I binge drink on either friday or saturday, usually 3 times a month. When i do i drink about 4-6 oz Ethanol in various drinks (the equivalent of 8-12 standard drinks).
However, on some days i get headaches (not hangovers, i dont get hangovers). Ibuprofin is worthless, Naproxen doesn’t work too well either however combining acetaminophen and aspirin seems to work so when i get headaches i take 500mg acetaminophen and 975mg aspirin. Usually i only need to do that once.
It was/is my understanding that alcoholics shouldn’t take more than 2 grams of acetaminophen a day. I never take acetaminophen on the same days i drink but i do on other days of the week. My weekly dose of it usually never tops 2 grams a week, and daily use virtually never goes above 1 gram a day (split into 500mg 2x a day), usually 500mg a day is enough.
So is this dangerous? While im on the topic, does binge drinking as opposed to chronic drinking of smaller amounts make acetaminophen more dangerous or less? im not talking about on the same day, im saying is it more dangerous to binge drink once a week and take acetaminophen on another day or to drink 2-3 drinks a day and take acetaminophen? The label says not to take it if you take 3 drinks a day, but it says nothing about taking 12 drinks 3 days ago.
What about the aspirin? that permanently binds to the COX enzyme, so i dont know if that puts me at risk of bleeding.
I dont know if it matters much, but i take 500mg alpha lipoic acid on most days. I’ve read that alpha lipoic acid recycles glutathione, which is depleted by alcohol and causes the damage from acetaminophen/alcohol combination.
First of all, IANAD. I have ghost-written a few journal articles, and I know how to use PubMed, and I’m a former EMT. Hopefully, QtM will be along to help, but until then:
I think you’re taking big risks with your liver. I remember treating a college student who had jaundice from combining acetaminophen (APAP) and alcohol (ETOH).
Your attempts to modulate the damage by taking alpha lipoic acid are likely to be only partially-successful. A study in Hepatology shows that depletion of glutathione by ETOH increases the liver toxicity of APAP. However, the combination also produces the poison N-acetyl-p-benzoquinone imine (NAPQI) though a metabolic path unrelated to glutathione.
But I interpret the crux of your OP as: “How long after I take APAP should I wait before binging on ETOH?” You want to know how long it takes to metabolize and excrete the drug. [One source](http://www.druginfonet.com/acetamin.htm#CLINICAL PHARMACOLOGY) says “Approximately 85% of an oral dose appears in the urine within 24 hours of administration.”
Note also that binge drinking of the type you describe has its own toxic effects on the liver, absent APAP. For example, here, here, and here.
im not trying to modulate the damage, im just adding in that ALA can raise glutathione levels, and that acetaminophen depletes them. Since the max dose for an alcoholic of acetaminophen is 2.4 grams or so a day, i figured 500 grams a day three days a week was relatively safe.