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Cholesterol Medications and Alcohol: Can You Mix Them?

Medically reviewed by Leigh Ann Anderson, PharmD. Last updated on June 9, 2024.

You should consider moderating or eliminating your alcohol intake with certain cholesterol medicines. Cholesterol-lowering drugs like statins, when mixed with excessive alcohol, may elevate triglyceride levels, worsen muscle side effects and possibly lead to liver damage. Talk to your doctor first if you have more than 1 to 2 alcoholic drinks daily and you take a statin.

To help reduce health problems, medical experts often recommend limiting alcohol intake to one drink per day for women and no more than 2 drinks per day for men. One drink is equal to 5 ounces of wine, 12 ounces of beer, or 1.5 ounces of liquor.

Introduction

HMG-CoA reductase inhibitors, also called statins, are a widely prescribed group of medications used in addition to diet to help lower high cholesterol and other lipids. Statins are used to help protect the heart and blood vessel system and may help lower the risk of heart attack, stroke, angina and heart bypass surgery. But should you drink alcohol while taking a cholesterol medication? 

Statins or other cholesterol medications work by lowering LDL (low density lipoproteins, or “bad” cholesterol) and triglycerides. They can also raise HDL (high density lipoprotein, or “good” cholesterol). These oral medicines are available as single agents or in combination with other medicines.

Can I drink alcohol if I take a statin?

You may consider moderating or eliminating your alcohol intake with statins (like Lipitor (atorvastatin), Zocor (simvastatin), Crestor (rosuvastatin) or Livalo (pitavastatin).

Patients combining cholesterol medications and alcohol who have liver disease due to excessive alcohol use (for example, cirrhosis) or who consume large quantities of alcohol should alert their doctor to this issue.

Statins can lead to liver disease in roughly 2% of patients, and ongoing monitoring of liver function may be needed. Your doctor may check your liver enzymes and assess you for liver disease before starting a statin. You should NOT use statins if you have active liver disease or elevated liver enzymes.

Heavy drinking is also linked with high levels of LDL cholesterol and triglycerides, which can further worsen heart health.

Related: List of Medicines Used for High Cholesterol

Can I drink alcohol with Nexlizet or Nexletol?

The manufacturer's labeling for Nexlizet (bempedoic acid and ezetimibe) and Nexletol (bempedoic acid) does not list alcohol (ethanol) as a possible drug-drug interaction.

But both of these medicines work in the liver and bempedoic acid has been associated with elevated liver enzymes (AST and/or ALT) in clinical studies, which may indicate a risk for liver toxicity. 

If you have alcohol-related liver disease or other diseases of the liver, be sure to discuss this with your doctor before you start treatment with either of these drugs. Ask your doctor if it's safe for you to drink alcohol if you take one of these medicines.

Can I drink alcohol with niacin?

Niacin or niacin extended-release, a B vitamin, may be used in addition to diet to lower cholesterol and other lipids. Niacin may lower total cholesterol, LDL, and triglycerides and raise HDL levels.

You should generally avoid drinking alcohol with niacin. It may increase your risk of liver damage. Consumption of large amounts of alcohol is also linked with elevated cholesterol and triglycerides. Talk to your doctor first.

Tell your doctor if you have liver disease or consume large amounts of alcohol on a regular basis. Niacin should not be used if you have liver problems or a history of liver disease, elevated liver enzyme levels or current liver disease.

If you choose to drink with niacin, avoid alcohol at the time you take the medicine due to an increased risk of flushing (warmth, redness, or tingly feeling under your skin), itching, nausea, dizziness, and vomiting. Hot drinks or spicy foods may also cause the same reactions with niacin.

Can I drink alcohol if I take Juxtapid?

Juxtapid (lomitapide) is a medication used in patients with an inherited (genetic) type of high cholesterol known as homozygous familial hypercholesterolemia.

It is important you limit alcohol consumption with Juxtapid to no more than one alcohol-containing drink per day. Before you start treatment with Juxtapid, tell your doctor if you drink alcohol.

There is a risk of liver toxicity with Juxtapid (lomitapide). Drinking alcohol with this medicine may increase your chance of having liver problems or make your liver problems worse.

If you have symptoms of liver injury (such as nausea, vomiting, dark-colored urine, light-colored stools, stomach pain, loss of appetite, fever, rash, itching, yellow skin or whites of the eyes, extreme tiredness, flu-like symptoms) contact your doctor immediately.

Can I drink alcohol with Praluent or Repatha?

The package insert for Praluent (alirocumab) and Repatha (evolocumab) do not list alcohol (ethanol) as a possible drug-drug interaction. However, these agents work in the liver and Praluent has been linked with elevated liver enzymes, which may signal liver toxicity.

If you have alcohol-related liver disease or other diseases of the liver, be sure to discuss this with your doctor before you start treatment with either of these drugs.

Learn more: Search on alcohol (ethanol) drug interactions with your medication

Common Cholesterol Medications

Generic Name Brand Name
alirocumab Praluent
atorvastatin Lipitor
bempedoic acid Nexletol
bempedoic acid and ezetimibe Nexlizet
evinacumab Evkeeza
evolocumab Repatha
fluvastatin Lescol, Lescol XL
lomitapide Juxtapid
lovastatin Mevacor
niacin (vitamin B3) Niacor, Niaspan ER, Slo-Niacin
pitavastatin Livalo, Zypitamag
pravastatin Pravachol
simvastatin Zocor
rosuvastatin Crestor

*Note: This is not a complete list. Always check with your pharmacist or other healthcare provider for possible drug-alcohol interactions. Tell your healthcare providers about all the other medications you use, including prescription and over-the-counter (OTC) drugs, vitamins, dietary supplements and herbal products.

Types of Drug Interactions With Alcohol

Sources

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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