The most defensible general position in this subcategory: identify the plausible mechanism, check whether it has been studied, and where it has not, say that rather than filling the gap. The confident version of this sentence would be wrong, so here is the hedged one.
Alcohol: what is documented and what is folklore — the long version — setting out what I have, and where I think it stops being reliable.
A narrow question about Alcohol, deliberately narrow, because the broad version has been asked here four times and produced four long threads and no answer.
One question, stated units, stated method, and what I have already ruled out.
The most defensible general position in this subcategory: identify the plausible mechanism, check whether it has been studied, and where it has not, say that rather than filling the gap.
The confident version of this sentence would be wrong, so here is the hedged one.
Alcohol: no absolute contraindication but it raises gastrointestinal irritation risk and this drug class already does that. The conservative position during titration is to limit it.
Worth reading the earlier posts in this thread before acting on mine.
Post #3 answers the question as asked. The question underneath it is different.
On Alcohol, the part that usually goes wrong is that the question is asked as though it has one answer. It has a range, and the width of the range is the interesting bit.
If you can post the two or three numbers you are working from, several people here will check the arithmetic rather than argue about the conclusion.
Anticoagulant questions come up regularly and are the clearest case for professional advice rather than discussion, because the consequence of being wrong is not gradual.
The answer changed when I changed how I was measuring, which was informative.
Clear enough that I do not think I have a follow-up, which is unusual.
Post #6 is right about the mechanism and I think understates the practical bit.
A note on scope: what I am saying about Alcohol applies to the case in the first post and I would not extend it further without checking.
Post #8 put the caveat in the right place and I want to underline it.
Alcohol is not contraindicated in the labelling and it does irritate a stomach that is already emptying slowly. There is no published interaction study, and the conservative reading is the obvious one.
I would put a moderate confidence on that and no more.
SGLT2 inhibitors: frequently co-administered and relevant to renal and cardiovascular discussion, not to interactions. There is no pharmacokinetic interaction of concern.
A partial answer, offered because a partial answer beats none.
Useful. I have added it to my own notes with the date on it.
This follows post #11 rather than contradicting it.
Speaking only to Alcohol as I have actually seen it, rather than as it is usually described: the effect is real, it is smaller than the thread suggests, and the variance between people is larger than the effect.
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