Why Mixing Tylenol and Alcohol Is NOT Recommended

Article at a Glance

• Sleeping pills, including prescription, over-the-counter, and herbal varieties, are commonly used to aid sleep but can be dangerous when mixed with other substances, especially alcohol.
• Alcohol and sleeping pills have sedating effects and when taken together, can increase the risk of side effects and potentially fatal overdose.
• Prescription sleeping pills like Ambien, Lunesta, Restoril, and Silenor should not be taken with alcohol due to the enhanced sedative effects and potential adverse reactions.
• Over-the-counter sleep aids, such as melatonin, diphenhydramine, doxylamine, and valerian root, can also have increased sedative effects and side effects when combined with alcohol.
• The length of time it takes for the body to metabolize alcohol varies, but it is recommended to wait until all alcohol has been cleared from the body before taking sleeping pills to avoid the risks and dangers associated with mixing the two substances.
• If struggling with alcohol and sleeping pill addiction, professional help is available through programs like medical detox and rehabilitation to overcome the addiction and learn skills for a sober life.

Alcohol and acetaminophen — the active ingredient of Tylenol — can negatively affect the liver when taken independently. When mixed, however, their synergistic effect on the liver multiplies the potential damage they can cause. 

Acetaminophen is an extremely common over-the-counter drug. Globally, acetaminophen sales totaled $9.4 billion in 2021. While the medication is generally safe for pain and fever, it should only be taken as directed on the package labeling and should not be mixed with alcohol.

Can You Take Tylenol With Alcohol?

A healthy person may safely use Tylenol while drinking lightly and infrequently, but safety is not guaranteed. Typically, mixing Tylenol and alcohol should be avoided unless instructed by a doctor.

What Is Tylenol?

Tylenol is a brand name for the generic drug acetaminophen. Acetaminophen is a pain reliever that can also help to reduce fevers. Some types of Tylenol may include other drugs as part of its formulation — for example, Tylenol PM is a combination of acetaminophen and diphenhydramine.

Some drugs also contain acetaminophen but are not labeled as Tylenol. Regardless, any drug containing acetaminophen should generally not be mixed with alcohol.

Acetaminophen Side Effects

Acetaminophen use can damage the liver, even when alcohol is not used. This is rare in healthy individuals who follow acetaminophen dosage instructions. However, it may occur in people who take acetaminophen in excess or have certain underlying health conditions, especially ones affecting the liver. 

Side effects with acetaminophen are uncommon but may include:

• Nausea
• Stomach pain
• Itching
• Dark urine
• Yellowing of the skin 
• Decreased appetite
• Headache

If you have side effects with acetaminophen, consulting with your doctor is a good idea. These effects can sometimes indicate liver damage.

Mixing Tylenol and Alcohol 

Tylenol and alcohol are foreign chemicals to the body, and the body breaks down both by using the liver. While each substance individually puts some strain on the liver, the strain multiplies when both are used together. This makes it harder for the liver to break down these substances, which causes higher levels of each substance to remain in the liver. This can potentially lead to irreversible liver damage.

While light drinking paired with normal Tylenol use may not have a significant effect, someone using too much Tylenol or drinking heavily or frequently may experience more substantial liver problems.

How Does Alcohol Interact With Acetaminophen?

Acetaminophen (Tylenol) and alcohol have an interaction that can cause liver damage. When someone drinks a lot of alcohol regularly, they can increase liver enzymes as the body struggles to compensate for the alcohol. Unfortunately, the increased amount of these enzymes means that acetaminophen can be broken down faster than expected, leading to the increased production of acetaminophen breakdown products that can harm the liver.

Effects of Alcohol and Tylenol

Liver damage can be permanent and may require a liver transplant in advanced cases. Some symptoms of liver damage from acetaminophen overdose include:

• Malaise
• Nausea with or without vomiting
• Abdominal pain
• Pain in the upper part of your torso on the right-hand side
• Excessive bleeding
• Mental status changes
• Enlarged liver
• Liver lab abnormalities
• Kidney problems

If you have any of these symptoms, especially after using alcohol and Tylenol, you should see a doctor. These can indicate that liver damage from alcohol has occurred and you will need medical care.

How Long After Drinking Is It Safe To Take Tylenol?

You should consult with a doctor to see what is best for your specific situation, but in most cases, it may be safe to take Tylenol 24 hours or more after using alcohol.

Will 1 or 2 Drinks Harm My Liver?

For most people, it is unlikely that one or two drinks will harm your liver: Tylenol package labeling specifically warns against having three or more drinks a day while taking Tylenol. However, if you drink a large amount regularly, take high doses of acetaminophen or have other medical conditions, even a small amount of alcohol may harm your liver. Talking to your doctor about drinking is best, especially if you take acetaminophen.

Alternatives to Acetaminophen

Tylenol is one of two common over-the-counter (OTC) pain medications. The other major type of OTC pain medication is non-steroidal anti-inflammatory drugs (NSAIDs). This class of drug includes Aleve, ibuprofen and aspirin. These drugs are usually safer to use with alcohol, but they may cause gastrointestinal discomfort or even bleeding in those with a history of gastrointestinal bleeding. Prescription pain medications may be safer to use with alcohol.

Ultimately, you should always consult with your doctor before using any medication at the same time as alcohol.