# Alcohol and pain relievers **URL:** \ **Category:** Factual Questions\ **Created:** [January 22, 2006, 7:00pm UTC](https://boards.straightdope.com/t/alcohol-and-pain-relievers/341133 "2006-01-22T19:00:54Z")\ **Posts on this page:** 20\ **Page:** 1
**Author:** ![gazpacho](https://avatars.discourse-cdn.com/v4/letter/g/6f9a4e/32.png) [@gazpacho](https://boards.straightdope.com/u/gazpacho)\ **Post date:** [January 22, 2006, 7:00pm UTC](https://boards.straightdope.com/t/alcohol-and-pain-relievers/341133/1 "2006-01-22T19:00:54Z")
Naproxen, Ibuprofen, Acetaminophen and aspirin all come with warnings about using these drugs if you have more than 3 drinks a day. When did this start? I remember that Acetaminophen has had these warnings for some time now when did the others start? What are the problems with drinks and pain relievers? ---
**Author:** ![Joey\_P](https://avatars.discourse-cdn.com/v4/letter/j/919ad9/32.png) [@Joey\_P](https://boards.straightdope.com/u/Joey_P)\ **Post date:** [January 22, 2006, 7:08pm UTC](https://boards.straightdope.com/t/alcohol-and-pain-relievers/341133/2 "2006-01-22T19:08:06Z")
> [@gazpacho](#): > > Naproxen, Ibuprofen, Acetaminophen and aspirin all come with warnings about using these drugs if you have more than 3 drinks a day. When did this start? I remember that Acetaminophen has had these warnings for some time now when did the others start? What are the problems with drinks and pain relievers? I belive the problem with Asprin is that both asprin and alcohol thin your blood. I’m not sure about the others though. [sarcasm]I just take percocet instead[/sarcasm] ---
**Author:** ![Shagnasty](https://avatars.discourse-cdn.com/v4/letter/s/9dc877/32.png) [@Shagnasty](https://boards.straightdope.com/u/Shagnasty)\ **Post date:** [January 22, 2006, 7:22pm UTC](https://boards.straightdope.com/t/alcohol-and-pain-relievers/341133/3 "2006-01-22T19:22:07Z")
The problem is mainly with acetaminophen and its effects on the liver. Acetaminophen use can sometimes cause sudden, acute liver failure in people that drink a lot. It is thought that some of the liver problems that heavy drinkers and alcoholics have faced was exacerbated by taking Tylenol and other acetaminophen based pain relievers for hangovers. Of course heavy drinking can cause these problems on its own so that isn’t solely to blame. However, there are some that have gone into sudden liver failure and died as the result of mixing these substances. Heavy drinkers are advised to never take acetaminophen based pain killers. I think you will find that most of these warnings are on substances with acetaminophen. I am not aware of similar warnings on drugs where it is not present. ---
**Author:** ![gazpacho](https://avatars.discourse-cdn.com/v4/letter/g/6f9a4e/32.png) [@gazpacho](https://boards.straightdope.com/u/gazpacho)\ **Post date:** [January 22, 2006, 7:29pm UTC](https://boards.straightdope.com/t/alcohol-and-pain-relievers/341133/4 "2006-01-22T19:29:09Z")
Shagnasty that is what I remember about Tylenol but yesterday when perusing the analgesics aisle I noticed the warning on all of the pain releivers. ---
**Author:** ![Barbarian](https://avatars.discourse-cdn.com/v4/letter/b/e19adc/32.png) [@Barbarian](https://boards.straightdope.com/u/Barbarian)\ **Post date:** [January 22, 2006, 10:40pm UTC](https://boards.straightdope.com/t/alcohol-and-pain-relievers/341133/5 "2006-01-22T22:40:36Z")
IANAD but I believe the problem with mixing anti-inflamatories and alcohol is stomach bleeding due to ulceration. When you mix booze and aceteminophen, you get liver scarring. ---
