Last reviewed: 21 October 2026
Audience: People living with aspergillosis, families and carers
Series: The Questions We Don’t Always Ask

Alcohol and Aspergillosis: What If I Drink More Than I Should?

Most people know that drinking too much alcohol can affect their health. But knowing something and changing it are very different things. For someone living with aspergillosis, alcohol may raise additional questions about antifungal medicines, liver health, fatigue and recovery. These are questions worth discussing openly, without embarrassment or judgement.

Why can alcohol be difficult to talk about?

Alcohol is part of everyday life for many people. It may be associated with relaxing after work, social occasions, celebrations or simply enjoying a familiar routine.

For someone living with a long-term illness, it may also become a way of coping with anxiety, loneliness, pain, frustration or uncertainty about the future.

People sometimes avoid mentioning how much they drink because they worry about being judged, criticised or told to stop altogether.

But your healthcare team needs accurate information, not an idealised version of your lifestyle. The purpose of asking about alcohol should be to understand your health and help you make informed decisions.

You do not have to wait until drinking has become a serious problem before raising the subject.

Does alcohol make aspergillosis worse?

There is limited direct research into how different levels of alcohol consumption affect chronic pulmonary aspergillosis (CPA), allergic bronchopulmonary aspergillosis (ABPA) or other forms of aspergillosis.

However, heavy or prolonged drinking can affect several aspects of health that matter when living with chronic lung disease.

• Immune function: Heavy alcohol consumption can impair immune responses and increase susceptibility to some infections.
• Nutrition: Drinking heavily may contribute to poor dietary intake and nutritional deficiencies.
• Sleep: Alcohol may initially make someone feel sleepy, but it can disrupt sleep quality later in the night.
• Fatigue: Hangovers, dehydration, disturbed sleep and poor nutrition can make existing tiredness more difficult to manage.
• Other medical conditions: Alcohol can worsen some liver, cardiovascular, metabolic and mental health problems.

These effects do not mean that an occasional drink necessarily causes measurable harm to someone’s aspergillosis. The amount consumed, frequency, other health conditions and prescribed medicines all matter.

Alcohol and medicines used to treat aspergillosis

People with aspergillosis may take antifungal medicines, corticosteroids, biologic treatments or other medicines for their lung disease and associated conditions.

Medicines differ. Some have specific precautions involving alcohol, while others have no established direct alcohol interaction. However, alcohol may still affect general health or make certain side effects more difficult to manage.

The best starting point is the Patient Information Leaflet (PIL) supplied with your medicine. This explains important precautions, interactions and side effects. You can also find UK patient leaflets through the electronic Medicines Compendium (eMC).

If the leaflet does not mention alcohol, that does not automatically mean drinking is safe for you. Your medical history, other medicines and blood test results may affect the advice you receive.

Antifungal medicines

Antifungal treatments include itraconazole, voriconazole, posaconazole, isavuconazole and, in some circumstances, other medicines such as amphotericin B or echinocandins. Newer antifungal treatments are also being developed and introduced.

Some antifungals can affect liver function. Heavy alcohol consumption can independently damage the liver, so it is particularly important to discuss drinking with your prescribing team if you are taking long-term antifungal treatment or have abnormal liver tests.

Different antifungals have different safety profiles. For example, amphotericin B treatment requires particular attention to kidney function and blood electrolytes. This is not the same as having a proven direct interaction with alcohol.

For newer or investigational antifungals, follow the specific advice provided by your specialist team or clinical trial. Alcohol restrictions may form part of a trial protocol even when a medicine has no established alcohol interaction.

Steroids and biologic treatments

Corticosteroids such as prednisolone, methylprednisolone and inhaled steroids are frequently used to manage allergic or inflammatory lung conditions, including ABPA.

Alcohol is not universally prohibited with corticosteroids. However, drinking may aggravate problems such as stomach irritation, poor sleep, changes in mood or difficulties controlling blood glucose.

Biologic treatments used for severe asthma and some patients with ABPA have different safety considerations. Do not assume that all biologics have the same advice about alcohol.

Check the leaflet for your particular treatment and ask your pharmacist or specialist team if you are uncertain.

Where can I check my medicine?

Always read the Patient Information Leaflet supplied with your medicine. You can also search for UK medicines and their leaflets using the electronic Medicines Compendium (eMC).

Examples of medicines used in aspergillosis care include:

• Itraconazole – product information
• Voriconazole – product information
• Posaconazole – product information
• Isavuconazole – product information
• Amphotericin B – product information
• Prednisolone – product information
• Methylprednisolone – product information

Important: Select the leaflet matching your actual medicine and formulation. Not all medicines, particularly investigational treatments, will have a UK PIL available through eMC. Your prescribing team can provide the appropriate information.

For a broader explanation of antifungal treatment, see our guide to antifungal medicines.

When is extra caution particularly important?

Discuss alcohol use with your healthcare team if:

• You have liver disease or abnormal liver function tests.
• You take medicines that can cause liver injury.
• You have kidney problems or are receiving treatment requiring careful fluid and electrolyte monitoring.
• You have diabetes or difficulty controlling your blood glucose.
• You take several medicines and are concerned about interactions.
• You have been specifically advised to avoid alcohol.
• You are participating in a clinical trial with alcohol restrictions.

Do not stop, skip or change prescribed treatment because you have consumed alcohol. If you are concerned about a possible interaction, contact your pharmacist or prescribing team for advice.

What if my liver tests are abnormal?

