Tylenol and Alcohol

Why Mixing Tylenol and Alcohol Can Be Dangerous

Tylenol (acetaminophen) is one of the most commonly used over-the-counter medications for pain and fever. It’s also a key ingredient in many cold and flu remedies.

But while Tylenol is safe when used correctly, combining it with alcohol can put serious stress on your liver, even if you’re only taking a regular dose.

What Happens When You Take Tylenol with Alcohol?

Both Tylenol and alcohol are processed in the liver, and they actually use some of the same enzymes for breakdown. That means when you take them together, your liver has to work overtime.

Usually, your body clears out acetaminophen safely, but a small amount always turns into a toxic byproduct. To handle that, your liver uses a protective substance called glutathione.

But if you’ve been drinking—especially heavily—your body may not have enough glutathione to keep up. That allows toxic compounds to build up in your liver, raising the risk of inflammation, damage, or even liver failure.

This can happen even if:

• You’re only taking regular doses of Tylenol
• You’ve been drinking moderately but frequently
• You already have existing liver issues

Health Risks of Mixing Tylenol and Alcohol

The liver is the primary organ affected when acetaminophen and alcohol are used together, but it’s not the only part of the body at risk. This combination can lead to serious complications beyond liver damage, especially when used frequently or in high amounts.

Other potential health risks include:

• Gastrointestinal bleeding, particularly if you drink heavily or already have stomach lining irritation
• Pancreatitis, or inflammation of the pancreas, can cause intense abdominal pain and digestive issues
• Kidney damage or failure, especially in those with pre-existing conditions or who take other medications that strain the kidneys

In addition to these long-term risks, mixing alcohol and Tylenol may also increase the severity of common acetaminophen side effects, such as:

• Abdominal pain or cramping
• Indigestion, diarrhea, or constipation
• Nausea and vomiting
• Shortness of breath (dyspnea) or unexplained coughing
• Dry mouth
• Skin rashes or itching

If you experience these symptoms after taking Tylenol while drinking—or while alcohol is still in your system—it could be a sign your body is under too much stress. Seek medical advice, especially if the symptoms are severe or don’t go away.

Can You Ever Take Tylenol If You Drink Alcohol?

Whether or not it’s safe to take Tylenol depends on how much alcohol you’ve consumed and how often you drink.

For most people, an occasional Tylenol after one or two drinks likely won’t cause harm, especially if it’s taken the next day once alcohol has mostly cleared from the system.

However, the risks increase significantly for people who drink frequently, heavily, or binge drink. In those cases, the liver may already be under stress, and adding acetaminophen can increase the chance of toxic buildup.

According to the Centers for Disease Control (CDC), excessive drinking includes:

• Binge drinking: 4 or more drinks in one sitting for women and 5 or more for men.
• Heavy drinking: 8 or more drinks in a week for women and 15 or more for men.

If you regularly consume alcohol, it’s best to speak with a healthcare provider before using Tylenol or other medications that impact liver function.

Safer Options for Pain Relief

If you’ve been drinking and need pain relief, non-Tylenol alternatives may be safer in some cases.

Medications like ibuprofen or aspirin belong to a group called NSAIDs (non-steroidal anti-inflammatory drugs). These drugs are broken down by a different liver enzyme, which can reduce the risk of toxin buildup that Tylenol poses when mixed with alcohol.

Common over-the-counter NSAIDs include:

• Ibuprofen (Advil, Motrin)
• Naproxen (Aleve)
• Aspirin

But keep in mind—NSAIDs aren’t risk-free either. They can irritate the stomach lining and increase your chances of internal bleeding, especially if alcohol is already in your system. Just one drink a day can raise that risk by over 30%.

If you drink regularly or have other health concerns, talk to your healthcare provider before choosing any pain relief option.

What to Do If You Think You Took Too Much

If you’ve taken too much Tylenol or mixed it with a large amount of alcohol, try to stay calm, but watch closely for signs of an acetaminophen overdose.

Symptoms may not appear immediately, so it’s important to pay attention to how you feel in the following hours.

Warning signs of liver toxicity include:

• Nausea or indigestion
• Vomiting blood
• Bruising or bleeding
• Yellowing of the skin and eyes (jaundice)
• Pain in your upper right abdomen, just below the ribs
• Blurry vision
• Dark or bloody urine
• Confusion
• Fatigue

It’s crucial to act fast when liver injury is at risk. If you think you or someone you know is experiencing liver toxicity, call 911 or a poison control hotline for medical advice or go straight to the emergency room.

Take Steps to Protect Your Liver and Your Future

Combining Tylenol and alcohol can cause a toxin buildup that increases your risk of liver damage or failure, with heavy drinkers facing the highest risk.

Chronic drinking can lead to even more long-term health issues like high blood pressure, anxiety, depression, heart attacks, strokes, or even cancer.

If you need help getting your drinking habits under control, act now to protect your physical and mental well-being. Talk to your doctor about alcohol abuse treatment options, or find local substance abuse clinics with SAMHSA’s online treatment locator.

By reaching out, you’re taking proactive steps to protect your liver and lay the foundations for a happier, healthier life.

Written by

Brooke Helton

Medical Content Writer

Brooke Helton is a freelance writer passionate about wellness topics, especially the relationship between physical and mental health. As a contributor to AddictionHelp.com, she’s proud to combine her writing and research skills to inform and empower people impacted by substance abuse.

Reviewed by

• Fact-Checked
• Editor

Kent S. Hoffman, D.O.

Co-Founder & Chief Medical Officer

Kent S. Hoffman, D.O. has been an expert in addiction medicine for more than 15 years. In addition to managing a successful family medical practice, Dr. Hoffman is board certified in addiction medicine by the American Osteopathic Academy of Addiction Medicine (AOAAM). Dr. Hoffman has successfully treated hundreds of patients battling addiction. Dr. Hoffman is the Co-Founder and Chief Medical Officer of AddictionHelp.com and ensures the website’s medical content and messaging quality.