The Dangers of Mixing Painkillers and Alcohol

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You might not think much about taking an over-the-counter pain medication and then continuing to drink alcohol in the same sitting. However, you should be mindful of what the possible risks or effects may be if you are combining substances. There is a lot of information about the dangers of mixing Aspirin and alcohol, but what about other painkillers such as Ibuprofen, Acetaminophen, and Naproxen Sodium? Let’s discuss the risks of mixing painkillers and alcohol.

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Mixing Over-the-Counter Painkillers and Alcohol

Let’s look at what can happen if you mix the following substances with alcohol. If you are ever noticing symptoms or are concerned you might be experiencing harmful side effects from alcohol or pain medication; please seek medical assistance.

Common Over-the-Counter Painkillers:

  • Ibuprofen
  • Acetaminophen (Tylenol)
  • Naproxen Sodium (Aleve)
  • Aspirin

Ibuprofen & Alcohol

Ibuprofen is a nonsteroidal anti-inflammatory drug, also known as an NSAID. This medication relieves pain, inflammation, swelling, and fever. It is also under many brand names, such as Advil, Midol, and Motrin.

It can be dangerous to mix any substance with alcohol, but in particular, Ibuprofin is risky because of the side effects of gastrointestinal bleeding, the damage Ibuprofen can have on the kidneys and decreased alertness.

If taking Ibuprofin alone, there are possible side effects of developing gastrointestinal bleeding or ulcers. However, combining alcohol increases the risk of bleeding. One study indicated a higher risk of gastrointestinal bleeding when alcohol and ibuprofen were combined versus those who did not mix the two substances or engaged in very light or mild alcohol use.

Please seek medical assistance immediately if you notice any of the following symptoms.

Common Signs of Gastrointestinal Bleeding:

  • An upset stomach that does not go away.
  • Black, tarry stool.
  • Blood in vomit.

Ibuprofen can be particularly difficult on the kidneys, and combined use of alcohol can lead to kidney damage.

Please seek medical assistance immediately if you notice any of the following symptoms.

Common Signs of Kidney Damage:

  • Tiredness.
  • Blood in urine.
  • Swelling in hands, feet, and ankles.
  • Shortness of breath.

Finally, mixing ibuprofen and alcohol can lead to decreased alertness. When you combine the effects of both alcohol and ibuprofen, it increases a slower reaction time, sleepiness, and impaired judgment. For these reasons, one should not drive while taking ibuprofen and alcohol together, even in small amounts.

Acetaminophen & Alcohol

Acetaminophen or Tylenol is one of the most common over-the-counter medications for pain relief. Usually, a quarter of adults in the United States take Tylenol once per week. However, it may not be well known that mixing acetaminophen and alcohol can lead to liver damage.

Please seek medical assistance if you notice the following symptoms.

Common Symptoms of Liver Damage: 

  • Excessive fatigue.
  • Weight loss.
  • Lack of appetite.
  • Nausea or vomiting.
  • Pain or discomfort in the upper right side of the abdomen.

Are there certain people at risk for developing liver damage with acetaminophen and alcohol?

Yes, here are the people most at risk for developing liver damage when combining alcohol and acetaminophen.

People Most at Risk for Liver Damage: 

  • People who drink alcohol in excess.
  • People who take acetaminophen in excess.
  • People with chronic liver disease.
  • People with autoimmune disease-psoriasis or rheumatoid arthritis.
  • People who take medications and supplements for other health conditions.

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Naproxen Sodium & Alcohol

Naproxen Sodium, or Aleve, is another type of NSAID commonly taken to relieve pain due to toothache, menstrual cramps, and muscle pain. Again, there are some complications if this drug is combined with alcohol.

There are higher risks of developing a bleeding ulcer, gastritis, or gastrointestinal bleeding when combining naproxen sodium and alcohol.

Gastritis is a painful GI condition that occurs when the acidity of alcohol increases inflammation in the lining of the stomach. If you are experiencing the following symptoms, please seek medical attention:

Common Symptoms of Gastritis: 

  • Stomach pain (often above the navel or between the ribs).
  • Heartburn or indigestion.
  • Excessive belching.
  • Nausea or vomiting.
  • A burning, gnawing sensation in the upper abdomen.
  • Lack of appetite.
  • Blood in your feces or vomit.

