Cape Cod: a drink nobody has studied, built from two things that have been

The strongest numbers attached to this drink are about cranberry taken as a medicine. Across 23 trials with 3979 people prone to urinary infections, cranberry products cut repeat infections by 30 percent (RR 0.70, 95% CI 0.59 to 0.83), and juice did better than capsules or tablets (RR 0.65, 0.54 to 0.77). A network meta-analysis of 50 randomised trials in 10495 people put cranberry at a risk ratio of 0.72 (0.60 to 0.87) against placebo, behind D-mannose at 0.34 (0.21 to 0.56). Both of those pooled therapeutic cranberry products given to women with recurrent infections, to children and to people with urinary catheters, so they describe a treatment rather than a mixer. Nobody has studied the drink itself. Our corpus holds no human study of vodka with cranberry juice as a combination, so this page is assembled from the two things in the glass, measured separately. One of them has an agency position behind it. WHO holds that no level of alcohol consumption is safe for health, and it names ethanol a toxic, psychoactive and dependence-producing substance that the International Agency for Research on Cancer classified a Group 1 carcinogen decades ago. That says the evidence for cancer in people is convincing, and it carries no number for the risk at one drink. What the mixer does to the alcohol has been measured once, though not with cranberry. Twelve healthy adults drank vodka at 0.5 g per kg of body weight in one minute, and a sugar-free cola pushed peak breath alcohol to 38.3 against 34.8 micrograms per 100 mL. With the sugar-free mix the stomach emptied half its contents in a mean 100 minutes against 111, with the scatter between people wider than the gap itself (100.09 +/- 35.42 against 110.74 +/- 66.71 minutes), so that is a direction and not a measured effect. If you take warfarin, the cranberry half of this drink has two trials behind it and they came out on opposite sides, which is a question for whoever manages your INR.

What your body absorbs

• In 12 adults given vodka at 0.5 g per kg, a sugar-free mixer raised peak breath alcohol to 38.3 against 34.8 micrograms per 100 mL. — 12 healthy adults, 8 men and 4 women, aged 19 to 64 years, open-label two-way crossover, vodka 37.5% ABV at 0.5 g per kg body weight drunk in 1 minute, breath alcohol measured every 15 minutes for 3 hours (n = 12) Evidence B source
  Peak breath alcohol 38.3 +/- 9.45 against 34.8 +/- 6.82 micrograms per 100 mL with the sugar-free mixer, area under the breath ethanol curve over 180 minutes 45249.0 against 40439.25, gastric half-emptying time 100.09 +/- 35.42 against 110.74 +/- 66.71 minutes

What it does to your health

• Cranberry products cut repeat urinary tract infections by 30% across 23 trials with 3979 people at risk, and juice did better than capsules, but the trials used cranberry as therapy rather than a cocktail mixer. — 3979 participants in 23 trials: women with recurrent infections, children and people with indwelling catheters (n = 3979) Evidence A source
  Overall risk ratio 0.70 (95% CI 0.59 to 0.83); women with recurrent infections RR 0.68 (0.56 to 0.81), children RR 0.55 (0.31 to 0.97), catheter users RR 0.49 (0.33 to 0.73); juice against capsules or tablets RR 0.65 (0.54 to 0.77)
• In a network meta-analysis of 50 randomised trials with 10495 people, cranberry lowered urinary infections by a risk ratio of 0.72, which placed it behind D-mannose at 0.34 among the non-antibiotic options. — 10495 people in 50 randomised controlled trials of 14 non-antibiotic interventions, nearly 80% of trials blinded (n = 10495) Evidence A source
  Cranberry RR 0.72 (0.60 to 0.87) against placebo; D-mannose RR 0.34 (0.21 to 0.56), vaccine 0.65, probiotics 0.69, cranberry plus probiotics plus vitamin A 0.27; no significant difference in adverse events against placebo

