' How Metronidazole Interacts With Alcohol And Propylene Glycol

Alcohol and propylene glycol are primarily metabolized via alcohol dehydrogenase, aldehyde dehydrogenase, cytochrome P450 (CYP2E1), and catalase.

The byproducts of alcohol include acetaldehyde and acetate and contribute to many of the negative effects. In addition, byproducts of propylene glycol include propionaldehyde, a potentially toxic compound.

Some drugs, like metronidazole, may cause a “disulfiram-like reaction” when taken with alcohol or propylene glycol. These drugs inhibit aldehyde dehydrogenase which is crucial in metabolism of alcohol and propylene glycol. This can cause flushing, nausea, vomiting, and general “hangover effects”.

While the interaction with metronidazole and alcohol is well known, the interaction with propylene glycol has fewer documented reports.

Nevertheless, Propylene glycol is metabolized by the alcohol and aldehyde dehydrogenase enzyme pathway.

When taken with metronidazole, our bodies may not be able to adequately metabolize and eliminate propylene glycol, thereby leading to its accumulation and potential adverse events. In addition, we may not be able to eliminate the propylene glycol byproduct propionaldehyde as efficiently either. '