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Acetaminophen and Alcohol: Know the Risks

According to Tylenol.com:

“Can I drink alcohol and take TYLENOL®?

Excessive alcohol use may increase the risk of liver toxicity from acetaminophen overdose. When used according to package directions, TYLENOL® may be used by the occasional, moderate drinker. See “Warnings” on the package label.”

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Many people are aware that taking Aspirin and drinking can cause gastric bleeding, however, it’s less well known that replacing Aspirin with acetaminophen (Tylenol) and excessively drinking can also seriously compromise your health.

Acetaminophen is a pain reliever that is included in many over-the-counter cold, cough and flu medications. It’s a safe and effective pain reliever when used according to directions. However, chronic heavy drinking has been shown to activate the enzyme CYP2E1 in the liver. This enzyme is responsible for transforming acetaminophen into chemicals that cause acute liver damage.

Does this mean if you’ve had a few drinks with friends, go home, and take a Tylenol for a headache you’re at risk?

According to Dr. Elizabeth Roth, an internist at Massachusetts General Hospital, drinking before taking the recommended dose of acetaminophen-based medications is not a big issue for most people, although she does not advise it. She went on to explain that in patients without underlying liver disease and who are not chronic alcoholics, acute alcohol intake is not a risk factor for liver damage from acetaminophen.

“The bottom line is that for the otherwise healthy person without chronic liver disease or a history of alcoholism, they don’t have to wait before taking two regular Tylenol after having a drink. But no medical advice fits all patients,” Roth stated.

Combining Tylenol and excessive drinking can cause:

Kidney Toxicity

As mentioned above, individuals that have abused alcohol over a long period of time increase their enzymes that break down Tylenol and toxic metabolites are created as a result. While this is happening glutathione, your body’s way of discarding toxic substances, is considerably depleted due to alcohol consumption.  Rogue toxins are then passed through the kidneys and other organs, which can cause kidney diseases and lead to kidney failure.

Hepatotoxicity and Liver Damage

The combination of binge (or continuous) drinking and Tylenol results in extremely weakened liver that is unable to adequately handle either substance. Each one poisons the liver and interferes with the liver’s ability to detoxify. This “tag-team” effect usually results in liver damage which left untreated can lead to liver failure.

Liver Failure

If caught and treated early and properly, liver damage can be reversible before it turns into complete liver failure. One of the first stages of liver damage is hepatitis. If left unaddressed progression leads to cirrhosis and liver failure. Your liver is pretty important, in case you weren’t aware – it’s responsible for synthesizing different types of proteins necessary for various functions in the body. The liver makes proteins to build muscle and maintain a strong immune system. It is also responsible for manufacturing specific proteins (known as blood-clotting protein factors), vital for the blood-clotting process in the body. Failure of these systems results in physical signs that muscles are wasting away, increased infections, and profuse bleeding. If left untreated, patients will enter into delirium, seizures, coma and eventually death.