**Author:** ![Qadgop\_the\_Mercotan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/qadgop_the_mercotan/32/83_2.png) [@Qadgop\_the\_Mercotan](https://boards.straightdope.com/u/Qadgop_the_Mercotan)\ **Post date:** [January 23, 2006, 12:42am UTC](https://boards.straightdope.com/t/alcohol-and-pain-relievers/341133/6 "2006-01-23T00:42:55Z")
**Barbarian** is pretty close. Mixing alcohol with NSAIDS (aspirin, ibuprofen, naproxen, ketoprofen, etc) raises the risk of GI bleeding, as both alcohol and NSAIDS cause GI irritation separately. Together, their effects can be even more powerful. Also, both acetaminophen (tylenol, APAP, non-aspirin) and alcohol can stress the liver, causing hepatitis (liver inflammation) as risking acute liver failure. Together, the risk of this occurring is higher. Liver scarring (cirrhosis) generally doesn’t come into play acutely in this scenario, but is more of a problem over decades for some heavy drinkers. QtM, MD ---
**Author:** ![ZipperJJ](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/zipperjj/32/211_2.png) [@ZipperJJ](https://boards.straightdope.com/u/ZipperJJ)\ **Post date:** [January 23, 2006, 6:25am UTC](https://boards.straightdope.com/t/alcohol-and-pain-relievers/341133/7 "2006-01-23T06:25:16Z")
ermm… can I hijack this thread (since QtM is here…) and ask where Vicodin fits into these lists of drugs? What’s the effect on the body of Vicodin and beer? ---
**Author:** ![CynicalGabe](https://avatars.discourse-cdn.com/v4/letter/c/3e96dc/32.png) [@CynicalGabe](https://boards.straightdope.com/u/CynicalGabe)\ **Post date:** [January 23, 2006, 6:39am UTC](https://boards.straightdope.com/t/alcohol-and-pain-relievers/341133/8 "2006-01-23T06:39:20Z")
> [@ZipperJJ](#): > > What’s the effect on the body of Vicodin and beer? Intoxication. ---
**Author:** ![Joey\_P](https://avatars.discourse-cdn.com/v4/letter/j/919ad9/32.png) [@Joey\_P](https://boards.straightdope.com/u/Joey_P)\ **Post date:** [January 23, 2006, 7:15am UTC](https://boards.straightdope.com/t/alcohol-and-pain-relievers/341133/9 "2006-01-23T07:15:49Z")
> [@CynicalGabe](#): > > Intoxication. Moreso then just that. Rather then an additive effect, they multiply. So if you take two percocets and two beers, instead of the feeling of being high from two percocets and drunk from two beers, you might feel like you’re high from 4 percocets and/or drunk from 8 beers. At least that’s the way I’ve always understood it, if I’m wrong, I’m sure one of the Drs or nurses on the board will correct me. ---
**Author:** ![Excalibre](https://avatars.discourse-cdn.com/v4/letter/e/898d66/32.png) [@Excalibre](https://boards.straightdope.com/u/Excalibre)\ **Post date:** [January 23, 2006, 12:40pm UTC](https://boards.straightdope.com/t/alcohol-and-pain-relievers/341133/10 "2006-01-23T12:40:53Z")
> [@ZipperJJ](#): > > ermm… can I hijack this thread (since QtM is here…) and ask where Vicodin fits into these lists of drugs? > > What’s the effect on the body of Vicodin and beer? Vicodin is hydrocodone - an opiate - and acetaminophen. The acetaminophen has been addressed already - so combining vicodin with alcohol is already bad. Add in the fact that both hydrocodone and alcohol are central nervous system depressants, and you’ve got potential to get yourself in trouble. Using multiple drugs can have synergistic effects, and you probably don’t want multiple depressants potentially lowering your respiration and stuff. ---
