Alcohol and Metformin; Yay or Nay?

alcohol for metformin article

Alcohol and Metformin….Bottom Line; Ask your Health Care Provider.  Here’s why……

The most frequently prescribed medication for type 2 diabetes is metformin.  It is also used for women with PCOS and some medical practioners prescribe it to those with pre diabetes to help prevent the progression to type 2 diabetes.

There is a warning on the label of metformin:  Do not drink alcohol while taking this medication.  Does this mean NO alcohol???

 The problem is that certain people who take metformin are at increased risk for lactic acidosis, a potentially fatal side effect.  Because this potential exists, before taking metformin, be sure to talk to your healthcare provider about drinking alcohol while taking the drug.

alcohol 2

 What is lactic acidosis?

Lactic acidosis can be a life-threatening condition.  It is extremely uncommon.  It is caused by 3 issues:  excessive lactate in the blood, not enough oxygen in the blood, and low blood pH (acidic blood).   Although lactate is naturally produced in the body, increased levels can result in potentially fatal toxic effects.

 Some of the symptoms of lactic acidosis include difficulty breathing, shortness of breath, nausea, vomiting, weakness, muscle pain, rapid or  irregular heartbeat , sweating,  cold/blue hands, lips, feet, and dizziness, confusion.  If you take metformin and experience these symptoms, call 911.

Because of its potential for serious health issues, there is a black box warning on metformin regarding the potential of lactic acidosis.  These are the conditions that increase the chance of lactic acidosis:

  • Having kidney problems, including kidney failure (renal failure)
  • Having liver problems, including liver failure or cirrhosis of the liver
  • Having congestive heart failure(CHF) or worsening of CHF
  • Having had a recent heart attack
  • Having a procedure using contrast dye
  • Drinking large amounts of alcohol on a regular basis
  • Drinking a large amount of alcohol at one time (binge drinking).

If you have the aforementioned medical conditions (including kidney or liver problems), there may be some situations where avoiding alcohol entirely might be a good idea.  To be honest, if you have these conditions, metformin is not the drug of choice to help your blood sugar.

In any case, drinking large quantities of alcohol on a regular basis or binge drinking a large amount of alcohol at once is not healthy for anyone.  If you are taking metformin, it makes excessive drinking potentially more harmful..

It is usually not necessary to completely avoid alcohol while taking metformin. The amount of alcohol that is typically considered a reasonable amount: 1-2 drinks.  One drink consists of one of the following: 5 ounces of wine, 1 ½ ounces of liquor, 12 ounces of beer.  Drink slowly and with food.  Make sure you are hydrated (water and decaf fluid).

Drinking large amounts of alcohol while taking metformin is not recommended for anyone. Be sure to ask your healthcare provider if it would be okay to drink alcohol while taking metformin.  Your healthcare provider understands your particular situation and is in the best position to factor in all of the variables (including other medical conditions or other medications you may be taking) before giving recommendations about metformin and alcohol.


Love Diane Kress’ work?  Here are links to her books and support site!

 The Metabolism Miracle:

The Metabolism Miracle Cookbook:

The Metabolism Miracle Update:  (Brand new!)

The Diabetes Miracle:

The Interactive Support Group for Followers of The Metabolism Miracle and The Diabetes Miracle:





About Diane Kress

Author of The New York Times Bestseller; The Metabolism Miracle, The Metabolism Miracle Cookbook, and The Diabetes Miracle. and The Metabolism Miracle, Revised Edition. Owner, developer, and administrator of The Metabolism Miracle's support site: Registered Dietitian, Certified Diabetes Educator, Email:
This entry was posted in ADA, AMA, Atkins diet, carb blocker, Diane Kress, Diet, dLife, LADA, low carb, Met B, Metabolic syndrome, Metabolism B,, PCOS, pre diabetes, prediabetes, The Diabetes Miracle, The Metabolism Miracle, The Metabolism Miracle Cookbook, The Metabolism Miracle Update, type 1.5 diabetes, type 2 diabetes, Uncategorized and tagged , , , , , , , , , , , . Bookmark the permalink.

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