Using Tylenol for Hangovers? Here’s Why Tylenol and Alcohol Don’t Mix

It may seem harmless to take Tylenol after a night of drinking, but the combination of substances in the body can potentially cause irreversible damage to vital parts of your body.1

Tylenol is a brand name for the generic drug acetaminophen, which is also sold under the brand name Paracetamol.1 You can purchase it at your local drug store to treat mild to moderate pain and fever. When combined with alcohol, acetaminophen can cause adverse side effects, with the biggest risk being liver damage. This can happen when a person who regularly consumes alcohol also regularly takes this medication.

What Are the Risks of Mixing Tylenol and Alcohol?

Taking acetaminophen alone can cause toxic damage to the liver. When taken in excess over time, acetaminophen can cause what is known as acetaminophen-induced hepatotoxicity.1

Because of the common use of this drug for everyday aches and pains, overuse of acetaminophen is the most widespread cause of acute liver failure in the United States. Many people each year are hospitalized due to this condition.1

The damage results from how the body breaks down the acetaminophen with enzymes produced by the liver. Digestion breaks down a small portion of acetaminophen into a toxin called NAPQI. Then the liver produces an antioxidant called glutathione, which helps the body remove this toxin.1

Because the liver only stores a small amount of glutathione, it can be easily overwhelmed when acetaminophen is taken in large amounts or regularly over an extended period of time. When the body receives more than the recommended dosage of this drug, the liver becomes overwhelmed with more NAPQI toxins than it can handle.1

Your liver is responsible for breaking down both alcohol and Tylenol . Both substances pass through the liver before their waste products are eliminated from the body.

This is why taking acetaminophen with alcohol is dangerous. The combination of alcohol and acetaminophen in the body can easily create an overwhelmed liver that cannot properly remove toxins from the body. This can lead to very dangerous liver toxicity that can be fatal.1

Side effects of taking alcohol and acetaminophen together include:1

  • Upset stomach
  • Racing heartbeat
  • Stomach ulcers that can bleed
  • Liver damage and scarring

When you regularly take acetaminophen for pain, or you are dependent on alcohol, you are at a greater risk for the effects of consuming this drug in combination with alcohol.

Who Is at Risk of Mixing Tylenol and Alcohol?

One of the biggest at-risk populations for mixing alcohol and acetaminophen in any form, such as Tylenol or a cold medicine with acetaminophen as an active ingredient for pain relief and fever reduction, are those with alcohol dependence.

Signs and symptoms of alcohol dependence include but are not limited to:2

  • Spending increased amounts of time obtaining, using, or recovering from the effects of alcohol
  • Being unable to limit the amount of alcohol you drink
  • Developing a tolerance to alcohol, so that you need larger amounts of alcohol to feel the same effects
  • Feeling a strong urge or craving to drink
  • Using alcohol in unsafe situations
  • Experiencing withdrawal symptoms when you try to stop consuming alcohol, such as nausea, vomiting, or headache

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You are also at higher risk of mixing alcohol and Tylenol if you have a physical dependence on acetaminophen as you are more likely to already have acetaminophen in your system when you use alcohol.

Dependence on acetaminophen most often occurs if you or someone you know is dealing with chronic pain. Signs and symptoms of dependence on acetaminophen include but are not limited to:3

  • Needing acetaminophen to get through the day
  • Loss of interest in usual activities
  • Experiencing physical side effects from taking acetaminophen but continuing to take acetaminophen anyway
  • Feelings of apathy
  • Needing to take larger doses of acetaminophen to feel the same pain relief

Is There a Risk of Overdosing on Tylenol and Alcohol?

Many people in the United States each year unintentionally overdose on acetaminophen. When the liver is damaged from overuse of this drug, especially when used in combination with alcohol, it cannot function at normal levels.1

This is very dangerous because the liver is responsible for several different important functions in the body. The liver detoxifies the blood, plays a role in the blood’s ability to form clots to heal wounds, and helps the body digest food.3

Using alcohol with acetaminophen increases the risk and severity of overdose. Signs and symptoms of an acetaminophen overdose include but are not limited to:3

  • Confusion
  • Appetite loss
  • Unusual bruising
  • Swelling of the mid-region or abdomen
  • Yellowing of the skin, known as jaundice
  • Nausea
  • Vomiting
  • Repeated loose stools
  • Headache
  • Dark urine
  • Chills
  • Seizure
  • Loss of consciousness
  • Light-colored stools
  • Tightness in the chest

How Can I Avoid Mixing Tylenol and Alcohol?

Most overdoses of acetaminophen are accidental and can be avoided. Overdose often happens when this drug is taken to relieve pain in conjunction with other substances, like alcohol. You can avoid Tylenol and alcohol interaction by doing the following:4

  • Do not exceed the maximum daily dose
  • Do not drink any alcoholic beverages while taking Tylenol
  • Take only one product that contains acetaminophen at a time and always check other over-the-counter medicines you take to see if they contain acetaminophen
  • Ask your doctor before taking acetaminophen if you are currently taking any other medications
  • Do not take Tylenol for more than five days in a row for acute pain
  • Do not take Tylenol for more than three days in a row for acute fever
  • If pain or fever lasts longer than three to five days, call your doctor to discuss further treatment options

You can relieve pain without using Tylenol or another form of acetaminophen. Some alternatives include:4

  • Cold therapy, which controls swelling and inflammation, especially with acute injury
  • Heat therapy, which stimulates blood flow and should be used to alleviate tightness, stiffness, or muscle spasms
  • Rest and elevation if it is a limb that is affected or injured
  • A warm bath or shower
  • Massage therapy, including massaging the affected area yourself
  • Gentle stretching and movement—such as walking or swimming—for mobility and reduced acute pain
  • In-office visits and at-home recommendations from a chiropractor, exercise physiologist, or licensed physical therapist
  • Targeted yoga poses for the affected area
  • Meditation and mindfulness practices, which have been shown to reduce perceived pain levels when practiced consistently over time
  • Acupuncture or acupressure
  • Nerve blocks
  • Radio wave treatment
  • Electrical signal treatment

You might want to try some of these alternatives to see if your pain can be helped in a different way using another method.

If you experience high levels of acute pain—for example, pain that is so intense it causes nausea or affects your ability to stay conscious—seek medical attention. Additionally, if your pain persists at a consistent level for a week or more, tell your doctor about your symptoms.

If you or someone you know is struggling with using Tylenol and alcohol together, or individually, know that help is available. Call 800-839-1686Who Answers? to speak with an addiction treatment specialist.

Resources

  1. The Mayo Clinic. (2021). Acetaminophen and Codeine (Oral Route). Drugs and Supplements.
  2. National Institute on Alcohol Abuse and Alcoholism. (2021). Understanding Alcohol Use Disorder.
  3. Help Guide. (2021). Drug Abuse and Addiction.
  4. American Society of Anesthesiologists. (2021). Non-Opioid Treatment.

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