Acetaminophen is an over-the-counter medication used to treat mild to moderate pain and reduce fever. It is also known as paracetamol or sold under the brand name Tylenol. Acetaminophen is metabolized in the liver, and in high doses, it can cause liver damage.
Alcohol is also metabolized in the liver, and when people drink alcohol the liver prioritizes the metabolism of alcohol above all other substances. This can result in a dangerous build-up of acetaminophen in the liver, increasing the risk of liver damage and other serious health problems.
After drinking, people are often tempted to use over-the-counter pain relievers to prevent or treat a hangover, but it is not safe nor is it recommended to mix Tylenol (acetaminophen) and alcohol. Together, Tylenol and alcohol can irritate the stomach and liver, resulting in ulcers, internal bleeding, and liver damage. If you are hungover or find yourself injured while you’ve been drinking, you should avoid taking acetaminophen until the alcohol leaves your system.
Understanding Tylenol (Acetaminophen)
Tylenol is a non-opioid pain reliever and fever reducer that you can purchase at virtually any grocery store, drug store, or gas station. Acetaminophen is the active ingredient in Tylenol that may also be sold generically. Acetaminophen is often found in flu medications and opioid medications to enhance the effectiveness of them.
Acetaminophen works by inhibiting prostaglandins in the brain. Prostaglandins are chemicals that cause fever and pain, and inhibiting them helps to reduce fever and pain.[1]
How are Tylenol and Alcohol Processed in the Body?
Acetaminophen is metabolized in two different ways. About 90% of the drug is processed through glucuronidation, a process that does not produce any toxic byproducts. The rest of the medication is broken down by the CYP2E1 liver enzyme, however, the process produces a dangerous byproduct called NAPQI. In response, the liver produces glutathione, an antioxidant that the body requires to remove NAPQI from the body before it can cause liver damage.[2]
Alcohol is also metabolized in the liver, but when alcohol enters the body, the liver prioritizes the metabolism of alcohol before other medications or food. Alcohol increases the activity of the liver enzyme CYP2E1, causing the body to produce more NAPQI. At the same time, alcohol decreases the production of glutathione, allowing dangerous levels of NAPQI to build up in the liver.
When both alcohol and Tylenol are present in the body, both substances will stay in the bloodstream for longer periods of time because the liver won’t be able to filter toxins at the same rate it usually would.
Can You Take Tylenol (Acetaminophen) After Drinking?
No, it is never recommended to take Tylenol during or after drinking. Taking Tylenol with alcohol can cause several severe side effects, including:
- Rapid heartbeat
- Upset stomach
- Stomach ulcers
- Internal bleeding
- Liver damage
If you have an alcohol use disorder (AUD), you may be at an increased risk of severe side effects. Research has even suggested that acetaminophen use of any kind can be dangerous in people who drink alcohol regularly.[3]
For maximum safety, you should wait 12 to 24 hours after drinking before taking Tylenol.
Dangers of Mixing Tylenol and Alcohol
It is possible to overdose on either Tylenol or alcohol, but there isn’t evidence linking Tylenol to an increased risk of alcohol overdose. The main reason why mixing Tylenol and alcohol is dangerous is because of the substances’ effects on the liver.
Taking Tylenol after drinking will not enhance the effects of alcohol, but it will place extreme stress on the liver. Even without alcohol, high doses of acetaminophen can cause toxic damage to the liver–a condition called acetaminophen-induced hepatotoxicity. Acetaminophen-induced hepatotoxicity is the most common cause of acute liver failure in the U.S. as it is responsible for nearly 56,000 ER visits each year.[4,5]
Liver damage can impair liver function, reducing the organ’s ability to carry out vital bodily functions. The liver is responsible for filtering toxins out of the blood, assisting in blood clotting, and aiding in food digestion. Drinking too much alcohol, even if you don’t take acetaminophen, can lead to liver damage and failure.
Symptoms of liver damage include:[6]
- Appetite loss
- Fatigue
- Sweating
- Nausea
- Vomiting
- Abdominal swelling
- Abdominal pain
- Jaundice (yellowing of the skin or whites of the eyes)
- Confusion
- Unusual bruising or bleeding
You can reduce your risk of liver damage by:
- Taking no more than the recommended dose
- Checking to make sure other medications you take do not contain acetaminophen
- Only taking one acetaminophen product at a time
- Avoiding drinking alcohol in excess
- Avoiding mixing alcohol with other drugs
If you or someone you love has drank too much alcohol or taken too much Tylenol, you should seek medical attention right away. Liver damage often doesn’t cause any symptoms until the damage is severe, but early treatment can help.
Get Help for Alcohol Abuse and Alcoholism Today
Even though it isn’t an illicit substance, alcohol is highly addictive, and people who are addicted to alcohol have an increased risk of liver damage because of their drinking patterns. If you have difficulty controlling or moderating your drinking, it’s time to get the help you deserve.
At Next Step Recovery, we provide comprehensive alcohol rehab programs that can help you quit alcohol successfully and learn how to maintain lifelong sobriety. Contact us today to learn more about our programs and how we can help.
References:
- Tufts University School of Medicine: How Does Acetaminophen Work?, Retrieved April 2023 from https://medicine.tufts.edu/news-events/news/how-does-acetaminophen-work
- National Library of Medicine: The biochemistry of acetaminophen hepatotoxicity and rescue: a mathematical model, Retrieved April 2023 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3576299/
- National Library of Medicine: Acetaminophen, Retrieved April 2023 from https://pubchem.ncbi.nlm.nih.gov/compound/acetaminophen#section=Drug-Warning
- National Library of Medicine: Acetaminophen-Induced Hepatotoxicity: a Comprehensive Update, Retrieved April 2023 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4913076/
- National Library of Medicine: Acetaminophen Toxicity, Retrieved April 2023 from https://www.ncbi.nlm.nih.gov/books/NBK441917/
- National Library of Medicine: Hepatic Failure, Retrieved April 2023 from https://www.ncbi.nlm.nih.gov/books/NBK538227/
