Alcohol & Metformin: Interactions & Side Effects

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Are you taking Metformin and want to know if you can drink alcohol safely while using the medication? Metformin is a drug often prescribed to individuals with type 2 diabetes. The drug can be prescribed alone or with other medications, such as insulin, to help manage one’s blood sugar levels. Individuals with type 2 diabetes struggle to produce insulin consistently, and blood sugar becomes irregular. Metformin helps to regulate blood sugar levels to manage symptoms of diabetes. 

According to the CDC, approximately 37 million Americans have diabetes, and 90-95% have type 2 diabetes. Insulin is a hormone created by the pancreas. Insulin lets blood sugar into the cells to be used for energy. People with type 2 diabetes develop insulin resistance, and the pancreas creates more insulin to make up for the blood sugar. However, the pancreas can’t keep up, and blood sugar rises, which triggers prediabetes or type 2 diabetes. High blood sugar damages the body leading to possible health problems such as heart disease, vision loss, or kidney disease. 

In addition to diabetes, or even preventative treatment for diabetes, Metformin is also prescribed to treat polycystic ovarian syndrome (PCOS). 

This article will discuss what happens when you mix alcohol and Metformin, the side effects and risks of combining the two substances, and how one can manage diabetes while drinking alcohol. 

Do you have diabetes and are worried about your alcohol consumption? Please get in touch with us to take control of your health. Guardian Recovery is a leader in alcohol-use disorder with two decades of experience helping individuals and their families find freedom from their addiction. Contact us to learn more about our alcohol treatment programs, medically-supervised detox, addiction therapy, and insurance programs, or to schedule a pre-admission assessment. Getting your health and life back on track is only one phone call away. 

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Alcohol & Metformin Side Effects

Metformin is often the first line of defense for individuals with prediabetes or diagnosis of type 2 diabetes when exercise and diet can not help regulate symptoms alone. There can be side effects when taking Metformin alone. 

Common Side Effects of Metformin:

  • Nausea.
  • Diarrhea.
  • Stomachache.
  • Loss of appetite. 
  • Vitamin B12 deficiency.

As we have learned in previous articles, alcohol and other drugs create adverse side effects when combined: Alcohol and AccutaneAlcohol and LisinoprilAlcohol and PhentermineAlcohol and ZzzquilAlcohol and LatudaAlcohol and AntibioticsAlcohol and Aspirin

As with most drug interactions, alcohol often worsens the side effects of Metformin. 

Common Side Effects of Alcohol & Metformin:

  • Stomach pain and discomfort. 
  • Chest pain.
  • Muscle pain.
  • Indigestion and heartburn.
  • Bloating and gassiness.
  • Loss of appetite.
  • Diarrhea. 

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Alcohol and Metformin Risks

Additionally, there are dangerous health effects when combining alcohol and Metformin. People with diabetes who drink while using Metformin are at risk of the following conditions:  

Lactic Acidosis: 

Lactic Acidosis is one of the most dangerous conditions when taking Metformin and using alcohol. This dangerous condition occurs when the Ph balance drops and lactic acid levels rise. This increase in acidity can cause a life-threatening reaction. Lactic Acidosis is rare on its own; 1 in 30,000 people develop the condition. However, when combined with alcohol, the risks increase significantly. For this reason, the Food and Drug Administration has issued a black box warning on Metformin about the dangers of Lactic Acidosis and alcohol-use disorder. 

If you have any of these symptoms, call 911 immediately. 

Signs of Lactic Acidosis:

  • Stomach cramps.
  • Diarrhea.
  • Fast, shallow breathing.
  • Rapid, irregular heartbeat.
  • Muscle seizures.
  • Intense weakness.
  • Low blood pressure.
  • Nausea.
  • Vomiting.


Drinking alcohol and having diabetes can cause some complications. Alcohol alone can cause blood sugar to drop. Low blood sugar is known as the condition of hypoglycemia. The purpose of Metformin is to lower blood sugars. The combination of alcohol and Metformin can cause dangerously low blood sugar levels. If blood sugars drop too low, it can cause some individuals to pass out or lose consciousness. 