Safety, limits and interactions

• Cranberry raised the effect of warfarin by 30% on the INR-time curve in 12 healthy men without touching warfarin levels in the blood, so the juice half of this drink is the half that can matter to someone on an anticoagulant. — 12 healthy male volunteers of known CYP2C9 and VKORC1 genotype, open-label three-treatment randomised crossover, single 25 mg dose of warfarin alone or after 2 weeks of cranberry (n = 12) Evidence B source
  Area under the INR-time curve 30% higher with cranberry; no change in S- or R-warfarin pharmacokinetics or plasma protein binding; garlic changed nothing
• The opposite trial exists: in 30 patients already stable on warfarin, 240 mL of cranberry juice daily for 2 weeks changed no warfarin level and moved INR on 1 day out of the whole period. — 30 patients on stable warfarin anticoagulation with INR 1.7 to 3.3, randomised double-blind to 240 mL cranberry juice (14 people) or a colour and taste matched placebo drink (16 people) daily for 2 weeks with 1 week of follow-up (n = 30) Evidence B source
  No significant difference in mean plasma R- and S-warfarin concentrations; mean INR differed significantly only on treatment day 12 (P < 0.02); 4 people on juice and 4 on placebo developed minimally elevated INR of 3.38 to 4.52
• A review of 149 reports on warfarin and food named cranberry among the items whose users faced a raised bleeding risk, alongside green tea, ginger, spinach and chamomile. — 149 articles describing 78 herbs, foods or dietary supplements reported to interact with warfarin, published up to 31 December 2019 (n = 149 reports) Evidence C source
  45 of 78 items (57.7%) reported to potentiate warfarin, 23 (29.5%) to inhibit it; 20 herbs and supplements were linked to bleeding events ranging from gum bleeding to fatal intracranial bleeding
• WHO holds that no amount of alcohol is safe for health, and the ethanol in this drink is the same Group 1 carcinogen the agency names, whatever it is mixed with. — general population; WHO Regional Office for Europe statement of 4 January 2023 Evidence E source
  No safe amount of alcohol that does not affect health; ethanol classified as a Group 1 carcinogen by the International Agency for Research on Cancer
• The Nordic Nutrition Recommendations review of alcohol found that for several cancers no safe limit can be set, while all-cause mortality was not raised by light to moderate drinking in middle-aged and older people who avoided binges. — adults, evidence on cardiovascular disease, cancer and all-cause mortality published up to 31 May 2021, mainly observational studies with Mendelian randomisation analyses alongside Evidence C source
  No safe limit can be set for several cancers; all-cause mortality not increased with light to moderate intake in middle-aged and older adults without binge drinking; total abstinence associated with the lowest mortality risk in young adults

What is still unknown

• Nobody has studied this drink, and the alcohol evidence behind it rests on observational work that the reviewers themselves call methodologically hampered. — literature on alcohol and health, and on this cocktail as a named drink Evidence C source
  Zero human studies of vodka with cranberry juice as a combination in the corpus; alcohol evidence limited by how intake is measured, how exposure groups are chosen and by confounding

The bottom line

There is no USDA composition record for this drink, and there is not much prospect of one, because a cocktail is a proportion rather than a product. The only household measure in our data comes from the federal food-coding database, which files Cape Cod under liquor and cocktails and puts one drink at 225 g. That entry sits in a dataset we have not verified by machine, so treat the weight as indicative. The name is part of why the shelf is bare. Both hits for cape cod in our research corpus are the place in Massachusetts rather than the drink, so searching for it by name returns a coastline. The mixer trial is worth one more paragraph, because it is the only measurement of this drink’s mechanics that exists. Twelve healthy adults aged 19 to 64, 8 men and 4 women, drank vodka at 0.5 g per kg in a single minute and had breath alcohol read every 15 minutes for 3 hours. With the sugar-free mixer the area under the breath ethanol curve over those 3 hours was 45249 against 40439, and the peak was 38.3 against 34.8 micrograms per 100 mL. That was 12 people and a cola, so none of those numbers describes a cranberry mixer. What carries over is the mechanism, which is that sugar in the mixer slows the stomach and the same alcohol then arrives more slowly. Which side a cranberry mix falls on depends on how much sugar is in it, and nobody has measured that. Cranberry and warfarin is the one place where this drink can reach a medicine, and the two trials that tested it disagree. In 12 healthy men given a single 25 mg dose of warfarin after 2 weeks of cranberry, the area under the INR-time curve came out 30 percent higher, with no change in warfarin levels in the blood or in protein binding. That is a pharmacodynamic effect, which means the juice changed how the drug acted rather than how much of it was present, and it came from healthy men and one large dose rather than from a bleeding rate. In 30 patients already stable on warfarin, 240 mL of cranberry juice a day for 2 weeks against a colour and taste matched placebo changed no warfarin level, and mean INR differed significantly only on treatment day 12 (P < 0.02). Minimally raised INR values of 3.38 to 4.52 appeared in 4 people on juice and 4 on placebo, and the authors called the single-day difference unlikely to matter clinically and possibly random. The disagreement has a shape. The first trial used a big single dose in healthy volunteers and the second used an ordinary glass in real patients, and both were small. A review of 149 reports published up to the end of 2019 lists cranberry among the foods whose users were reported to bleed more, next to green tea, ginger, spinach and chamomile, and that is a count of publications rather than a rate of events. Anyone on warfarin should put this to whoever manages their INR rather than to a web page. Where the alcohol question is genuinely unsettled is mortality, and it is worth saying why. The alcohol review behind the 2023 Nordic Nutrition Recommendations found that no safe limit can be set for several cancers. The same review found that all-cause mortality was not raised by light to moderate drinking in middle-aged and older adults who did not binge, while total abstinence carried the lowest mortality risk in young adults. Those findings sit together because the evidence under them is observational, and the reviewers name the measurement of intake, the choice of comparison groups and uncontrolled confounding as the reasons it cannot settle the question. What is missing on this page is almost everything specific. No study has given anyone vodka with cranberry juice and measured the result, no agency writes about the drink, and we found nothing on pregnancy, on breastfeeding or on anyone below drinking age, so this page says nothing about those. The two cranberry meta-analyses above are about a therapeutic dose of a cranberry product in people who keep getting urinary infections. Nobody has measured how much juice a poured cocktail carries, and whatever it carries comes beside a Group 1 carcinogen, so reading those trials as a reason to pour one is the single mistake this page exists to prevent.