**Author:** ![gazpacho](https://avatars.discourse-cdn.com/v4/letter/g/6f9a4e/32.png) [@gazpacho](https://boards.straightdope.com/u/gazpacho)\ **Post date:** [January 23, 2006, 4:34pm UTC](https://boards.straightdope.com/t/alcohol-and-pain-relievers/341133/11 "2006-01-23T16:34:34Z")
> [@Qadgop the Mercotan](#): > > **Barbarian** is pretty close. > > Mixing alcohol with NSAIDS (aspirin, ibuprofen, naproxen, ketoprofen, etc) raises the risk of GI bleeding, as both alcohol and NSAIDS cause GI irritation separately. Together, their effects can be even more powerful. > > Also, both acetaminophen (tylenol, APAP, non-aspirin) and alcohol can stress the liver, causing hepatitis (liver inflammation) as risking acute liver failure. Together, the risk of this occurring is higher. Liver scarring (cirrhosis) generally doesn’t come into play acutely in this scenario, but is more of a problem over decades for some heavy drinkers. > > QtM, MD Ack to many acronyms. I could find NSAIDS (Nonsteroidal Antiinflammatory Drugs) I guess the last s is pluralizing NSAID but what is APAP? ---
**Author:** ![Excalibre](https://avatars.discourse-cdn.com/v4/letter/e/898d66/32.png) [@Excalibre](https://boards.straightdope.com/u/Excalibre)\ **Post date:** [January 23, 2006, 4:51pm UTC](https://boards.straightdope.com/t/alcohol-and-pain-relievers/341133/12 "2006-01-23T16:51:03Z")
> [@gazpacho](#): > > Ack to many acronyms. I could find NSAIDS (Nonsteroidal Antiinflammatory Drugs) I guess the last s is pluralizing NSAID but what is APAP? APAP is acetominaphen. ---
**Author:** ![lieu](https://avatars.discourse-cdn.com/v4/letter/l/c2a13f/32.png) [@lieu](https://boards.straightdope.com/u/lieu)\ **Post date:** [January 23, 2006, 5:47pm UTC](https://boards.straightdope.com/t/alcohol-and-pain-relievers/341133/13 "2006-01-23T17:47:21Z")
Within what time proximity should these pain killers not be taken in conjunction with alcohol? I always figured the day after drinking to relieve a hangover was too soon but is this in fact the case? ---
**Author:** ![DrDeth](https://avatars.discourse-cdn.com/v4/letter/d/b487fb/32.png) [@DrDeth](https://boards.straightdope.com/u/DrDeth)\ **Post date:** [January 23, 2006, 5:56pm UTC](https://boards.straightdope.com/t/alcohol-and-pain-relievers/341133/14 "2006-01-23T17:56:31Z")
> [@lieu](#): > > Within what time proximity should these pain killers not be taken in conjunction with alcohol? I always figured the day after drinking to relieve a hangover was too soon but is this in fact the case? That’s _probably_ OK. It depends on how often you take acetaminophen- which is very dangerous to your liver _if taken improperly_. Excedrin seems to be a rather good hangover cure- taken with some juice or milk. And, acetaminophen hides in a lot of OTC drugs- like cold medicines (and in Excedrin). So, taking a glug of Nyquil, then a couple of extra-stength Tylenol as you go to bed after some heavy drinking- and you could wake up in the hospital with liver failure. :eek: \*If \* taken properly- and \*if \* your liver is healthy, and _if_ you’re not a heavy drinker- then acetaminophen is quite safe. But watch those “ifs”. Personally, I consider the NSAIDS to be safer. More common problems (stomach bleeding) but those problems are _usually_ less dangerous. ---
**Author:** ![gazpacho](https://avatars.discourse-cdn.com/v4/letter/g/6f9a4e/32.png) [@gazpacho](https://boards.straightdope.com/u/gazpacho)\ **Post date:** [January 23, 2006, 8:44pm UTC](https://boards.straightdope.com/t/alcohol-and-pain-relievers/341133/15 "2006-01-23T20:44:23Z")
> [@DrDeth](#): > > That’s _probably_And, acetaminophen hides in a lot of OTC drugs- like cold medicines (and in Excedrin). So, taking a glug of Nyquil, then a couple of extra-stength Tylenol as you go to bed after some heavy drinking- and you could wake up in the hospital with liver failure. :eek: If this is really the case then they need to modify the warning. From the [tylenol](http://www.tylenol.com/page.jhtml?id=tylenol/hdache/subpregwarn.inc) website. > [@](#): > > Alcohol warning: If you consume 3 or more alcoholic drinks every day, ask your doctor whether you should take acetaminophen or other pain relievers/fever reducers. Acetaminophen may cause liver damage. The tylenol warning implies to me that you need to worry if you are a regular drinker not if you drank a lot just recently but usually don’t have 3 drinks a night. ---
