Alcohol: what is documented and what is folklore posts 121–135

Helpful, and easy to find again, which is half of what a good reply is.

I would rather this thread reach "we do not know" about alcohol than reach a confident answer that nobody can support when asked.

The arithmetic in post #122 is right; the assumption feeding it is the part to check.

A supplement is a drug for interaction purposes, and the fact that it is sold without a prescription tells you nothing about whether it interacts. The paperwork is usually worse rather than better.

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.

Taking post #124 at face value and following it one step further.

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.

The variance between people here is larger than the effect being discussed.

Everything in post #124 holds. The case it does not cover is the one I have.

The most useful thing anyone has posted about alcohol in this category was a table of what had been measured and by whom. That is what I would want again.

Alcohol has been discussed here with more heat than it deserves, mostly because two definitions have been in play the whole time.

I had written a reply contradicting post #127 and deleted it. Here is what survived.

SGLT2 inhibitors: frequently co-administered and relevant to renal and cardiovascular discussion, not to interactions. There is no pharmacokinetic interaction of concern.

I have seen it go both ways, which is why I hedge.

Two people in this thread mean different things by alcohol and are disagreeing about the definition while believing they are disagreeing about the facts. Worth pausing to define it.

Worth separating two things that post #128 runs together.

Where a published interaction study exists it usually reports an area-under-curve ratio, and that number is far more informative than a yes-or-no answer.

It took me longer than it should have to see that.

Post #131 is right about the mechanism and I think understates the practical bit.

Agreed on alcohol, with one qualification that I think matters. The reasoning holds for the case as described. Change the starting assumption and it does not, and the starting assumption is the part nobody states.

Adding a reference point for alcohol. Mine is a single case, collected without controls, and I am posting the method alongside it so it can be discounted appropriately.