Does Pepcid AC help to reduce alcohol flushing?

Dear Red in the Face, 

It’s great that you’re looking out for your friends’ health and the safety of mixing medications with alcohol. Famotidine (often referenced by the brand name Pepcid AC) has been used to reduce redness from alcohol consumption, so your concern is valid! It’s more common among those of East Asian descent, with as many as 40 percent experiencing alcohol flushing. It’s important to recognize that the flushing your friends are experiencing may not just be a side effect of drinking alcohol. It could indicate that they have an alcohol intolerance. So, while you may be happy to know that stomach damage is not a common side effect of combining famotidine and alcohol, there are other effects to be aware of when the party starts. 

It might help to start with some background on how famotidine emerged as an at-home remedy for alcohol flushing. There's an enzyme in the body that processes the toxins found in alcohol and if you're someone who has a lower amount of that enzyme, or the enzyme is mutated (typically an inherited mutation from your parents) you may experience alcohol flushing. Famotidine limits the amount of acid the stomach produces, including the release of something called histamine. If someone has an alcohol intolerance, one reaction is to produce histamine to alert the body that it’s consumed something it doesn't like. In essence, famotidine attempts to manage the flushing reaction by blocking histamines giving it the potential to reduce alcohol flushing and facial redness. 

While alcohol won't change the way famotidine is processed in the body, famotidine can actually change the way alcohol is absorbed. Since famotidine reduces the amount of acid in your stomach, it can cause alcohol to be absorbed by the body faster and more intensely, contributing to that feeling of alcohol "hitting all at once".  For some people, reducing alcohol flushing may give the perception that they can drink more, therefore increasing the chances of experiencing negative effects of alcohol. That said, while damage to the stomach lining is not a common effect of combining famotidine and alcohol, stomach lining damage is a potential effect of drinking alcohol at higher amounts. 

Regardless of whether famotidine reduces alcohol flushing or not, it doesn't address the root cause. It’s possible that the flushing may be due to alcohol intolerance. If left untreated, alcohol intolerance has the potential of leading to a variety of other risks including being at a higher risk of developing esophageal cancer. In addition, famotidine may not address other symptoms that come from an alcohol intolerance such as itchy skin, runny or stuffy nose, low blood pressure, and nausea. Unfortunately, there are currently no FDA-approved medications that reduce alcohol flushing. That said, there are some things your friends can do to help reduce alcohol flushing and lower their risks of other impacts of alcohol use. Some of these strategies to reduce redness include: 

• Reducing and avoiding shots of hard liquor 
• Alternating with non-alcoholic drinks and water throughout the period in which they are drinking 
• Opting for drinks with lower alcoholic content 
• Reducing the overall number of drinks they consume 

If you feel that your friends may benefit from some additional advice or guidance, you may suggest that they reach out to a health promotion specialist or a medical professional. These professionals can help provide more information about specific drug and alcohol interactions. Great job reaching out for more information and here’s to helping your friends be smart, safe, and responsible!