Victoza and Alcohol

There’s no bold warning on the Victoza label about alcohol, but that doesn’t mean combining the two is without risk. Alcohol can affect your blood sugar in unpredictable ways, especially if you have type 2 diabetes. It can cause sudden drops or spikes, depending on when and how much you drink.

If you’re using Victoza for weight loss, alcohol may also slow your progress by adding empty calories and increasing appetite. Even more, it can make side effects like nausea or dizziness worse, without warning.

Before you take that sip, here’s what’s rarely explained but could make all the difference.

Can you drink alcohol while taking Victoza?

There’s no direct interaction between Victoza and alcohol, but whether drinking is safe for you depends on why you’re taking the medication.

• • If you’re using Victoza to lower your risk of heart attack or stroke, alcohol could work against that goal. It can raise your blood pressure and place added strain on your heart, which may increase cardiovascular risks.

• • For type 2 diabetes, alcohol makes blood sugar less predictable. It can lead to spikes or sudden drops, especially if you’re also on insulin or other glucose-lowering medications.

• • If weight loss is part of your treatment plan, alcohol adds empty calories and may slow your progress without offering any health benefits.

Moderate drinking is sometimes considered acceptable, defined as up to one drink per day for women and two for men. A standard drink is:

• • 12 oz of beer (5% ABV)
  • 5 oz of wine (12% ABV)
  • 1.5 oz of distilled spirits (40% ABV, such as vodka or whiskey)

However, these guidelines are based on studies involving generally healthy adults. If you’re managing chronic conditions like diabetes, heart disease, or obesity, even small amounts of alcohol could impact your treatment.

What happens if you drink alcohol while taking Victoza?

Combining Victoza with alcohol may lead to intensified side effects, as both can impact your digestive system, blood sugar, hydration levels, and even your mood. Here’s what you might experience:

1. Digestive discomfort may worsen

Victoza often causes gastrointestinal (GI) symptoms on its own, such as nausea or stomach pain. Alcohol can make those issues more intense, especially if your stomach is already sensitive.

Alcohol increases the production of stomach acid, which can irritate your digestive tract. If you’re already dealing with symptoms like abdominal pain or diarrhea from Victoza, drinking could make those worse.

Studies show that beer and wine significantly boost acid production, sometimes to near-maximum levels in the stomach. That’s largely due to certain compounds like maleic and succinic acid found in fermented drinks. Spirits like whiskey or gin, on the other hand, seem to trigger less of a response.

Victoza also slows how quickly food leaves your stomach, helping manage hunger. Alcohol may add to that delay, leaving you overly full or nauseated.

Interestingly, research shows that the effect alcohol has on digestion depends on how strong the drink is. Drinks over 15% alcohol, such as vodka or whiskey, can slow gastric emptying. Meanwhile, lower-alcohol drinks like beer and wine may actually speed things up a bit. Still, this can vary. Short-term drinking tends to slow digestion, while long-term heavy use might do the opposite.

2. Risk of dehydration increases

Both Victoza and alcohol can make you lose fluids. Victoza may cause vomiting, diarrhea, or nausea, all of which can reduce your hydration levels. Alcohol, being a diuretic, makes you urinate more, further depleting your body’s fluids. Together, they can leave you feeling dizzy, lightheaded, or tired from dehydration.

3. Higher chance of low blood sugar

If you’re using Victoza for type 2 diabetes, drinking alcohol can increase your risk of hypoglycemia, or dangerously low blood sugar.

Normally, your liver keeps your blood sugar stable by releasing stored glucose when you need it. But when you drink, your liver focuses on processing the alcohol instead, and glucose production slows down or stops altogether.

Another issue is that alcohol can use up the stored sugar in your liver, called glycogen. Your body typically relies on those glycogen reserves to maintain steady blood sugar between meals. If those reserves are depleted from drinking, it becomes even harder to bounce back from a dip in blood sugar.

Without enough glucose in your bloodstream, you might experience:

• • confusion
  • shakiness or dizziness
  • sweating
  • fainting (in more severe cases)

Drinking on an empty stomach can make this worse. With no food to provide an extra source of sugar, your risk of a sudden drop increases, especially if you’re on insulin or other diabetes medications in addition to Victoza.

4. Added strain on your liver

Your liver already works hard to break down alcohol. While Victoza isn’t heavily metabolized by the liver, there have been reports of liver issues after starting liraglutide.

In one case report, a 64-year-old woman was hospitalized after experiencing diffuse abdominal pain (pain spread across her entire abdomen) for four days. She has multiple chronic conditions, including:

• • high blood pressure
  • type 2 diabetes
  • high cholesterol
  • a history of gallbladder removal

She was taking lisinopril (for blood pressure), metformin (for diabetes), and liraglutide (for diabetes). She denied alcohol or drug use and was not taking any supplements or herbal products.

On physical exam, the only significant finding was tenderness in the upper abdomen (epigastric area). There were no signs of liver failure (e.g., confusion, jaundice with bleeding, or fluid accumulation). However, her liver blood tests showed significant abnormalities that indicated hepatocellular liver injury (damage to liver cells).

