Asthma And Alcohol 

What is asthma?

Asthma is a chronic illness that affects both children and adults. It is the inflammation and tightness of the smooth muscle around the tube that transports air to the lungs, therefore restricting air from easily flowing in and out of the lungs, which eventually prevents comfortable breathing. According to WHO, in 2019, asthma afflicted approximately 262 million individuals and killed 455,000 people.

Asthma attack

Asthma attacks, also known as asthma exacerbations or asthmatic episodes, occur when the airways constrict and generate more mucus, forming a partial barrier that stops air from easily passing in and out of the lungs.1

Common asthma triggers

In people who already have asthma, due to the hypersensitivity of their airway, a variety of things might precipitate an attack. These variables are known as triggers because someone with asthma is exposed to them anytime; they elicit mild to severe asthma symptoms. These triggers include: 

  • viral upper respiratory tract infection (cold and flu)
  • aeroallergens like animal fur, dust mites, pollen, feathers
  • exercise
  • changes in emotions
  • irritant fumes
  • weather (cold air, dry air and heat)1

Symptoms of asthma

The symptoms of asthma differ from person to person. You may have occasional asthma attacks, only have symptoms when exposed to triggers (intermittent), or have symptoms at all times (persistence). Symptoms might also range from mild to severe. Mild symptoms can be easily managed at home with bronchodilators or steroids; however, moderate to severe symptoms require immediate treatment from a clinician.

According to Mayo Clinic, symptoms of asthma include:

  • wheeze
  • cough
  • shortness of breath
  • atopic symptoms such as itching of the skin, runny nose, sneezing and redness of the eye
  • chest tightness

Some severe symptoms include:

  • inability to speak in full sentences
  • confusion
  • blue tint to the lips indicating shortness of oxygen (cyanosis)
  • breathlessness
  • increased heart rate (tachycardia)
  • increased breathing rate (tachypnoea)1

Alcohol-induced asthma

Alcohol can trigger an asthma attack because it contains histamine and sulphites. Although it is less well known compared to other asthma precipitating factors, it is crucial to realise that not everyone with asthma has an episode that starts or intensifies when they consume alcohol.


Histamine is a naturally occurring substance found in food and alcoholic drinks. Acetaldehyde, an alcohol metabolite, also increases the level of histamine in the body, by stimulating the release of histamine from mast cells.2 Histamine is the chemical produced in your body when you experience an allergic response and can lead to an asthmatic attack. 


Sulphites are used as preservatives in a wide range of foods and drinks. They are naturally created during the production of beer, wine, and cider, and additional sulphite may be added to wine to prevent it from fermenting in the bottle.2

Can all alcohols trigger an asthma attack?

Alcohol triggers asthmatic symptoms in 75% of persons with the condition, according to Asthma UK. Not all alcohol can trigger asthma symptoms, wine, which has both sulphites and histamines, is the main offender. Histamine levels in white wine are generally lower than those in sparkling white or heartier red wines. Sulphites are generally absent from organic wines. Options that are either fully devoid of sulphites and histamines or low in these substances are available. Compared to beer, hard ciders, and wines, spirits are often safer options. It's important to keep in mind that many mixers used in drinks contain not only preservatives but also sulphites.2

Can you prevent alcohol-induced asthma attacks?

Studies have shown that the main substance responsible for triggering asthmatic symptoms in an alcoholic drink is histamine, although sulphites have a major role to play in alcohol-induced asthma.3,4 Taking histamine antagonists before ingesting alcohol has been encouraged. Histamine antagonists (H1), such as terfenadine, will help prevent symptoms of asthma if taken two hours before the intake of alcohol.3 In general, severe alcohol-induced asthma attacks are rare. Alcohol use is frequently avoided by individuals with asthma out of concern that it would worsen or trigger their symptoms. While it is evident that abstinence will prevent alcohol-induced asthma, it is realistic to anticipate that some individuals with asthma may occasionally drink.

What to do when you have an asthma attack after drinking alcohol?

To prevent asthma episodes from beginning, prevention and long-term management are essential. The typical course of treatment is learning to identify your triggers, taking precautions to avoid them, and monitoring your breathing to ensure that your medication is controlling your symptoms. You may need to use a quick-relief inhaler if your asthma flares up.

In situations where you have an asthma attack due to intake of alcohol, it is important to take short-term medications to relieve symptoms. This include:

  • Short-acting beta-agonist: These aerosol bronchodilators begin to work within minutes, quickly reducing asthma attack symptoms. Short-acting beta-agonists can be given with a nebuliser, a device that turns asthma drugs into a fine mist, or with a portable, hand-held inhaler. Examples include albuterol and levalbuterol.
  • Corticosteroids: They help to relieve the inflammation in the airway during an attack. Examples include prednisolone and methylprednisolone.

An immediate-relief inhaler helps relieve your symptoms if you are experiencing an asthma attack. But if your long-term control medications are performing as intended, you shouldn't need to use your quick-relief inhaler very frequently. However, if the symptoms persist after the use of short-term medication, then you have to visit your doctor to assess you and also create a treatment plan to manage your condition.


Asthma is a critical chronic disease that is identified by some core symptoms like wheezing, coughing, chest tightness, and shortness of breath. It results in significant morbidity and sometimes death. There is a significant association between alcohol intake and asthmatic attack due to the presence of histamine and sulphides in alcoholic drinks. It is therefore important for patients with asthma to avoid alcohol or reduce their intake while adhering to the short- and long-term treatment plans prescribed to them by their physicians.  


  1. Asthma [Internet]. 2017 [cited 2022 Nov 1]. Available from:
  2. Sisson JH. Alcohol and airways function in health and disease. Alcohol [Internet]. 2007 Aug [cited 2022 Nov 1];41(5):293–307. Available from:
  3. Fujimura M, Myou S. Alcohol-induced asthma. Intern Med [Internet]. 2001 [cited 2022 Nov 1];40(7):557–8. Available from:
  4. Matsuse H. Mechanism and management of alcohol-induced asthma. Nihon Arukoru Yakubutsu Igakkai Zasshi. 2016 Jun;51(3):214–20.

Innocent Chijioke

Bachelor of Medicine, Bachelor of Surgery - MBBS, Medicine, University of IbadanUniversity of Ibadan, Nigeria

Innocent Dike is a final-year medical student at the University of Ibadan, Nigeria. He has more than two years of experience in research and health blog article writing. He serves as an ambassador for i-medics, where he trains his peers on blog article writing. presents all health information in line with our terms and conditions. It is essential to understand that the medical information available on our platform is not intended to substitute the relationship between a patient and their physician or doctor, as well as any medical guidance they offer. Always consult with a healthcare professional before making any decisions based on the information found on our website.
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