**Author:** ![DrDeth](https://avatars.discourse-cdn.com/v4/letter/d/b487fb/32.png) [@DrDeth](https://boards.straightdope.com/u/DrDeth)\ **Post date:** [January 23, 2006, 9:22pm UTC](https://boards.straightdope.com/t/alcohol-and-pain-relievers/341133/16 "2006-01-23T21:22:59Z")
> [@gazpacho](#): > > If this is really the case then they need to modify the warning. From the .tylenoli ff you are a regular drinker not if you drank a lot just recently but usually don’t have 3 drinks a night. Yes but if you read my post I also threw in an overdose of acetaminophen with both Nyquil and Tylenol dosages. About twice what you should take, in fact. But a mistake far too often made. And of course, generally, those who “drink heavily” do so too often. But I suppose that ONE night of “drinking heavily” a year, combined with just one night of taking acetaminophen that same night, plus a normally healthly liver would be OK. I wouldn’t risk it, myself. IANAD- but I would suggest strongly that those who are drinkers stay away from acetaminophen except on a rare occassion, and be sure not to overdose. I certainly would not take it on a daily basic for chronic pain if I was much of a drinker. It’s also way too damn easy to overdose on acetaminophen. ☹ ---
**Author:** ![DrDeth](https://avatars.discourse-cdn.com/v4/letter/d/b487fb/32.png) [@DrDeth](https://boards.straightdope.com/u/DrDeth)\ **Post date:** [January 23, 2006, 9:24pm UTC](https://boards.straightdope.com/t/alcohol-and-pain-relievers/341133/17 "2006-01-23T21:24:49Z")
> [@DrDeth](#): > > combined with just one night of taking acetaminophen that same night, ( …taking TOO MUCH… :smack: ---
**Author:** ![Kalhoun](https://avatars.discourse-cdn.com/v4/letter/k/3bc359/32.png) [@Kalhoun](https://boards.straightdope.com/u/Kalhoun)\ **Post date:** [January 23, 2006, 9:53pm UTC](https://boards.straightdope.com/t/alcohol-and-pain-relievers/341133/18 "2006-01-23T21:53:40Z")
> [@gazpacho](#): > > Naproxen, Ibuprofen, Acetaminophen and aspirin all come with warnings about using these drugs if you have more than 3 drinks a day. When did this start? I remember that Acetaminophen has had these warnings for some time now when did the others start? What are the problems with drinks and pain relievers? Tylenol and booze can damage the liver. It can do it rather quickly as I understand it. But my husband had a steady diet of Tylenol and beer for decades and he’s still kicking. No idea if there’s any damage to his liver though. ---
**Author:** ![DrDeth](https://avatars.discourse-cdn.com/v4/letter/d/b487fb/32.png) [@DrDeth](https://boards.straightdope.com/u/DrDeth)\ **Post date:** [January 23, 2006, 10:20pm UTC](https://boards.straightdope.com/t/alcohol-and-pain-relievers/341133/19 "2006-01-23T22:20:30Z")
> [@Kalhoun](#): > > Tylenol and booze can damage the liver. It can do it rather quickly as I understand it. But my husband had a steady diet of Tylenol and beer for decades and he’s still kicking. I’d have him get a complete physical and mention that to his MD. ---
**Author:** ![Kalhoun](https://avatars.discourse-cdn.com/v4/letter/k/3bc359/32.png) [@Kalhoun](https://boards.straightdope.com/u/Kalhoun)\ **Post date:** [January 23, 2006, 10:45pm UTC](https://boards.straightdope.com/t/alcohol-and-pain-relievers/341133/20 "2006-01-23T22:45:13Z")
> [@DrDeth](#): > > I’d have him get a complete physical and mention that to his MD. He doesn’t want to know. He’s been sober for almost nine years. That would be like the guy who quit smoking and got lung cancer (his dad). [Next page](https://boards.straightdope.com/t/alcohol-and-pain-relievers/341133.md?page=2)