It is a common assumption that over-the-counter medications are safe. While this may be true in some respects, it is important to read the label before taking any medication and to understand that some OTCs react with other over-the-counter medications, prescription medications and alcohol. Acetaminophen, an OTC pain reliever and fever reducer, is one medication that you should never take after consuming alcohol.
Alcohol Metabolism
After ingestion, your gastrointestinal tract absorbs alcohol. Alcohol has no nutritional value, so your body tries to eliminate the alcohol as fast as it can upon absorption. According to Elmhurst College, the metabolism of alcohol begins in the liver through oxidation by liver enzymes. During this process, the liver enzymes transform ethanol to acetaldehyde. The acetaldehyde further oxidizes into acetic acid, which the citric acid cycle changes to CO2 and water.
Alcohol-acetaminophen Syndrome
Ingesting alcohol and acetaminophen at the same time or within a close time frame causes the liver to work overtime. As your liver works to metabolize alcohol from your body, the process speeds up as it tries to eliminate the acetaminophen, as well. In the process, transaminase -- a liver protein -- steadily rises in your body. According to Health Services at Columbia University, high levels of transaminase are the signature sign of alcohol-acetaminophen syndrome. Aside from an overproduction of transaminase, the increase in liver metabolism fails to effectively breakdown the acetaminophen, leaving toxic acetaminophen enzymes floating around in your body.
Hepatotoxicity
When excess amounts of toxic acetaminophen enzymes exist in your body, you have a heightened risk of developing hepatotoxicity. Even doses of acetaminophen that the manufacturer states are "safe" can be a cause for concern when taken with alcohol. In fact, the University of California at Davis explains that severe hepatotoxicity can develop after ingesting as few as eight extra strength tablets or 4 g of acetaminophen within 24 hours of drinking alcohol. All too often, acute liver damage or total liver failure follows hepatotoxicity.
Chronic Alcoholism
The more you drink, the higher the risk of acetaminophen associated toxicity. Chronic drinking damages the liver and reduces glutathione levels in the body, increasing the likelihood that you will develop hepatotoxicity. It is important to consider how much alcohol you drink before taking acetaminophen. It takes approximately five days for your body to eliminate alcohol, completely. Harvard Medical School Family Health Guide explains that for chronic drinkers -- those who consume three or more alcoholic beverages per day -- this window is even longer. If you are a chronic drinker, lowering your dose of acetaminophen or eliminating your use all together is wise.
