Mixing Tylenol (acetaminophen) and alcohol can be dangerous and can damage your liver and kidneys. Learn how the two substances interact and how it can be harmful to your body.

Article at a Glance:

It can be harmful to mix alcohol and Tylenol.

The biggest risk tends to be to the liver, but this combination can also increase the risk of kidney disease.

You should never drink more than three alcoholic beverages in a day, and you should always make sure you’re not combining Tylenol with any other medicine that contains acetaminophen.

You should never take more than 3,000 mg of acetaminophen in a day, and you shouldn’t take it for longer than ten days in a row.

Can You Mix Alcohol and Tylenol?

To put it simply, if you’re asking “can you mix alcohol and Tylenol,” the answer is no.

The standard guideline is that if you’re taking acetaminophen, you should have no more than three drinks in a day, but many physicians and pharmacists will recommend avoiding alcohol altogether. This is because the risks are so high.

For example, a standard serving size of alcohol tends to be much smaller than what most people would think. With wine as an example, a standard drink is only five ounces. It’s very easy to go over what’s meant as the guideline for moderate drinking and put yourself at risk as a result.

The Risks of Mixing Alcohol and Tylenol

There are enzymes found in your liver that are responsible for breaking down substances that enter the body. If you drink, it can make it more difficult for your liver to break down and process the Tylenol. When this happens, you’re at risk for severe liver damage. This risk goes up as you take more of the pain reliever or drink more alcohol.

When your body uses acetaminophen for fever or pain relief, it produces a toxic substance called NAPQI. NAPQI is metabolized by a substance called glutathione. By taking too much acetaminophen, the body’s glutathione is depleted, so it is unable to metabolize and process other harmful substances. This leads to a toxic buildup of NAPQI. When toxic substances build in the body, it can lead to liver damage.

When you experience liver damage, it can reduce the functionality of this vital organ and it can also lead to pressure in the brain, and abnormal bleeding or swelling.

What is Tylenol?

Tylenol is the brand name for acetaminophen, an over-the-counter (OTC) pain and fever reducer. It’s one of the most commonly used pain medicines in the world and can be used to treat everything from headaches to arthritis. Acetaminophen is also an ingredient in other combination products available as prescriptions and over-the-counter.

There are many different forms of Tylenol on the market including Tylenol Children’s, Tylenol Extra Strength, Tylenol Cold and Flu, Tylenol Allergy, Tylenol PM, and others.

Some of the brand name medications that contain acetaminophen include Theraflu and DayQuil, which are used to treat colds and the flu. Prescription drugs with acetaminophen include Norco and Percocet, among others. When acetaminophen is included in prescription pain relievers, it’s combined with another active ingredient, often opioid painkillers.

How Does Acetaminophen Work? Is it Safe?

Acetaminophen is classified as a non-opioid analgesic. It blocks an enzyme that produces prostaglandins, which create pain and inflammation. It’s different from NSAIDs, like aspirin, because it doesn’t reduce swelling and inflammation. It can also be used for the treatment of migraines, and it’s often combined with aspirin and caffeine in the drug Excedrine.

Despite how widely used Tylenol is, and the fact that it’s considered relatively safe, there is the potential for an acetaminophen overdose. People who take more than the maximum dosage of Tylenol, which is usually 3,000 milligrams in a day, may experience severe side effects including liver damage, acute liver failure, or death. The dose should never exceed 3,000 mg per day unless advised by a physician.

For the most part, acetaminophen overdoses are accidental. People simply don’t realize how much they’re taking and how severe the side effects can be.

Signs of Liver Damage

Symptoms of liver damage can include yellowing of your skin or the whites of your eyes, pain in the upper right portion of your abdomen, swelling of the abdomen, loss of appetite, nausea, vomiting, tiredness, and sweating.

Liver damage from the combination of alcohol and Tylenol is called acute liver damage, and this condition can occur very quickly. For many people, it’s possible to recover from liver damage resulting from mixing alcohol and Tylenol, but for some people, the damage can be pervasive or can lead to death.

Some people are at a higher risk of liver damage than others. For example, people with existing liver damage should not use or combine the two substances. Also, binge drinkers or heavy drinkers should avoid Tylenol.

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Nicole LaNeve
Editor – Nicole LaNeve
Nicole leads a team of passionate, experienced writers, editors and other contributors to create and share accurate, trustworthy information about drug and alcohol addiction, treatment and recovery for The Recovery Village and all Advanced Recovery Systems sites. Read more
Conor Sheehy
Medically Reviewed By – Dr. Conor Sheehy, PharmD, BCPS, CACP
Dr. Sheehy completed his BS in Molecular Biology at the University of Idaho and went on to complete his Doctor of Pharmacy (PharmD) at the University of Washington in Seattle. Read more

American Society of Health-System Pharmacists. Acetaminophen“>Acetaminophen.” National Institutes of Health, April 15, 2017. Accessed May 15, 2020.

Medical Disclaimer

The Recovery Village aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.