Should You Drink After Taking Cough Medicine?

You're at a party, and a friend offers you a drink. But you were up all night coughing and took cough medicine just hours ago. You might even need another dose later. Should you accept the drink or stick with water? Here's why water is the safer choice.

Understanding Codeine in Cough Medicine

Codeine is an opioid painkiller sometimes found in prescription cough suppressants. It's classified as a Schedule 3 controlled substance due to its high addiction potential. Codeine works by suppressing the brain's cough reflex and acts as a central nervous system depressant.

Due to opioid addiction concerns, codeine is prescription-only in the U.S. Many cough syrups now use dextromethorphan (DXM) instead, which has similar effects and abuse risks.

What's in Cough Syrup?

Typical codeine-containing cough syrup contains about 15 mg of codeine per 5 mL. Standard doses are around 10 mL (30 mg codeine) every few hours. Many brands also include about 10% alcohol as a solvent or preservative.

Both codeine and DXM can produce intoxication-like effects at high doses, which contributes to their abuse potential.

Side Effects of Codeine

When taken as directed, cough syrup is generally safe. However, exceeding recommended doses can cause:

• Dizziness
• Distorted awareness and perception
• Fainting
• Confusion
• Hallucinations

The safe limit is typically no more than 30 mg of codeine over 24 hours. Doses exceeding 300 mg enter overdose territory.

Risks of Mixing Cough Medicine With Alcohol

Combining alcohol with codeine or DXM cough medicine is dangerous. If you're coughing, you're likely sick and should avoid alcohol anyway. The combination can cause:

• Liver damage: Both substances stress the liver, potentially causing pancreatitis and other damage
• Nausea and vomiting: Leading to dehydration
• Brain effects: Dizziness, poor coordination, impaired thinking, and concentration problems
• Heart and lung effects: Both are CNS depressants that can slow breathing and heart rate, potentially causing fatal respiratory arrest

If you experience these symptoms after mixing these substances, seek medical attention immediately.

How Long Should You Wait?

Codeine has a half-life of about three hours, meaning it takes approximately half a day to leave your system. It's safest to wait at least 24 hours after your last dose before consuming alcohol. Better yet, wait until your cough completely resolves and enjoy non-alcoholic alternatives in the meantime.

The Dangers of "Lean" or "Purple Drank"

Intentionally mixing cough syrup with alcohol—known as "Lean," "Purple Drank," or "Sizzurp"—has become a dangerous recreational trend. This practice involves consuming doses far exceeding medical recommendations to achieve a high.

Risks include:

• High addiction and overdose potential
• Psychosis and disorientation
• Brain damage, seizures, and behavioral changes
• Potential fatality

If someone has consumed Lean, contact poison control immediately (800-222-1222 in the U.S.).

What About Cough Drops?

Most cough drops contain menthol, which is safe with alcohol. However, some contain DXM, so check ingredients carefully. Regardless, if you're coughing or have a sore throat, avoiding alcohol supports faster recovery.

Safety Tips When You're Sick

• Avoid alcohol while taking cough medicine
• Decline unfamiliar drinks and know drug-related slang terms
• Read medication labels carefully and follow dosing instructions
• Don't use cough medicine for more than seven days without consulting a doctor
• Consider alcohol-free alternatives or herbal remedies like honey-lemon tea

Final Recommendation

Mixing cough medicine and alcohol—whether intentional or accidental—poses serious health risks. Understanding these dangers and making informed choices protects your wellbeing. When sick, prioritize hydration and rest over social drinking. Your health deserves that consideration.