Sources

1. ccr5-01 · randomised crossover trial
   Diet coke increased both the peak BrAC (38.3 ± 9.45 vs. 34.8 ± 6.82 μg/100 mL) and the area under the breath ethanol curve between 0 and 180 minutes (45249.0 ± 95.7 vs. 40439.25 ± 72.5 μg·min/L).
   Toxicol Lett, 2025 · checked 2026-09-24
2. ccr5-06 · meta-analysis of clinical trials
   This meta-analysis included 23 trials with 3979 participants. We found that cranberry-based products intake can significantly reduce the incidence of UTIs in susceptible populations (risk ratio (RR) = 0.70; 95% confidence interval(CI): 0.59 ~ 0.83; P<0.01).
   PLoS One, 2021 · checked 2026-09-24
3. ccr5-07 · network meta-analysis of randomised controlled trials
   50 RCTs comprising 10,495 subjects and investigating 14 interventions, were included...D-mannose (risk ratio [RR] 0.34, 0.21 to 0.56), vaccine (RR 0.65, 0.52 to 0.82), probiotics (RR 0.69, 0.50 to 0.94), cranberry (RR 0.72, 0.60 to 0.87), and triple therapy (cranberry plus probiotics plus vitamin A) (RR 0.27, 0.09 to 0.87), exhibited a significant reduction in UTI incidence compared to the placebo.
   Infection, 2025 · checked 2026-09-24
4. ccr5-02 · randomised crossover trial
   Cranberry significantly increased the area under the INR-time curve by 30% when administered with warfarin compared with treatment with warfarin alone. Cranberry did not alter S- or R-warfarin pharmacokinetics or plasma protein binding.
   Br J Pharmacol, 2008 · checked 2026-09-24
5. ccr5-03 · randomised double-blind trial
   Cranberry juice has no effect on plasma S- or R-warfarin plasma levels, excluding a pharmacokinetic interaction. A small though statistically significant pharmacodynamic enhancement of INR by CJ at a single time point is unlikely to be clinically important and may be a random change.
   J Clin Pharmacol, 2009 · checked 2026-09-24
6. ccr5-04 · systematic review of interaction reports
   These include Chinese wolfberry, chamomile tea, cannabis, cranberry, chitosan, green tea, Ginkgo biloba, ginger, spinach, St. John's Wort, sushi and smoking tobacco.
   Br J Clin Pharmacol, 2021 · checked 2026-09-24
7. ccr5-05 · WHO position statement
   Alcohol is a toxic, psychoactive, and dependence-producing substance and has been classified as a Group 1 carcinogen by the International Agency for Research on Cancer decades ago
   WHO Regional Office for Europe, No level of alcohol consumption is safe for our health, 2023 · checked 2026-09-24
8. ccr5-08 · scoping review
   For several cancers, it is not possible to set any safe limit. All-cause mortality is not increased with light to moderate alcohol intake in middle-aged and older adults who do not engage in binge drinking. Total abstinence is associated with the lowest risk of mortality in young adults.
   Food Nutr Res, 2024 · checked 2026-09-24
9. ccr5-09 · scoping review
   Observational studies on alcohol consumption are hampered by a number of inherent methodological issues such as ascertainment of alcohol intake, selection of appropriate exposure groups, and insufficient control of confounding variables, colliders, and mediators.
   Food Nutr Res, 2024 · checked 2026-09-24