Fluoxetine (Prozac) is a type of depression medication. It belongs to a class of drugs called selective serotonin reuptake inhibitors (SSRIs). Doctors sometimes use Prozac to treat other conditions, such as anxiety.

While not common, liver injury has been linked to Prozac use in some people. Alcohol use is another risk factor for liver damage, but it’s unclear whether a combination of the two can lead to liver problems. Doctors generally recommend that you don’t drink alcohol while taking antidepressants.

Read on to learn more about what we do know about Prozac and liver function and what risks are associated with Prozac and alcohol use.

Drug-induced liver injury (hepatoxicity) is an acute condition specific to certain medications, supplements, or herbs you may take. Researchers believe this is the most common cause of acute liver injury in the United States.

Drug-induced liver injuries are most commonly linked with the following:

Notably, Prozac and other SSRIs aren’t on this list. While Prozac isn’t a common cause of acute liver failure, researchers believe it can, in rare instances, cause this serious liver condition.

Research suggests that less than 1% of people who take Prozac may be at risk of acute liver injury. Such effects on the liver tend to occur 2 to 12 weeks after starting this SSRI. A doctor may recommend monitoring your liver enzymes to detect any issues.

Mixing Prozac with alcohol may lead to other health concerns. Keep in mind that alcohol is a depressive agent. It can be dangerous if you’re taking mental health medications.

Drinking alcohol while taking Prozac may make your medication less effective. According to a 2014 report from the National Institute on Alcohol Abuse and Alcoholism (NIAAA), mixing alcohol with SSRIs may also cause:

  • dizziness
  • drowsiness
  • worsening symptoms of depression, including hopelessness
  • increased risk of a possible alcohol overdose

To date, duloxetine (Cymbalta) is the only antidepressant reported by the NIAAA as having a link to liver damage when mixed with alcohol. But this doesn’t mean there isn’t a risk with other antidepressants like Prozac.

You should also be aware of possible interactions between alcohol and other medications you may take. According to the NIAAA’s 2014 report, some common interactions include, but aren’t limited to:

Liver damage may not cause symptoms in the early stages. There’s also no specific treatment for liver damage. Once liver damage progresses, it may lead to permanent damage called cirrhosis.

Most people don’t know they have cirrhosis until the damage is severe enough to stop the liver from functioning properly (liver failure).

Possible early symptoms of cirrhosis may include:

  • abdominal pain
  • fatigue and weakness
  • reduced appetite and unintentional weight loss
  • nausea and vomiting

As liver damage worsens, you may experience:

Is it safer to wait a few hours after taking Prozac before drinking alcohol?

With long-term medications like Prozac, it doesn’t make a difference if you wait a few hours before drinking alcohol. Medications may interact with alcohol at any point of the day, even if you don’t use them both at the same time.

How long does Prozac stay in your body?

It takes 4 to 8 weeks for antidepressants like Prozac to take full effect. As such, you can expect Prozac to stay in your body for several days after use.

The exact timeline for medications staying in your body varies, even among SSRIs. Prozac can take 25 days or longer to fully exit your body.

You shouldn’t suddenly stop taking Prozac or change your dose. This may lead to withdrawal symptoms and decrease the overall efficacy of your medication. If a doctor recommends that you stop taking Prozac, they’ll let you know how to do it gradually.

Are there any antidepressants that are OK to take if you want to drink alcohol?

There’s a risk of interactions if you take any antidepressant while drinking alcohol. Additionally, Cymbalta carries a specific risk of liver damage.

Other common SSRIs besides Prozac include paroxetine (Paxil), sertraline (Zoloft), and escitalopram (Lexapro).

SSRIs aren’t the only types of antidepressants available. Other classes may include serotonin and norepinephrine reuptake inhibitors (SNRIs), such as Cymbalta; atypical antidepressants, such as bupropion (Wellbutrin); and tricyclic antidepressants.

Is liver damage permanent?

Liver damage is generally irreversible. This includes alcohol-related damage to your liver. However, you may be able to prevent further liver damage with lifestyle changes.

If your liver has already incurred damage from alcohol or medications, the best thing you can do is stop drinking alcohol. This may limit further damage to your liver and possibly prevent the development of cirrhosis.

Prozac and alcohol both pose certain risks to your health, with alcohol posing a higher risk to your liver overall. While research on liver damage from using Prozac and alcohol is minimal, there are other serious health risks to consider.

As a rule of thumb, you shouldn’t drink alcohol while taking Prozac. Since medications and alcohol use are also highly individual, you may wish to further discuss these concerns with a doctor.