Understanding Medication Interactions Around the Holidays

The holidays often bring more than festive gatherings—they also bring colds, flu, and the temptation to mix over-the-counter (OTC) medicines, supplements, or alcohol with your regular prescriptions. If you take blood thinners, blood pressure medicine, or other heart medications, certain combinations can cause problems. There are many possible interactions, but here are some of the most common ones to be aware of during the holidays.

Over-the-Counter (OTC)

Cold and Flu Meds

Decongestants like pseudoephedrine and phenylephrine are common in cold and sinus medicines. If you take medications like lisinopril, losartan, metoprolol, or amlodipine, decongestants can make blood pressure harder to control or trigger headaches, palpitations, or chest discomfort. Always check the label, since most OTC cold and flu medicines warn those with heart conditions to talk with a clinician before use.

Pain relievers can also interact with prescription medicines. Ibuprofen (Advil®, Motrin®) and naproxen (Aleve®), also known as nonsteroidal anti-inflammatory drugs or NSAIDs, increase bleeding risk when combined with blood thinners like warfarin, apixaban (Eliquis®), or rivaroxaban (Xarelto®). They can also interfere with blood-pressure-lowering medicines by causing your body to retain salt and fluid. Many cold products also contain acetaminophen (Tylenol®), which can increase bleeding risk in high doses.

Supplements and Herbal Remedies

Many people reach for supplements during cold and flu season, hoping to “boost” their immune system or recover faster—but some of these products can also interfere with heart medicines.

Ginseng, often marketed for immune support or energy, can interfere with warfarin and possibly other blood thinners. Evidence of interactions with blood pressure or heart medicines is limited, but caution is still advised when taking it with prescription drugs.

Garlic and turmeric, commonly used for “immune health” or inflammation, can also increase bleeding risk when taken with blood thinners like warfarin, apixaban, or rivaroxaban. Even “natural” products can have strong effects and may vary widely between brands since they're not regulated by the Food and Drug Administration. Always talk with your pharmacist or clinician before starting anything new, especially during cold and flu season.

Want a full list of supplements that can affect blood thinners?
Explore our easy-to-read guide here.

Alcohol and Medication Safety

Holiday gatherings often include wine, beer, or cocktails, but alcohol can interact with many heart and blood-thinning medications. These interactions can change how drugs work, worsen side effects, and increase cardiovascular risks.

If you take warfarin, alcohol can affect how well it works. Heavy or binge drinking can make warfarin work too strongly and increase the chance of serious bleeding, while frequent long-term drinking can make it less effective and increase your risk of a clot.

While alcohol doesn’t directly interact with direct oral anticoagulants like apixaban and rivaroxaban, it can still increase bleeding risk since both alcohol and blood thinners make it harder for your blood to clot.

Some heart medications can also intensify alcohol’s effects. Beta-blockers like metoprolol may cause dizziness, low blood pressure, or a slow heart rate when combined with alcohol. Calcium channel blockers such as verapamil can worsen these symptoms and slow how your body breaks down alcohol, making the effects stronger and longer-lasting.

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Did You Know?

Alcohol and Fall Risk

Alcohol increases the risk of falls—a serious concern for anyone taking blood thinners. Even a minor fall can cause bruising or internal bleeding, so it's safest to limit alcohol and stand up slowly after drinking.

Holiday Heart Syndrome

Drinking too much at once, especially during celebrations, can also affect how your heart beats. Holiday heart syndrome occurs when heavy drinking triggers an irregular rhythm—often atrial fibrillation, a fast or fluttering heartbeat. It can happen even in people without existing heart problems.

The rhythm usually returns to normal once alcohol leaves your system, but if you notice chest discomfort, shortness of breath, or lightheadedness, seek medical care right away.

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References

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