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Flagyl is the trade name of metronidazole, an antibiotic indicated to treat a variety of infections, from stomach ulcers to meningitis. Most of Flagyl's adverse effects are run-of-the-mill, such as nausea and vomiting. However, Flagyl is reported to interact dangerously with another common drug which is alcohol.
Drinking even a small dose of alcohol while taking Flagyl can make a person very sick. Flagyl and alcohol together could result severe flushing, nausea and vomiting, fast heartbeat and shortness of breath. The reaction has been described similarly to the effects of Antabuse, a drug that cures alcoholism by causing patients to become very sick when they drink.
Obviously, a beverage that contains alcohol should not be consumed during treatment with Flagyl, but small amounts of alcohol can be found in hidden sources as well. The best examples would be some kinds of mouthwash and cold medicine contain alcohol. Patients should avoid all of these alcohol sources while administering Flagyl and for 48 hours following the end of treatment.
Because the Flagyl-alcohol reaction is said to resemble the Antabuse-alcohol reaction, researchers originally assumed that they have similar mode of action. Ordinarily, the liver breaks down ethanol in two ways: first into acetaldehyde, then into acetic acid. Antabuse limits the second steps, which lead to increase levels of acetaldehyde in the blood. The increase blood acetaldehyde will result to acute symptoms of vomiting, flushing, etc.
More recent research has showed that Flagyl does not block the breakdown of acetaldehyde, and that blood acetaldehyde does not increase when Flagyl and alcohol are combined. Therefore, some other mechanism must be at work. One set of researchers suggested it may be related to increased serotonin level because they were able to show that Flagyl also enhances brain serotonin in rats. Another set of researchers noted that there are only 10 human case reports of a bad Flagyl-alcohol reaction and suggested that the problem may not be as common as previously believed.