Symptoms of Hypoglycemia: 

  • Muscle weakness.
  • Sadness.
  • Anxiety.
  • Extreme fatigue.
  • Dizziness.
  • Sleep disturbances.
  • Headache.
  • Pale skin.
  • Rapid heartbeat.
  • Confusion and disorientation.
  • Slowed, shaky movement.
  • Blurry vision.
  • Cold sweats.
  • Poor concentration. 

B12 Deficiency: 

Vitamin B12 is an essential nutrient for cardiovascular and neurological health. Metformin and Alcohol individually block the absorption of B12, which can lead to significant health challenges. If you are experiencing any of the following symptoms, please seek emergency medical services. 

Symptoms of B12 Deficiency:

  • Confusion.
  • Numbness.
  • Tingling of hands/feet.
  • Neuropathy.
  • Impaired memory.
  • Dementia.
  • Headache.
  • Inability to concentrate.

Treatment may include immediate detox of alcohol and high doses of B12 vitamins injected. The goal is to help reduce damage to the brain from lack of nutrient absorption.

Managing Diabetes While Drinking Alcohol

Should you drink alcohol if you have diabetes? The answer is no; you shouldn’t drink alcohol when you have diabetes when numerous risks are involved, especially excessive drinking. However, if you are going to have a drink, here are some guidelines to follow to help you be as safe as possible. 

  1. Talk to your doctor. Ask about any medications you are taking and if there are any adverse side effects from combining alcohol and your prescriptions or if you are at risk for any of the conditions mentioned earlier. It may mean adjusting your meds, knowing what types of drinks you can have, and what time would be best. 
  2. Talk to your friends/loved ones. It would be best if you never drank alone when you have diabetes and have a risk of hypoglycemia. Understand what it looks like to be in a hypoglycemic state and how it can imitate intoxication. There is a chance you will not know if you are hypoglycemic, so it is best to rely on a loved one to look for the signs for you. 
  3. Don’t drink alcohol on an empty stomach. Eating a meal with complex carbs will help your body manage the alcohol and prevent the risk of hypoglycemia. 
  4. Know your alcohol limits. Keep track of how much alcohol you drink, the alcohol content, sugar/carb content, and the times you are consuming alcohol. 
  5. Check your sugar levels frequently. Check before, while you are drinking, and after you have had alcohol. Check as soon as you wake up and before you go to bed. Do not drink if your blood sugar is low. 
  6. Be prepared. Have ways to check your blood sugar, a snack, water, and people with you. 

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If you have diabetes and are struggling with alcohol addiction, you must seek professional help as soon as possible. Guardian Recovery is an expert in alcohol use treatment, and we have a multi-systematic approach to help you in your journey toward recovery. When you reach out to Guardian Recovery, whether by form, chat, or call, you will be instantly connected to one of our Treatment Advisors. Every one of our Treatment Advisor team members is in recovery or has helped a loved one through the process. We understand what you are going through and are ready to help make the process of receiving treatment straightforward. Call today to receive a free, no-obligation insurance benefits check and learn more about how we can help. 


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Reviewed professionally for accuracy by:

Ryan Soave


Ryan Soave brings deep experience as a Licensed Mental Health Counselor, certified trauma therapist, program developer, and research consultant for Huberman Lab at Stanford University Department of Neurobiology. Post-graduation from Wake Forest University, Ryan quickly discovered his acumen for the business world. After almost a decade of successful entrepreneurship and world traveling, he encountered a wave of personal and spiritual challenges; he felt a calling for something more. Ryan returned to school and completed his Master’s Degree in Mental Health Counseling. When he started working with those suffering from addiction and PTSD, he found his passion. He has never looked back.

Written by:

Cayla Clark

Cayla Clark

Cayla Clark grew up in Santa Barbara, CA and graduated from UCLA with a degree in playwriting. Since then she has been writing on addiction recovery and psychology full-time, and has found a home as part of the Guardian Recovery team.

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