Can You Drink Alcohol With Sickle Cell Disease?

Note: While research on alcohol is evolving, the World Health Organization says drinking less or not at all is better for your health.

Here’s what you need to consider when deciding whether to drink alcohol, as well as what amounts experts consider safe.

How Alcohol Affects Sickle Cell Disease

Dehydration affects blood flow and can make blood cells stick together more — that’s why patients with sickle cell are always advised to stay hydrated, says Nirmish Shah, MD, an associate professor of medicine and pediatrics at Duke University School of Medicine in Durham, North Carolina. “Alcohol, however, leads to a dehydrated state,” he says.

People who have iron overload may be at higher risk of a liver injury related to alcohol, says Payal Desai, MD, director of the Adult Sickle Cell Clinic at Atrium Health Levine Cancer in Charlotte, North Carolina.

Alcohol and Your Tolerance

“With sickle cell disease, alcohol can lead to more severe complications at lower doses, due to dehydration,” says Dr. Desai.

Is It Safe to Drink Before, During, or After a Pain Crisis?

Alcohol has directly led to pain crises in some patients, says Shah. “During, as well as before or after, a pain crisis, we advise patients to avoid alcohol, since it can dehydrate them and cause further issues. During these times, the focus should be on recovery, pain control, rest, and aggressive hydration,” he says.

Does Alcohol Interact With Sickle Cell Disease Medications?

Alcohol may interact with sickle cell medications, says Shah. Talk with your doctor before drinking if you take any of these medications:

• Opioids, Such as Oxycodone (OxyContin, Roxicodone) Doctors may prescribe opioids for serious sickle cell pain or pain that lasts for a long time.

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  Don’t drink alcohol while you’re taking opioids, because having both in your system at once raises the risk of side effects, says Shah. Combining the two can cause profound sedation, dangerously slowed breathing, coma, and death.

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• Ibuprofen (Advil, Motrin) and Acetaminophen (Tylenol) Over-the-counter pain relievers such as ibuprofen and acetaminophen are sometimes used to treat mild to moderate sickle cell pain.

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  While drinking small amounts of alcohol while taking these drugs may be okay (talk with your doctor), in larger amounts it raises the risk of stomach bleeding and liver issues.

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• Blood Thinners, Such as Warfarin (Coumadin, Jantoven) Blood clots are a possible complication of sickle cell disease.

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  For people who take blood thinners long term, alcohol may affect these medications, says Desai. Drinking is one of the strongest risk factors for major bleeding while taking warfarin.

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• Hydroxyurea (Droxia, Siklos) and L-Glutamine (Endari) Hydroxyurea makes red blood cells less likely to sickle, and L-glutamine reduces damage to red blood cells.

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  Alcohol may interact with these treatments, says Shah. Talk with your doctor about drinking if you’re taking one of these medications.

Are Some Alcoholic Drinks Safer for Sickle Cell Disease Than Others?

“In general, there is no specific type of alcohol that is better than others. It is the alcohol content and the effect on a patient that is important,” says Shah.

To keep track of how much alcohol you’re drinking, it helps to know what counts as one drink. In the United States, a standard drink contains about 14 grams of pure alcohol, the amount in:

• A 12-ounce can of regular beer (5 percent alcohol)
• A 5-ounce glass of wine (12 percent alcohol)
• A 1.5-ounce shot of distilled spirits (40 percent alcohol)

Safe Drinking Practices for People With Sickle Cell Disease

Questions about alcohol are very common among people with sickle cell disease, Shah says. The general advice isn’t to avoid drinking completely, but rather to be very careful about how much you drink.

“While a rare, small amount of alcohol is okay, more than one drink or drinking on a regular basis may significantly worsen the underlying sickle cell disease,” says Desai.

If you do choose to drink, these steps can help lower your risk: