Ethanol as a Context-Dependent Modifier of Drug Toxicity
This narrative review reframes alcohol-drug interactions as timing- and pattern-dependent pharmacological events rather than blanket avoidance warnings, giving interaction-focused pharmacists a mechanistic risk-stratification framework.
Ethanol dramatically alters drug toxicity, posing high risks for older adults.
Ethanol can significantly alter drug response and toxicity, which is particularly crucial for older adults who may have reduced organ reserve and are often on multiple medications. Ethanol affects drug pharmacokinetics and pharmacodynamics through mechanisms like CYP2E1 induction, acetaldehyde accumulation, and disrupted protein binding, especially in older adults and those with liver disease. Understanding these interactions is essential for managing medications in older adults, particularly those with alcohol use disorder or liver disease, to prevent adverse drug events. Ethanol is a potent modifier of drug toxicity, especially in older adults with complex health conditions.
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Authors:Bukowska B, Bukowski K, Broncel M
Citation:Bukowska B, Bukowski K, Broncel M Ethanol as a Modifier of Drug Toxicity in Humans: Pathways of Toxicity and Organ-Level Consequences. International journal of molecular sciences. 2026;27(14). doi:10.3390/ijms27146270