Many people take alcohol and paracetamol (chemically known as acetaminophen) without checking if this is safe or has any medical complications. In this article, we’ll discuss whether taking paracetamol and alcohol together is dangerous or not, and what are the most immediate consequences.
There are a few reasons why people take them together. Given below are 4 major reasons:
- Ignorance: Some people simply assume that taking paracetamol and alcohol (which are both pain relievers) together will have a combining effect and help reduce even more pain. This is a completely wrong assumption.
- Addiction: An addict just can’t reason properly. They will take as much alcohol or paracetamol as they want.
- Curing a hangover: After partying all night, they wake up the next day with a terrible hangover and the first thing they do is take some paracetamol to reduce the pain.
- Lack of knowledge on drugs: There are simply too many drugs that contain acetaminophen and many people buy these drugs without knowing what ingredients are in them, thereby unknowingly consuming acetaminophen.
Is it Dangerous to mix them?
It is potentially dangerous to take alcohol and paracetamol together, but not because of any specific reactions or chemical combination. Rather it is just due to overdosing on either of the two substances.
According to the NHS (National Health Service), it is safe to drink a reasonable and clinically standard amount of alcohol only if you are taking common acetaminophen-containing drugs that can be bought at any online medical store (commonly referred to as over-the-counter drugs). It is strongly advised not to drink alcohol if you are taking prescription drugs because this can increase the side effects of the medication.
Why is it dangerous to overdose on either substance?
Overdosing on acetaminophen
When you take paracetamol, it is absorbed into your bloodstream through the small intestine and the stomach and then passed into the liver. There are certain enzymes which turn most of the drug into a useful and less harmful form that helps in relieving headaches before eventually being excreted from the body through urine.
This useful form of acetaminophen releases certain chemical substances as by-products during the process of relieving pain and being excreted from the body.
One of these by-products ends up turning into a dangerous and toxic chemical compound that can damage the cells and tissues of the liver, but what protects is a substance produced by the liver (glutathione) which acts to neutralize the toxic chemical compound. Overdosing on paracetamol causes what is known as hepatotoxicity (paracetamol poisoning).
Overdosing on alcohol
Just like paracetamol, alcohol is a substance that is acted upon by the liver. Alcohol is broken down into a less harmful substance by a group of enzymes in the liver. What isn’t broken down is passed into the bloodstream and causes intoxication (or you may know it as being drunk). But just like acetaminophen, in the process of breaking down it releases some toxic by-products. These toxic by-products are also neutralized by glutathione (GSH) in the liver. Drinking too much alcohol over a long time period causes what is commonly known as alcoholic liver disease as well as many bladder issues.
The result of combining both substances
We know the effects of taking large amounts of either substance, so we can infer from that what happens when you combine them.
They both produce substances that are harmful to the liver, and these toxic substances are neutralized by glutathione. But there is a limited supply of glutathione in the liver so taking them together has the effect of weakening the level of resistance you have to either substance and thus leaving you vulnerable to the negative effects that can be seen from overdosing on either alcohol or paracetamol.
Is it dangerous to take paracetamol and alcohol if you have COVID-19?
Paracetamol has been recommended by the World Health Organization to treat the early symptoms of COVID-19 in patients looking for a safe domiciliary therapy. However, there’s an ongoing controversy, as several scientists raised alarm on this drug’s ability to deplete glutathione, an important liver enzyme that could protect the body from the most dangerous complications of the coronavirus.
Therefore, it may occur that you get prescribed paracetamol for the home management of COVID-19. Whether this is a good recommendation or not, you might ask yourself if drinking an alcoholic beverage may be a good idea or not. In this case, there are no doubts, though. Regardless of the interactions with acetaminophen, taking alcohol while you’re infected is always dangerous. Its consumption might impair your immune system and weaken your natural defenses.
Most commonly used medications that contain acetaminophen in the US
Acetaminophen is the most widely used drug ingredient in America and there are so many drugs that use it. They may be prescription medicines or OTC (over the counter) drugs which can be used without a prescription. In Europe, acetaminopen is also often called paracetamol and it’s available in many generic forms. It is also used in a variety of dosage forms (capsules, solutions, suppositories, tablets) and formulations (extended-release, film coated, quick-release, orally disintegrating), both alone and in association with other drugs such as codein, caffeine, ephedrine, and hydrocodone. Here is a list of the most common drugs containing this substance, including the generic names:
- Aspirin-Free Singlet
Side effects of taking alcohol and paracetamol
- Reduction of glutathione: This is the main side effect and the reason why other negative effects start to set in. Glutathione helps to protect us from the negative side effects of using too much of either alcohol or paracetamol. When this substance is depleted the liver becomes unprotected and the toxic substances from both alcohol and paracetamol start to damage the liver. This may also increase the risk of complications from COVID-19 (see above).
- Hepatotoxicity: This is also commonly referred to as paracetamol poisoning. This is caused by excessive use of paracetamol, but in this case, alcohol has weakened the resistance to paracetamol thereby making the body much more sensitive to the toxic substance in alcohol.
- Weakness and fatigue
- Weight loss
- Jaundice (the yellow discolouration of the skin)
By now, hopefully, you know the answer to the question, “Is it dangerous to use paracetamol and alcohol?”. Avoid the combination of these two and stay safe!
- Garry G. Graham, Kieran F. Scott, Richard O. Day. Alcohol and Paracetamol. NPS Medicinewise. https://www.nps.org.au/australian-prescriber/articles/alcohol-and-paracetamol
- National Health Service(NHS). Can I drink alcohol if I’m taking pain Killers? https://www.nhs.uk/common-health-questions/medicines/can-i-drink-alcohol-if-i-am-taking-painkillers/
- Acetaminophen Awareness Coalition; www.KnowYourDose.org
- Dr Okechuckwu Amako. Taking paracetamol after drinking alcohol: Why you should be careful. Medium. https://medium.com/@swiftcheckup/taking-paracetamol-after-drinking-alcohol-why-you-should-be-careful-58a9c2f3066d
- Sestili P., Fimognari C., 2020. Paracetamol-Induced Glutathione Consumption: Is There a Link With Severe COVID-19 Illness? Front. Pharmacol., 07 October 2020.
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Article updated on September 14, 2022