Hangover recovery
Symptoms after alcohol intoxication – headache, nausea, weakness, dehydration. Evidence-based measures are hydration, food, and sleep. Fast 'liver recovery' after drinking is a marketing category created by hepatoprotector and diuretic manufacturers. No international guideline contains recommendations for this 'state'.
6 drugs
Also known as: Hangover
Marketing claims without evidence base
The drug is promoted for these uses outside international guidelines. Each entry below is analyzed against AEMPS, FDA, EMA, Cochrane and major RCTs.
- DAdemetionineNot recommended · Amino acids and derivatives. Hepatoprotective agentHeptral is often taken 'after drinking' – this practice is not internationally supported. Hangover is treated with hydration, sleep, and food. SAMe preparations in acute alcoholic hepatitis are not recommended by EASL 2018 and AASLD 2019 – management is complete alcohol cessation and corticosteroids in severe disease.
- DDiosmectiteNot recommended · Intestinal adsorbents (natural smectite)Diosmectite (Smecta, Neosmectin) is promoted as an enterosorbent for hangover, poisoning, and detoxification. Convincing benefit for hangover has not been shown: there are no quality RCTs, and alcohol-intoxication guidelines (NICE 2017, ASAM 2020) do not mention it. The sorbent itself is well tolerated, and its established role is limited to acute diarrhea. A hangover resolves on its own; time, fluids, and sleep help. Note that diosmectite reduces the absorption of other drugs taken at the same time.
- DL-threonine + pyridoxine (Biotredin)Not recommended · Combined metabolic preparations (local classification). Russian development.L-threonine with pyridoxine (sold as Biotredin) is a metabolic supplement marketed to ease the morning after drinking and curb alcohol craving. No solid evidence shows the combination helps with a hangover or alcohol recovery, and the studies behind this use are low quality. What actually helps after drinking is time, fluids, and rest; heavy vomiting or marked dehydration is a reason to see a doctor.
- DSilymarin (Silybum marianum)Not recommended · Plant antioxidant from milk thistle fruits; IV silibinin is an antidote in Amanita phalloides poisoningSilymarin is an extract of milk thistle, promoted for liver support and recovery after drinking alcohol. The evidence does not show a clear benefit for this use – there is no solid data confirming faster recovery after alcohol. What actually helps is time, water and sleep, and medical care if you feel seriously unwell. The substance itself is harmless here, but you should not expect it to speed up recovery from alcohol.
- FFurosemideNot recommended · Loop diureticsFurosemide is sometimes taken 'after a drinking episode' to reduce puffiness. In reality a hangover involves dehydration, not fluid overload – a diuretic worsens the state. Evidence-based measures are water, salt, and simple food. Combining furosemide with alcohol raises hypotension, electrolyte disturbance, and syncope risk.
- FLoperamideNot recommended · AntipropulsivesLoperamide is taken as a stool-firming aid after binge drinking and for hangover-related diarrhea, relying on rapid opioid-mediated suppression of bowel motility. NICE (2017) and ASAM (2020) acute alcohol intoxication guidelines, as well as the Pittler 2005 Cochrane review on hangover, do not mention loperamide. Quality RCTs for alcohol-related diarrhea are absent and the evidence base for this indication is missing. High-dose loperamide in opioid-tolerant users causes arrhythmias and QT prolongation (FDA Drug Safety Communication 2016), so casual self-dosing carries real risk.
How to read tiers A–F
Evidence tiers belong to the drug-indication pair, not to the drug as a whole: the same substance can be A for one condition and F for another.
- AStrong evidence – first or second line in international guidelines
- BRecommended in selected cases
- CStudy data contradict each other
- DBenefit not proven, no documented harm
- FDocumented harm, or risk without benefit