PAIN
November 25, 2013

Acetaminophen and Alcohol Don't Mix

If you are a regular drinker, taking acetaminophen for pain is dangerous for your kidneys as well as your liver.

As the holiday hangover season approaches, there's a new reason for people who drink to avoid taking acetaminophen. Even light to moderate drinking, paired with taking the painkiller, more than doubled people's risk of kidney damage, according to new research.

Acetaminophen is the painkiller found in Tylenol and many other over-the-counter pain relief medications.

A reported increase in kidney problems of over 100% is something those who drink should know about and a risk they should try to avoid.

Even without alcohol, taking too much acetaminophen can damage the liver. But it is far worse when the two are taken together. Like many drugs, acetaminophen is broken down in the liver. Most of it is excreted in the urine, but a fraction of the acetaminophen is transformed into a compound that is extremely harmful to liver cells.

When alcohol and acetaminophen are used together, even the recommended dose of acetaminophen can cause irreversible damage. That is why most packaging warns people who have three or more drinks a day against taking acetaminophen.

And now a new study finds a similar large increase in kidney problems among people who mixed even smaller amounts of alcohol with acetaminophen.

The study, based on information from the 2003-2004 National Health and Nutrition Examination Survey (NHANES), analyzed more than 10,000 respondents. Neither taking acetaminophen at its suggested dose nor light to moderate drinking was associated with any kind of kidney problem. But among people who combined the two, there was a 123% increased risk of kidney disease.

The research was presented earlier this month at the American Public Health Association Annual Meeting. Until published in a peer- reviewed journal, the results are considered preliminary. But a 123% increase in kidney problems is something those who drink should know about.

People who take acetaminophen daily should avoid alcohol; people who drink regularly should try another painkiller or avoid OTC pain medications altogether. And people who have been taking acetaminophen for a few days in a row should not drink alcohol for a day or two after they stop taking the drug.

All OTC painkillers have their problems. While they have undeniable benefits and are safer than their prescription counterparts, it is still a good idea to take them as infrequently as possible and in the lowest effective dose.
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