Mixed Tylenol and Alcohol
July 8, 2012 12:14 PM   Subscribe

I just mistakenly took 2 Tylenol pills in the middle of the night to avoid a hangover tomorrow after a night of fairly heavy drinking. How bad is this?

Acetaminophen + alcohol is terrible for you liver. Am I in any danger?
posted by Tenacious.Me.Tokyo to Health & Fitness (16 answers total)
No. Don't worry about it at all. I have done this loads of times and I'm still kicking.
posted by Nightman at 12:20 PM on July 8, 2012 [4 favorites]

Call Poison Control, even if you don't think you'll die in the next three minutes. My neighbor is a pharmacologist and says they hear absolutely everything, so don't worry about it being not a huge emergency.
posted by Madamina at 12:20 PM on July 8, 2012 [2 favorites]

Absolutely no problem
posted by sanka at 12:22 PM on July 8, 2012 [1 favorite]

You will be 100% fine.
posted by tylerkaraszewski at 12:22 PM on July 8, 2012 [1 favorite]

IANAD but anecdotally I took 32 acetaminophen pills and washed it down with an alcopop (I was 14, it was the best I could get for alcohol) and required no treatment. I'm pretty sure my bf has taken tylenol after drinking to ward off hangovers more than a few times.

Do you have a history of liver problems? Otherwise I wouldn't worry about it.
posted by missmagenta at 12:23 PM on July 8, 2012

If you do it regularly and often--otherwise go back to sleep and reduce the frequency of hangovers by other more direct means ( less alcohol). Sleep tight and unencumbered
posted by rmhsinc at 12:24 PM on July 8, 2012 [1 favorite]

People were habitually taking Tylenol with alcohol for many years before a) Advil, b) anyone knew it was bad. And people drink with Vicodin all the time, which is a bad idea on several levels but they don't spontaneously combust or anything.

Some of those people may eventually run into trouble, but one dose of Tylenol with alcohol is no worse for your liver* than alcohol.

*Assuming you do not have liver disease.
posted by Lyn Never at 12:25 PM on July 8, 2012 [2 favorites]

Given the low dose, and in the absence of any underlying liver disease, you will be fine. It tends to be chronic alcohol consumption + acetaminophen that's the problem.
posted by gaspode at 12:33 PM on July 8, 2012 [3 favorites]

You are fine. If 2 Tylenol (a normal dose) on top of alcohol were really this dangerous to the general public, acetaminophen would have been banned a long time ago.
posted by scody at 12:42 PM on July 8, 2012

Not that I am a role model or anything but I did this regularly for approximately 7 years before having any liver problems. I think this one time event means you are good to go.
posted by elizardbits at 12:46 PM on July 8, 2012

This is more of a chronic issue with potential long-term implications than an acute issue. I'd imagine you'll be fine -- I've certainly done that -- but it's probably not a great idea to make a habit of it.
posted by J. Wilson at 1:04 PM on July 8, 2012

Don't do it again, but you don't have to go get your stomach pumped now that you've done it. It is injurious over the long haul, but vanishingly unlikely to be life-threatening as an isolated incident.
posted by Sidhedevil at 1:36 PM on July 8, 2012

You will be fine. Don't make it a regular thing, but seriously you will be totally OK. Unless you are taking very high doses (which has no additional painkilling effect, by the way) the danger with tylenol (aka acetominophen) is through chronic overuse, not acute overdose. Alcohol hastens the process of cumulative damage but isn't going to destroy your liver if combined with a single normal dose.

By the way, taking advil (aka ibuprofen) with alcohol can cause gastric bleeding so you're kind of damned if you do damned if you don't. Best practice is to wait until morning when most if not all of the alcohol is out of your system, and take some tylenol and/or advil with your breakfast.

By the way, you can take both tylenol and advil together without increasing your chance of harm from either one. They act differently, so their analgesic effects will stack but the harmful ones won't. Taking extra of just one won't help, but might hurt -- however you can safely take a normal dose of both and get additional benefit without additional risk. You're welcome.

Taking painkillers in the middle of the night is likely to also be futile as both tylenol and advil wear off in about four hours -- meaning that by morning it's as if you hadn't taken anything. Wait until morning, take them with breakfast.
posted by Scientist at 3:30 PM on July 8, 2012 [2 favorites]

Oh, I'm not a doctor of course. My information above comes from my mother, who is a nurse, and my father who is a doctor. Still though, use your own judgement and fact-check my advice.
posted by Scientist at 5:57 PM on July 8, 2012

It's dangerous to habitually combine Tylenol and heavy alcohol use. Once is not a problem.
posted by desuetude at 10:11 PM on July 8, 2012

Ooohhh...something I actually learned about in grad school.

Tylenol is dangerous because a small percentage of it is oxidized by P450 enzymes in your liver to a quinone, which is quite toxic. Normally, this toxic molecule is captured by glutathione, which reacts with the nasty quinone and shuffles it out of you. The minimum toxic dose of tylenol is 5-10 grams in normal individuals, if I remember correctly, if all taken in a single dose. The problem with alcohol is that chronic drinkers have more P450 (the body makes it to destroy the alcohol and get that poison of your body) and, usually, less glutathione reserves. So, chronic use of alcohol is usually the problem with tylenol poisonings.

Strangely, alcohol can have a protective property against tylenol poisoning; if you take too much tylenol drinking large amounts of alcohol keeps the P450 busy until the tylenol can leave your body through other (harmless) paths. This is the same reasoning behind giving people a big glass of 190 proof liquor for antifreeze poisoning (albeit a different enzyme is involved). I am NOT recommending this because there are way too many variables to consider at home.

Long story short, you are almost certainly fine, but less so if you are a heavy drinker. If this happens again, you can call poison control or stop by an urgent care to calm your nerves. Tylenol poisonings (suspected and real) are so common that they won't blink and most likely will tell you to have a good night's sleep.
posted by roquetuen at 5:45 AM on July 9, 2012 [2 favorites]

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