The medical team ruled out many other possible cause. They immediately stopped liraglutide and started N-acetylcysteine (a medication sometimes used to support the liver).

Her symptoms resolved, and all liver tests returned to normal two months later, suggesting liraglutide-induced liver injury.

A similar case happened to a 41-year-old woman with type 2 diabetes, fatty liver disease, and hypertension. She was hospitalized with diffuse abdominal pain, and her liver function tests showed hepatocellular injury, but other possible causes were ruled out.

Since she was taking liraglutide and no other cause was found, doctors suspected drug-induced liver injury. After stopping liraglutide, her symptoms resolved and liver enzymes gradually returned to normal over two months.

So, while liraglutide is generally considered safe for the liver, this report shows that rare idiosyncratic reactions (unpredictable side effects unrelated to dose or duration) can happen. Combining Victoza and alcohol could potentially increase the strain, particularly if you drink heavily or have existing liver concerns.

5. Dizziness

Dizziness has been reported in postmarketing experiences of Victoza.

Alcohol can also trigger dizziness by disrupting your vestibular system, located in your inner ear. This system is responsible for your sense of balance, spatial orientation, and coordination. When alcohol, illness, or injury affects the vestibular system, you may feel:

• • dizzy
  • lightheaded
  • unsteady
  • like the room is spinning (vertigo)

In one study, healthy adults drank 1.5 ml of whiskey/kg of body weight within five minutes, and researchers noted noticeable balance problems and eye movement changes just 30 minutes after drinking. This suggests that even moderate amounts can make you feel unsteady or disoriented.

6. Emotional effects may intensify

Both Victoza and alcohol can affect your mood. Alcohol interferes with brain chemicals involved in emotional regulation, sometimes triggering anxiety, sadness, or irritability. Data from the 2020 National Survey on Drug Use and Health (NSDUH), focusing on 27,170 participants, showed that tobacco use, alcohol use, and having a disability were all linked to worse mental health outcomes.

Victoza has also been associated with mood changes in rare cases, including depression or suicidal thoughts.

In a European study, researchers looked at adverse event reports submitted to the EudraVigilance database between January 2021 and May 2023. Out of all 31,444 adverse event reports, 372 were psychiatric adverse event reports.

The most common psychiatric symptoms reported included:

• • depression
  • anxiety
  • suicidal ideation

Liraglutide accounted for most of the fatal psychiatric outcomes (8 out of 9 deaths were linked to liraglutide). In addition, 4 of the 11 life-threatening psychiatric events were also tied to liraglutide.

Another large community-based study found that patients using liraglutide or semaglutide had:

• • 98% higher risk of developing any psychiatric disorder
  • 195% increased risk of major depression
  • 108% higher risk of anxiety
  • 106% elevated risk of suicidal behavior

In a recent clinical case, a 39-year-old man with type 2 diabetes began taking liraglutide to help control blood sugar and lose weight. Shortly after starting the medication, he developed depressive symptoms.

A formal diagnosis of a depressive episode was made, and the timing suggested a potential link to liraglutide use. When liraglutide was discontinued and antidepressant therapy was started, his symptoms improved significantly within a week.

While this doesn’t prove that Victoza causes these conditions, it raises important safety concerns. If you’re sensitive to emotional shifts, drinking alcohol while on Victoza treatment may worsen those symptoms.

Can Victoza help reduce alcohol cravings?

Recent research suggests Victoza may help reduce your urge to drink. In the study:

• • Average alcohol consumption dropped by 7.1 units per week (from 11.8 to 4.3 units/week)

• • High alcohol consumers showed a 68% reduction

• • Low consumers showed a 55% reduction

• • No patients reported an increase in alcohol use after starting GLP-1 therapy

These reductions were seen in both male and female participants, with no significant gender differences in the amount or percentage of reduction.

Liraglutide appears to reduce alcohol relapse behavior and reverse the cognitive and emotional impairments caused by alcohol withdrawal in mice. These effects may be due to its ability to protect and restore synaptic health in brain areas involved in memory and emotion.

A large nationwide cohort study in Sweden investigated whether GLP-1 receptor agonists, specifically semaglutide and liraglutide, can reduce the risk of hospitalization for alcohol use disorder (AUD) in individuals already diagnosed with AUD.

During the study period, individuals who were using liraglutide had a 28% lower risk of being hospitalized for AUD compared to periods when they were not taking the medication. Liraglutide was also linked to a 22% reduced risk of hospitalization for any substance use disorder (SUD).

In terms of physical health, liraglutide use showed a 21% lower risk of somatic hospitalizations, which refers to hospitalizations due to non-psychiatric, physical health conditions. However, when it came to suicide attempts, liraglutide did not show a statistically significant effect.

Wrap-up

While a single drink may not always cause issues, the combination of Victoza and alcohol can increase your chances of side effects, some of them serious. If you’re unsure how alcohol might affect you while on Victoza, it’s best to have a conversation with your healthcare provider. They can guide you based on your medical history and treatment goals.

Frequently Asked Questions