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What Are the Risks of Combining Acetaminophen and Alcohol?

Tricia Christensen
Tricia Christensen
Tricia Christensen
Tricia Christensen

The risks of combining paracetamol, or acetaminophen, and alcohol have been well documented since the beginning of the 21st century. Both substances result in increased work for the liver, and if they are combined they create a cumulative effect that may result in liver damage. Early studies on this issue suggested that people who drank regularly in moderate amounts, roughly defined as two to three drinks a day, were most at risk. More recent evidence suggests that people who use acetaminophen and acetaminophen containing products like many cold formulas or prescription pain relievers should probably forgo concurrent alcohol use. One time high amounts of alcohol and acetaminophen, possibly to treat the effects of alcohol consumption, usually aren’t advised either.

The principal problem with using acetaminophen and alcohol together is that both require the liver to work in a similar way. Each substance is processed by the liver and can compromise it temporarily or until the person stops using that substance. To this end, organizations like the US Food and Drug Association (FDA) have suggested clear guidelines for the use of acetaminophen and alcohol.

Acetaminophen.
Acetaminophen.

The guidelines are that people who drink three or more alcoholic drinks daily should not use acetaminophen. Some suggest that women of slight build should not use the medication if they consume two or more drinks. The FDA has additionally lobbied to reduce the dosage amounts of acetaminophen so that the “regular strength” or 350 mg tablets are used instead of extra strength or 500 mg tablets. Acetaminophen containing products may also have dosage strength reduced. Some doctors feel the guidelines should be even stronger and advise their patients not to combine acetaminophen and alcohol at any time.

Combining acetaminophen and alcohol may result in liver damage.
Combining acetaminophen and alcohol may result in liver damage.

In terms of combining the two drugs, it’s very important that people understand the frequency at which acetaminophen may appear in other medications. It is a common additive in many prescription pain relievers like Vicodin®, Percocet® and codeine formulations, such as Tylenol 3®. Quite a few over the counter cold and flu remedies contain acetaminophen, too. Consumers need to read labels carefully for avoidance of acetaminophen, if they’re moderate drinkers or if they’re taking another acetaminophen drug.

It’s not only the case that acetaminophen and alcohol shouldn’t be combined. These substances can be toxic alone when taken in large amounts. Both have the capacity to permanently damage the liver, which may decrease longevity, or in severe cases may cause death. Medical experts suggest moderate or minimal usage of each, they and strongly advise that recommended dosage for acetaminophen not be exceeded, just as alcohol use should remain sensible.

Tricia Christensen
Tricia Christensen

Tricia has a Literature degree from Sonoma State University and has been a frequent contributor for many years. She is especially passionate about reading and writing, although her other interests include medicine, art, film, history, politics, ethics, and religion. Tricia lives in Northern California and is currently working on her first novel.

Tricia Christensen
Tricia Christensen

Tricia has a Literature degree from Sonoma State University and has been a frequent contributor for many years. She is especially passionate about reading and writing, although her other interests include medicine, art, film, history, politics, ethics, and religion. Tricia lives in Northern California and is currently working on her first novel.

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