People often wonder if it is okay to take painkillers (analgesics) while consuming alcohol. While the risks vary depending on the classification a particular drug belongs to, combining alcohol and pain relief pills is generally not advised since serious adverse reactions can occur.

Mixing Over-the-Counter Painkillers and Alcohol

Common combining over-the-counter (OTC) painkillers include ibuprofen, acetaminophen, naproxen and aspirin. The risk of combining OTC drugs with alcohol vary, depending on the drug taken.

Ibuprofen

Ibuprofen, sold as Motrin or Advil, poses little or no harmful effects when combined with alcohol when it is taken as advised by the manufacturer. However, the drug can cause stomach irritations or upper gastrointestinal bleeding on its own, so short-term use is advised.

Acetaminophen (Tylenol)

Acetaminophen, commonly known as Tylenol, is metabolized by the liver and can cause liver damage when taken in high amounts or for too long. Acetaminophen use, with or without alcohol, has been cited as the number one cause of acute liver failure in the United States. Alcohol use also affects the liver so combining the two can be a dangerous combination. Do not combine acetaminophen and alcohol unless advised by your doctor.

Naproxen sodium (Aleve)

Naproxen sodium, known as the brand name Aleve, is generally considered to be safe for use when consuming alcohol. However, like ibuprofen, naproxen sodium carries a risk of stomach bleeding and should be used for the shortest amount of time possible.

Aspirin

Aspirin, sold under various brand names, can also cause stomach bleeding and poses an additional risk when mixed with alcohol. A study done by the Bronx Veterans Affairs Medical Center in 1990 showed that taking two tablets of aspirin one hour before drinking caused blood alcohol levels to spike 30% percent higher than levels found from drinking alone. This happens because aspirin interferes with the action of an enzyme called alcohol dehydrogenase that is found in the stomach lining. This enzyme breaks down a portion of each drink as it is consumed before it enters the bloodstream, causing the spike.

According to Dr. Charles S. Lieber, one of the co-authors of the study, “This is a significant interaction, and people should be aware of it. If they know from past experience that a small amount of alcohol doesn’t interfere with their ability to drive or operate machinery, they may be in danger if they have taken aspirin as well.”

Mixing Prescription Painkillers and Alcohol

While mixing alcohol with non-prescription drugs can potentially cause harm, there are even more hazardous results when someone combines prescription painkillers with alcohol.

Prescription painkillers are commonly opioid drugs. Prescription opioids include hydrocodone, oxycodone and hydromorphone. Prescription opioids have a chemical composition that is similar to heroin, making their effects similar as well. Opioids are effective pain medications, but they also cause euphoria and enhance the pleasure/reward centers. 

People prescribed opioids as a means of pain management may find that continued use can lead to addiction and dependency and can negatively impact the health of the individual. If alcohol use is present as well, the risk of addiction may be increased.

Alcohol and opioid medications can both slow breathing via depression of the central nervous system. When combined, the effects are amplified. The interaction can cause serious breathing impairment, decreased oxygen in the blood, coma and even death. 

Some prescription pain combinations also contain acetaminophen, increasing the risk of liver damage when combined with alcohol.

Finally, aside from these effects, other body parts such as the heart, brain and pancreas can be seriously damaged by combining alcohol with any type of painkiller. Due to the risks associated with this combination, mixing the use of alcohol and painkillers of any kind is strongly discouraged.

Medical Disclaimer: The Recovery Village aims to improve the quality of life for people struggling with a 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 provider.