Aspirin & Alcohol

Aspirin is a common drug many people use when dealing with aches and pains associated with a headache, toothache, muscle pain, or mild injury. A doctor may also instruct people at risk for heart disease to take a small dose of aspirin every day to prevent diseases such as heart attack or stroke.

Not only do aspirin and alcohol have adverse side effects if combined, but it is also dangerous to use large amounts of alcohol or aspirin on its own. The toxicity of each substance can lead to severe consequences. If high doses are used consistently, alcohol and aspirin can lead to liver damage, potentially increase the risk of liver disease, and may lead to internal bleeding.

Common Symptoms of Aspirin & Alcohol Combined:

  • Nausea and vomiting.
  • Ulcers.
  • Heartburn.
  • Upset stomach.
  • Risk of gastrointestinal bleeding.
  • Increased toxicity of both aspirin and alcohol.
  • Increased risk of liver damage.

You may wonder why toxicity occurs with using alcohol and aspirin. To understand this, we need to look at how the liver plays a role in this process. The liver regulates most chemical levels in the blood and excretes bile waste. All the blood leaving the stomach and intestines passes through the liver. The liver processes this blood, breaks down substances, balances and creates the nutrients, and metabolizes drugs into more accessible forms for the rest of the body.

When the liver has to process drugs such as alcohol or aspirin, it can put more strain on the liver to remove the toxins. So as you can imagine, combining two harmful substances increases the amount of stress on the liver when processing additional chemicals. Having added toxins in the body can lead to increased toxicity. Increased toxicity means alcohol enters your bloodstream faster, making you impaired more quickly.

Additional Risks of Increased Toxicity:

  • Problems operating a vehicle as one’s blood alcohol content is higher at a much quicker rate if you didn’t take aspirin.
  • Increased risk of overdose.
  • Increased sleepiness, tiredness, lightheadedness, and difficulty breathing.

According to the Journal of the American Medical Association, people who took 2 extra strength aspirin tablets an hour before drinking had blood alcohol levels 30% higher than when they drank alcohol alone.

Understanding the risks and dangers associated with mixing aspirin and alcohol is imperative. Many people may think taking aspirin before drinking alcohol may prevent a headache from drinking alcohol in excess. However, this strategy will most likely backfire due to the increased toxicity levels of both substances.

Mixing Prescription Painkillers & Alcohol

Prescription pain medications are often categorized as opioids. Examples include Vicodin, Hydrocodone, Oxycodone, and Morphine. As you can imagine, there are dangerous risks associated with mixing alcohol and opioid prescription painkillers. Hazards include slowing breathing and leading to a coma, drowsiness or confusion, nausea and vomiting, and possible overdose. People must understand that alcohol can not be added to prescription painkiller medications as the side effects of this combination are often deadly.

Side Effects of Prescription Painkillers & Alcohol: 

  • Nausea, vomiting.
  • Dehydration.
  • Changes in blood pressure.
  • Irregular heart rate and rhythm.
  • Cardiovascular instability.
  • Dizziness, loss of coordination.
  • Abnormal behavior.
  • Loss of consciousness.
  • Respiratory arrest.
  • Coma.

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  1. https://pubmed.ncbi.nlm.nih.gov/10566713/
  2. https://jamanetwork.com/journals/jama/article-abstract/383896

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Reviewed professionally for accuracy by:

Ryan Soave

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Ryan Soave brings deep experience as a Licensed Mental Health Counselor, certified trauma therapist, program developer, and research consultant for Huberman Lab at Stanford University Department of Neurobiology. Post-graduation from Wake Forest University, Ryan quickly discovered his acumen for the business world. After almost a decade of successful entrepreneurship and world traveling, he encountered a wave of personal and spiritual challenges; he felt a calling for something more. Ryan returned to school and completed his Master’s Degree in Mental Health Counseling. When he started working with those suffering from addiction and PTSD, he found his passion. He has never looked back.

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Cayla Clark

Cayla Clark grew up in Santa Barbara, CA and graduated from UCLA with a degree in playwriting. Since then she has been writing on addiction recovery and psychology full-time, and has found a home as part of the Guardian Recovery team.

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