Abnormal liver function tests can have several causes, including medicines, alcohol, fatty liver disease, infections and other health conditions.

If your tests change during antifungal treatment, your team may need to investigate the cause and decide whether additional monitoring or treatment changes are necessary.

Tell them about your alcohol consumption, including any recent increase. This information may help them interpret the results.

Seek prompt medical advice if you develop yellowing of the skin or eyes, dark urine, pale stools, persistent vomiting or significant new abdominal pain, particularly while taking an antifungal medicine.

How much alcohol is too much?

UK Chief Medical Officers advise that, to keep health risks from alcohol low, adults who drink should not regularly exceed 14 UK units per week. If drinking this amount, it is better to spread it over three or more days rather than drink it all at once.

This is a low-risk guideline, not a guarantee of safety. Drinking less generally reduces risk, and there is no completely risk-free level of alcohol consumption.

People with liver disease, certain medical conditions or particular medication risks may be advised to avoid alcohol altogether.

What does 14 units look like?

• A 175 ml glass of wine at 12% alcohol contains approximately 2.1 units.
• A pint of beer at 4% contains approximately 2.3 units.
• A 25 ml measure of spirits at 40% contains 1 unit.

Alcohol strength and serving sizes vary considerably. Large wine glasses, stronger beers and generous home measures can contain more units than people expect.

You can calculate units using:

Units = volume in ml × alcohol strength (%) ÷ 1,000

For example, a 250 ml glass of 13% wine contains 3.25 units.

What if I regularly drink more than the recommended amount?

Many people do. It does not mean that you have failed or that your healthcare team cannot help.

It is worth thinking about what role alcohol plays in your life.

Do you drink mainly socially? Is it a habit at the end of the day? Does it help you manage anxiety or sleep problems? Do you sometimes drink more than you intended?

Understanding the reasons can be more useful than simply setting a target without a plan.

Small changes can make a difference

If you are not physically dependent on alcohol, possible ways to reduce consumption include:

• Keeping a record of what you drink for a week, including quantities and strengths.
• Choosing smaller servings or lower-alcohol alternatives.
• Replacing some alcoholic drinks with alcohol-free options.
• Setting a realistic weekly target and reviewing it.
• Identifying situations where you tend to drink more than intended.
• Finding alternative ways to relax or manage stress.
• Asking a GP, pharmacist or alcohol support service for help.

You do not need to make every change at once. For many people, gradual and sustained progress is more manageable than an ambitious target that is difficult to maintain.

What if I find it difficult to cut down?

Some people develop alcohol dependence. This means that their body has adapted to regular alcohol consumption and they may experience withdrawal symptoms when alcohol is reduced or stopped.

Possible symptoms include shaking, sweating, anxiety, nausea, disturbed sleep or feeling unwell until they have another drink.

Effective support is available, including structured psychological support, community alcohol services and, where appropriate, prescribed medication or supervised withdrawal.

What if I drink because living with aspergillosis is difficult?

Chronic illness can affect much more than the lungs.

Breathlessness, fatigue, uncertainty about the future, repeated appointments and limitations on everyday activities can all contribute to stress and low mood.

Some people use alcohol to switch off from these worries. The relief may feel real in the short term, even when drinking makes sleep, anxiety or fatigue worse afterwards.

If this sounds familiar, it may be helpful to talk about the problem behind the drinking, rather than focusing only on alcohol itself.

Support with anxiety, sleep, pain, social isolation or adjustment to chronic illness may make reducing alcohol easier.

What should I tell my respiratory or antifungal team?

You do not need to wait until alcohol has become a serious problem before discussing it.

You could simply say:

“I probably drink more than is recommended, and I’m worried it might affect my antifungal treatment. Can we talk about what is safe for me?”

Useful information to share includes:

• How often you drink and roughly how much.
• Whether your drinking has increased recently.
• Whether you have previously had abnormal liver tests or liver disease.
• Any difficulties you have experienced when trying to reduce drinking.
• Whether alcohol is affecting sleep, appetite, mood or taking your medicines.

Your healthcare team can then consider your circumstances when advising about medicines, monitoring and additional support.

Does everyone with aspergillosis need to stop drinking?

Not necessarily. There is no universal rule requiring every person with aspergillosis to avoid all alcohol.

However, abstinence may be the safest advice for some people, particularly those with significant liver disease, alcohol dependence, a history of alcohol-related harm or other important medical risks.

People taking antifungal medicines should obtain advice specific to their treatment and medical history rather than assuming that moderate drinking is always safe.

The aim is to make informed decisions based on your health, not to impose the same rule on everyone.

The question worth asking

Perhaps the most useful question is not simply, “Am I allowed to drink?”

It is:

“Given my lung condition, medicines and general health, what would reducing alcohol realistically achieve for me?”

That opens the door to a more useful conversation about risk, treatment and the changes that matter most.

Living with aspergillosis can already involve considerable restrictions. Good advice should help people understand their choices, not add unnecessary guilt or shame.

Where to find help

• NHS: Alcohol advice – UK drinking guidelines, units and ways to reduce drinking.
• NHS: Alcohol misuse – recognising problems, treatment and support.
• Drinkaware – alcohol information, unit calculators and practical resources.
• WithYou – support for alcohol and drug problems.
• Electronic Medicines Compendium – UK Patient Information Leaflets and medicine safety information.

Medicine safety: Information about medicines can change. Always check the Patient Information Leaflet supplied with your medicine and seek advice from your pharmacist or prescribing team. This article provides general educational information and does not replace individual medical advice.

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