll explore the mechanisms behind these risks, the symptoms to watch out for and offer guidelines on how to safely navigate the use of alcohol when taking metformin.

What is Metformin?

Metformin is a widely prescribed medication primarily used to treat type 2 diabetes. It belongs to the class of drugs known as biguanides and plays a crucial role in managing blood sugar levels. 

Metformin works by reducing the amount of glucose produced by the liver while increasing the body’s sensitivity to insulin, thus enhancing glucose uptake by cells.

This drug is taken orally in tablet form and is often recommended as a first-line treatment for type 2 diabetes, especially for individuals who cannot effectively control their blood sugar through lifestyle changes alone. 

Metformin can help lower hemoglobin A1c levels, decrease fasting blood sugar levels, and minimize the risk of diabetes-related complications.

Beyond diabetes management, some research suggests that metformin may have potential benefits in areas such as weight loss and polycystic ovary syndrome (PCOS). 

It is generally considered safe when used as directed, though it may have some side effects, including gastrointestinal issues, and should be taken under a healthcare professional’s supervision.

What Happens When You Mix Metformin and Alcohol?

Mix Metformin and Alcohol

Combining metformin and alcohol can potentially lead to adverse effects and is generally not recommended. 

Metformin is commonly prescribed to manage blood sugar levels in people with type 2 diabetes, and alcohol can interfere with the medication’s effectiveness while also posing its own risks.

Here’s what can happen when you mix metformin and alcohol:

Reduced effectiveness

Alcohol can affect your liver’s ability to metabolize metformin, potentially leading to higher levels of the drug in your bloodstream. 

This can increase the risk of side effects associated with metformin, such as gastrointestinal disturbances and lactic acidosis.


Alcohol can lower blood sugar levels, and when combined with metformin, the risk of hypoglycemia (low blood sugar) increases. 

Symptoms of hypoglycemia include dizziness, confusion, sweating, and in severe cases, loss of consciousness.

Gastrointestinal issues

Both metformin and alcohol can cause gastrointestinal side effects like nausea, vomiting, and diarrhea. Combining them can exacerbate these symptoms.

Lactic acidosis

Although rare, metformin can lead to a serious condition called lactic acidosis, characterized by an excessive buildup of lactic acid in the body. 

Alcohol may increase the risk of lactic acidosis when taken with metformin, as both can affect liver function.

It’s crucial to consult your healthcare provider about alcohol consumption while taking metformin. 

They can provide personalized guidance based on your specific health condition, medication dosage, and individual tolerance to alcohol. 

In many cases, moderation and close monitoring of blood sugar levels may be recommended if alcohol use is permitted. 

However, it’s best to prioritize your health and follow medical advice when it comes to alcohol consumption while on metformin.

Can Metformin And Alcohol Kill You?

The combination of metformin and alcohol can potentially pose serious health risks, including the rare but life-threatening condition known as lactic acidosis. 

While it’s not common for this combination to be immediately fatal, it can lead to severe health complications, and in rare instances, it may even be life-threatening. 

Lactic acidosis occurs when there is an excessive buildup of lactic acid in the bloodstream. 

Metformin itself can increase the risk of lactic acidosis, and alcohol can compound this risk by affecting liver function and metabolism. 

Symptoms of lactic acidosis include muscle pain, weakness, rapid breathing, irregular heartbeat, and extreme lethargy. If left untreated, it can progress to a critical condition.

Although the risk of death from this combination is relatively low, it underscores the importance of avoiding such interactions. 

Mixing metformin and alcohol can also lead to severe hypoglycemia (dangerously low blood sugar levels), which, if not promptly addressed, can lead to unconsciousness and, in extreme cases, be life-threatening.

To prioritize your health and safety, it is strongly advised to consult with a healthcare professional and adhere to their guidance regarding alcohol consumption while taking metformin. 

In most cases, they will recommend moderation or avoidance of alcohol to prevent potentially serious complications.

Why Combining Metformin and Alcohol Can Increase the Risk of Lactic Acidosis?

Combining metformin and alcohol can increase the risk of lactic acidosis due to their individual effects on the body, particularly on liver function and metabolism. 

Lactic acidosis is a rare but potentially life-threatening condition characterized by the buildup of lactic acid in the bloodstream. 

Here’s why this combination can be risky:

Impact on the Liver

Both metformin and alcohol are metabolized by the liver. Metformin is primarily excreted by the kidneys, but a small portion undergoes liver metabolism. 

Alcohol, on the other hand, places a significant metabolic burden on the liver. When you consume alcohol, the liver prioritizes metabolizing alcohol over other substances, including metformin.

Reduced Clearance of Metformin

Alcohol can slow down the liver’s ability to metabolize metformin effectively. 

As a result, metformin may accumulate in the body, increasing its concentration in the bloodstream. Higher levels of metformin can lead to a higher risk of lactic acidosis.

Alteration of pH Levels

Both alcohol and lactic acid are acidic substances. Alcohol consumption can lead to changes in the body’s pH balance, making it more acidic. 

When lactic acid is produced and accumulates due to various factors, including impaired liver function, the body may struggle to neutralize it. This can result in a more acidic environment that contributes to lactic acidosis.

While lactic acidosis is relatively rare, the combination of metformin and alcohol can exacerbate the risk, especially in individuals with pre-existing kidney or liver issues. 

It is crucial to consult a healthcare professional and follow their recommendations regarding alcohol consumption while taking metformin to minimize the risk of lactic acidosis and other potential complications. 

In many cases, healthcare providers advise moderation or complete avoidance of alcohol while on this medication.

