This is a continuation of a long topic, addressed by post number rather than by page. Start at post 1.
Where a published interaction study exists it usually reports an area-under-curve ratio, and that number is far more informative than a yes-or-no answer.
On balance I think that is right, and I would not bet much on it.
Whatever the answer on alcohol turns out to be, the method for getting there is the same: state the assumption, do the arithmetic in public, invite the correction.
Where I part company with post #61, and it is a narrow parting.
SGLT2 inhibitors: frequently co-administered and relevant to renal and cardiovascular discussion, not to interactions. There is no pharmacokinetic interaction of concern.
Alcohol is a good example of a question where the honest answer is boring and the interesting answers are unsupported. I would go with boring.
A pharmacist can answer most questions in this subcategory in a few minutes with access to a proper interaction database, and that access is the thing a forum does not have.
If this contradicts something upthread, the upthread version may well be the better one.
On post #68 — agreed on the reasoning, with one qualification.
A supplement is a drug for interaction purposes, and the fact that it is sold without a prescription tells you nothing about whether it interacts. The paperwork is usually worse rather than better.
On post #67 — agreed on the reasoning, with one qualification.
On alcohol I would separate what is worth knowing from what is worth acting on. The first list is long and the second is short, and conflating them is how threads get heated.
Picking up post #71: that is the part I would want checked first.
Counterpoint on alcohol, offered without confidence: the same observation is consistent with a much duller explanation, and nobody has ruled the dull one out.
Understood. Thank you for being specific about the limits of it.
Anticoagulant questions come up regularly and are the clearest case for professional advice rather than discussion, because the consequence of being wrong is not gradual.
The most defensible general position in this subcategory: identify the plausible mechanism, check whether it has been studied, and where it has not, say that rather than filling the gap.
Checked the alcohol claim against the primary source this morning. It survives, with a narrower scope than the version quoted here. Posting the narrower scope.
Anything that also slows gut motility compounds the same mechanism. That is a plausibility argument rather than a documented interaction, and it should be labelled as one.
Worth stating the null on alcohol before we explain it: the observation may be nothing. That possibility deserves a sentence and usually does not get one.
What I can speak to on alcohol is narrow, so I will keep it narrow rather than generalising from it. Beyond that boundary I do not know.
SGLT2 inhibitors: frequently co-administered and relevant to renal and cardiovascular discussion, not to interactions. There is no pharmacokinetic interaction of concern.
Post #83 put the caveat in the right place and I want to underline it.
Alcohol came up in a thread eighteen months ago and was answered well. I cannot find it, which is itself the problem, so here is the reconstruction.
A supplement is a drug for interaction purposes, and the fact that it is sold without a prescription tells you nothing about whether it interacts. The paperwork is usually worse rather than better.
Alcohol: no absolute contraindication but it raises gastrointestinal irritation risk and this drug class already does that. The conservative position during titration is to limit it.
Posted with less confidence than the sentence structure implies.
Picking up post #88: that is the part I would want checked first.
Practical answer on alcohol, since the theoretical one is upthread: do the simplest check first, write down the result, and only then decide whether the complicated explanation is needed. It usually is not.