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What really happens when Tylenol and alcohol mix
There are times where festivities abound and, a few drinks later, our heads pound. Some people wonder if it’s bad to take acetaminophen, more commonly known as Tylenol®, for a headache after drinking alcohol.
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Hepatologist Christina Lindenmeyer, MD, has the answers.
As it does for many medications, your body metabolizes acetaminophen in the liver. When you take the recommended dosage, most of it is converted by your liver into a benign substance that’s removed in your urine.
Your body converts a very small byproduct of metabolized acetaminophen into a toxic substance that can be harmful to your liver. Luckily, a secondary substance called glutathione helps minimize the toxic effects.
However, if you take too much acetaminophen, or if the liver does not have an abundant reserve of glutathione, the toxic metabolite can accumulate and cause significant damage to your liver.
Alcohol is also metabolized by liver cells. In fact, both acetaminophen and alcohol utilize glutathione in the liver to temper their toxic effects.
“Over time, chronic, heavy alcohol intake depletes your liver of its glutathione stores, which can lead to problems when acetaminophen is added to the mix,” Dr. Lindenmeyer says.
Typically, taking a normal dose of acetaminophen (no more than 4,000 mg in a day) after one night of drinking should not cause liver damage. However, regular, heavy alcohol use (more than one drink daily for women or more than two drinks daily for men) combined with repeated daily doses of acetaminophen predisposes the liver to acetaminophen-associated toxicity.
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In general, if you’re going to drink at a party or other social event and you take a couple of doses of acetaminophen the next day for your headache (again, no more than 4000 mg in a day), you should be fine.
However, if you regularly drink more than the recommended number of alcoholic drinks per day, you’d be best off to only use acetaminophen in rare instances and avoid daily doses greater than 4,000 mg.
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