Precautions and Guidelines After Taking Metformin and Alcohol At the Same Time

Taking metformin and alcohol together can be risky due to the potential for adverse effects, including lactic acidosis and hypoglycemia. 

However, if you have unintentionally consumed alcohol while on metformin, here are some precautions and guidelines to consider:

Seek Medical Attention

If you suspect that you have taken metformin and alcohol together, it’s important to contact a healthcare professional or seek medical attention immediately, especially if you experience symptoms such as severe abdominal pain, muscle weakness, rapid breathing, or confusion. 

These could be signs of lactic acidosis, or a medical emergency.

Monitor Blood Sugar Levels

Keep a close eye on your blood sugar levels if you’ve consumed alcohol while on metformin. 

Alcohol can lower blood sugar, and the combination with metformin may increase the risk of hypoglycemia (low blood sugar). 

Test your blood sugar regularly and be prepared to treat hypoglycemia if it occurs.

Stay Hydrated

Alcohol can dehydrate the body, so it’s essential to drink plenty of water to prevent dehydration. Dehydration can exacerbate the effects of both metformin and alcohol.

Avoid Driving or Operating Machinery

Alcohol impairs cognitive and motor skills, and combining it with metformin can further affect your ability to function safely. 

Refrain from driving or operating heavy machinery until you are sure the effects of both substances have worn off.

Limit or Avoid Alcohol

Going forward, it’s advisable to limit or avoid alcohol consumption while taking metformin. 

Consult your healthcare provider for personalized guidance on alcohol use and whether it can be safely integrated into your treatment plan.

Inform Your Healthcare Provider

Discuss the incident with your healthcare provider during your next appointment. 

They can assess your overall health and adjust your medication regimen or provide specific recommendations regarding alcohol use.

Remember that individual responses to the combination of metformin and alcohol can vary, and it’s crucial to prioritize your health and safety. 

When it comes to managing diabetes or any other medical condition, it’s best to follow your healthcare provider’s guidance and communicate openly about any potential issues or concerns related to your medication and lifestyle choices.

Alternatives to Alcohol to Drink While Taking Metformin

If you’re taking metformin and want to enjoy beverages but prefer to avoid alcohol, there are plenty of non-alcoholic alternatives available. Here are some options to consider:

  • Water: Staying hydrated is essential, and water is the best way to do that. It has no calories or sugar and helps with overall health.
  • Herbal Tea: Herbal teas like chamomile, peppermint, or ginger can be soothing and enjoyable. They are caffeine-free and come in various flavors.
  • Sparkling Water: Sparkling water or seltzer with a splash of lemon, lime, or even a few berries can mimic the fizzy sensation of alcoholic beverages.
  • Fruit Juices: Opt for 100% fruit juices without added sugars. You can mix them with sparkling water for a refreshing spritzer.
  • Non-Alcoholic Beer or Wine: These products mimic the taste of alcoholic beverages without the alcohol content. Just ensure they are truly alcohol-free.
  • Mocktails: Create alcohol-free versions of your favorite cocktails by substituting alcohol with soda, fruit juice, or flavored syrups.
  • Coconut Water: It’s hydrating and has a unique flavor, making it a great alternative to alcoholic drinks.
  • Kombucha: This fermented tea offers a tangy flavor and slight effervescence. It’s available in various flavors and is known for its potential health benefits.
  • Lemonade or Limeade: Freshly squeezed lemon or lime juice mixed with water and a touch of sweetener can be quite refreshing.
  • Iced Tea: Brew your favorite tea, let it cool, and add ice for a satisfying drink. You can sweeten it with a small amount of honey or stevia if desired.

Remember that while these alternatives can provide enjoyable beverages, it’s essential to consider any dietary restrictions or health conditions you may have, as some may have an impact on blood sugar levels. 

Always consult with your healthcare provider for personalized advice on what beverages are suitable for your specific situation while taking metformin or managing diabetes.


Can combining metformin and alcohol be lethal?

Answer: While it’s rare, the combination of metformin and alcohol can potentially lead to life-threatening conditions like lactic acidosis. 

It’s essential to avoid excessive alcohol consumption while taking metformin and seek medical attention if you experience severe symptoms.

How much alcohol is safe to consume while on metformin?

There’s no universally safe limit. It’s best to consult your healthcare provider for personalized advice. In many cases, moderation or complete avoidance of alcohol is recommended to minimize risks.

What are the symptoms of lactic acidosis?

Symptoms include severe muscle pain, weakness, rapid breathing, abdominal discomfort, and confusion. If you experience these symptoms after combining metformin and alcohol, seek immediate medical help.

Can occasional alcohol consumption with metformin be safe?

It’s essential to prioritize your health. 

While occasional and light alcohol consumption may be less risky, it’s still advisable to discuss it with your healthcare provider to ensure it’s safe for your specific situation.

How can I reduce the risks when drinking alcohol on metformin?

To minimize risks, limit alcohol intake, stay hydrated, monitor blood sugar levels, and avoid activities that require focus, like driving. 

Most importantly, follow your healthcare provider’s guidance and consider alternatives to alcohol when possible.

Wrapping Up

The combination of metformin and alcohol does carry risks that, while relatively low, should not be underestimated. Lactic acidosis and hypoglycemia can occur, potentially leading to severe health consequences. 

It is vital to prioritize your well-being and make informed choices regarding alcohol consumption while on metformin. 

Always consult with your healthcare provider for personalized advice and consider safer alternatives to alcohol to ensure your health remains a top priority. 

Remember, knowledge and caution are key to maintaining a healthy and balanced lifestyle while managing diabetes with metformin. So, here, I am taking my leave. Thank you.

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