Mixing alcohol with most medicated cough drops is unsafe due to the potential for amplified side effects and metabolic strain on the body. Cough drops, or throat lozenges, often contain over-the-counter (OTC) medications designed to treat cold, cough, and allergy symptoms. When these active agents are combined with alcohol, a central nervous system depressant, the resulting interaction can be unpredictable and dangerous. Understanding the specific ingredients in these lozenges and how they are processed by the body is important for safe health decisions.
Common Active Ingredients in Cough Drops
Cough drops contain active compounds intended to suppress coughing or soothe an irritated throat. Menthol is a common ingredient, providing a cooling sensation and acting as a mild local anesthetic to temporarily numb the throat. Benzocaine is another local anesthetic sometimes included in lozenges to relieve severe sore throat pain.
Other medicated lozenges contain systemic ingredients, such as Dextromethorphan (DM), a cough suppressant. DM works by targeting the cough reflex center in the brain to reduce the frequency and intensity of coughing fits. Combination cold and flu lozenges may also include sedating antihistamines like Diphenhydramine, which helps dry up nasal secretions and aids sleep. These systemic drugs carry the highest risk when consumed alongside alcohol.
Alcohol and Central Nervous System Depression
The most immediate danger of combining alcohol with medicated cough drops involves the central nervous system (CNS). Alcohol slows down brain activity, leading to effects like drowsiness, impaired coordination, and slowed reaction time. Dextromethorphan (DM) and Diphenhydramine are also CNS depressants, and when taken with alcohol, their effects are compounded.
This combined action creates an additive effect, intensifying sedation to a potentially dangerous level. The resulting extreme drowsiness can lead to impaired judgment, loss of balance, and a significant risk of accidents or falls. The combination also increases the risk of respiratory depression, where breathing becomes dangerously slow or shallow. Severe CNS depression can progress to unconsciousness, carrying the risk of choking or fatal overdose.
Metabolic Strain and Drug Processing
A separate, delayed risk involves the body’s metabolic machinery, primarily located in the liver. The liver breaks down both alcohol and the active ingredients in cough drops using specialized enzymes. Alcohol is prioritized by the liver because it must be processed immediately.
This prioritization means the liver’s enzymes become occupied with neutralizing the alcohol. As a result, the metabolism of drug ingredients, such as Dextromethorphan, is slowed down significantly. The drug remains in the bloodstream longer than intended, leading to a dangerous buildup of the medication. This prolonged presence can cause sustained side effects or acute toxicity, as the body struggles to eliminate both substances simultaneously.
Identifying High-Risk Cough Drop Formulas
The highest-risk lozenges contain cough suppressants or sedating antihistamines. To determine if a cough drop is safe to use with alcohol, check the “Active Ingredients” section on the packaging. Look specifically for Dextromethorphan, often abbreviated as “DM,” and Diphenhydramine.
Any product containing these ingredients should be avoided when consuming alcohol. Combination cold and flu lozenges are particularly risky because they may contain several active ingredients, including depressants. Simple drops containing only menthol or honey are generally lower risk, but consuming alcohol while ill can worsen symptoms and hinder recovery.