Alcohol and Metformin interaction

Alcohol and Metformin: the Metformin prescribing label flag this combination with the strongest language, such as a contraindication, a boxed warning, or an instruction to avoid it.

Major

Do not combine without a prescriber's guidance. The label language below is the strongest FDA uses.

What the FDA labels say

From the Metformin (Metformin hydrochloride) label · effective 2024-11-14

Major

…metformin-associated lactic acidosis include renal impairment, concomitant use of certain drugs (e.g., carbonic anhydrase inhibitors such as topiramate), age 65 years old or greater, having a radiological study with contrast, surgery and other procedures, hypoxic states (e.g., acute congestive heart failure), excessive alcohol intake, and hepatic impairment.

Boxed warningnames AlcoholView label on DailyMed
Major

Risk factors include renal impairment, concomitant use of certain drugs, age ≥65 years old, radiological studies with contrast, surgery and other procedures, hypoxic states, excessive alcohol intake, and hepatic impairment.

Boxed warningnames AlcoholView label on DailyMed
Moderate

Excessive Alcohol Intake: Alcohol potentiates the effect of metformin on lactate metabolism, and this may increase the risk of metformin-associated lactic acidosis.

Warnings and precautionsnames AlcoholView label on DailyMed
Moderate

Alcohol Clinical Impact: Alcohol is known to potentiate the effect of metformin on lactate metabolism.

Drug interactionsnames AlcoholView label on DailyMed
Moderate

Alcohol can potentiate the effect of metformin on lactate metabolism.

Drug interactionsnames AlcoholView label on DailyMed

Curated guidance for Alcohol

Moderate

Alcohol can cause low blood sugar with insulin or sulfonylureas, and heavy drinking with metformin raises the risk of lactic acidosis.

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Not medical advice. Interaction Checker quotes FDA label text and NIH fact sheets. Whether an interaction matters for you depends on doses, timing, kidney and liver function, and other conditions. Confirm with a pharmacist or prescriber.