Ask Your Pharmacist

December 27, 2022
Q:

My family is planning to gather over Christmas for the first time since the pandemic. Does anything out there actually work to prevent a hangover? 

A:

Many New Brunswickers plan to reconnect this Christmas season with family and friends we have not seen in some time, and I'm willing to bet some of us will share a bevvy or two more than usual. 

The only tried and true way to prevent hangover is not to drink alcohol. Since this strategy isn’t always practical during the holidays, there are a few actions you can take to lessen the chance of a holiday hangover and to manage the symptoms should you experience one.    

A hangover is a set of symptoms that occurs after drinking excessively. Hangover symptoms vary from person to person and may include headache, sensitivity to light and sound, nausea, stomach irritation, thirst, dizziness, irritability, sweating, anxiety, hypertension.  Alcohol is the main chemical responsible for symptoms of hangover. Substances such as congeners added during alcohol fermentation, and sulfites added as wine preservatives are also responsible for hangover symptoms.   

Although pharmacy shelves may have several over-the-counter remedies for hangovers, the reality is that few of these medications have been proven effective. Check with your pharmacist before taking any prescription, natural/herbal, or over-the-counter medications for hangovers to minimize the chance or drug interactions and other medication-related problems.   

Alcohol is a diuretic, and alcohol consumption leads to dehydration. Hangover symptoms can be alleviated by gradually replacing fluid and electrolytes lost during alcohol consumption. Some electrolyte replacement solutions contain excessive sugar, which can lead to stomach cramps and diarrhea if consumed too quickly. Dilute sugar-containing electrolyte drinks to 50 per cent with water to minimize this effect. One way to prevent dehydration is to alternate a non-alcoholic drink with your alcoholic drink. At the end of a night of drinking, you may choose to rehydrate with an electrolyte-containing drink before bed.   

Non-steroidal anti-inflammatory drugs (NSAIDS) [i.e.  ibuprofen, naproxen] have been used to treat headaches and muscle pain associated with hangovers. The usual adult dose of ibuprofen is 200 to 400 mg up to three times daily. Although ibuprofen may alleviate headache and muscle pains caused by hangover, NSAIDS also irritate the stomach lining and may contribute to worsened nausea, gastritis, and in severe cases may lead to stomach and duodenal ulcers. NSAIDS may also contribute to renal injury in people who are dehydrated and in those taking other medications that act on the kidney.  

Acetaminophen is often used to alleviate headache symptoms associated with hangovers. It is important to realize that both alcohol and acetaminophen are filtered by the liver.  If your liver is already working overtime because of your alcohol consumption, NSAIDS may be a better choice than acetaminophen.  The total daily maximum dose of acetaminophen in a healthy adult is 4 grams. When treating headache caused by excessive alcohol, it is wise to keep your acetaminophen well below this dosage. 

Famotidine (i.e. Pepcid) and ranitidine (ie. Zantac), H2-receptor antagonists, are available over the counter to treat symptoms of heartburn and mild gastric reflux. These medications have been shown to increase blood alcohol level in people who consume alcohol. Those taking this type of medication while drinking may experience symptoms of alcohol intoxication sooner than if they were not using this medication. Proton pump inhibitors (PPIs) (i.e. esomeprazole [Nexium], pantoprazole, omeprazole, rabeprazole) do not appear to have the same interaction with alcohol as H2 receptor antagonists. Those taking PPIs for their symptoms of gastric reflux should note however, that alcohol may increase the amount of stomach acid secreted, making one’s stomach symptoms worse during a hangover. 

Some report that dimenhydrinate (i.e. Gravol) relieves the nausea associated with alcohol-associated hangover. The combined use of alcohol and dimenhydrinate, which both depress our alertness and co-ordination, are not recommended to be used in combination. Using them together may lead to dangerous decreases in your level of consciousness. 

If you choose to use a natural product as a hangover remedy, ensure that it has an eight-digit natural product number (NPN) on the package. The presence of this number indicates that the product is approved by Health Canada, which guarantees that active ingredient listed on the product is actually contained in the product, though it makes no promise about the effectiveness of the product. A few studies have shown that use of the supplement L-cysteine 1200 mg after drinking alcohol may reduce alcohol by-products and related hangover. Nux Vomica is a homeopathic natural product with reported effects against the headache associated with hangovers. 

This Christmas season, make good choices when it comes to your alcohol consumption. If you choose to drink, do so in moderation. Do not drink and drive, ever. If drinking is having a negative impact on your life, reach out to Alcoholics Anonymous New Brunswick for assistance. https://www.frederictonaa.ca/ 

Dr Kevin Duplisea (PharmD BSc. Pharm, BSc. ACPR) is a pharmacist at Shoppers Drug Mart in Quispamsis, New Brunswick. His opinions expressed in this newspaper are published for educational and informational purposes only, and are not intended as a diagnosis, treatment or as a substitute for professional medical advice, diagnosis or treatment. Send your questions to AskYourNBPharmacist@gmail.com.