Liver damage caused by paracetamol and alcohol

The question often arises whether taking paracetamol while drinking alcohol at the same time is questionable. If paracetamol is used regularly, especially in high quantities, alcohol consumption should be avoided. Alcohol damages the liver.

Many people know this, but there is one thing many people do not know: Paracetamol also has liver-damaging side effects. Since it is not only acute damage, but rather insidious developments, the interval between the intake of paracetamol and alcohol consumption has no influence on the long-term liver damage. Regular alcohol consumption and the frequent intake of paracetamol therefore considerably increases the risk of liver damage.

However, paracetamol also impairs the breakdown of alcohol in the liver. The reason for this is that paracetamol is partially broken down and metabolized by the same enzymes in the body that break down alcohol. Paracetamol therefore delays the breakdown of alcohol in the body.

So if you want to drink alcohol on a given occasion, for example, you should not take paracetamol at the same time or immediately after consumption. Painkillers such as ibuprofen or diclofenac are more suitable, as they do not impair the breakdown of alcohol. It also takes about 15 hours for paracetamol to be completely broken down in the body. At least 15 hours should therefore pass between taking paracetamol and drinking alcohol.

Does paracetamol help with hangovers?

Paracetamol is not suitable to cure the headache of a “hangover”. The opposite is true: Paracetamol leads to a slower breakdown of alcohol in the body. Medications such as aspirin or ibuprofen are better suited to relieve the headaches after an intoxication.

Interactions of paracetamol

Paracetamol, like any drug, has interactions. In combination with alcohol or other stimulants, unpredictable interactions can occur. As a rule of thumb, the more drugs or stimulants are combined, the greater the risk of interactions and side effects.

In general, there are few interactions of paracetamol with other drugs. Alcohol plays a rather subordinate role in this case.

Some sleeping pills (barbiturates), in combination with alcohol, increase the liver-damaging effect of paracetamol, as more toxic substances are produced in the body.
The drug cholestyramine, which is used for lipid metabolism disorders, reduces the absorption of paracetamol in the gastrointestinal tract.
If paracetamol is taken regularly, the effect of anticoagulant drugs such as Marcumar or warfarin can be enhanced.
This increases the risk of bleeding. Alcohol also has a negative effect on the coagulation system, so that strong bleeding can occur in combination with paracetamol and anticoagulants.
Caution is advised with the drug carbamazepine, which is used to treat epilepsy: In combination with alcohol it increases the liver-damaging effect of paracetamol

Paracetamol overdose leads to severe damage to liver cells, which can ultimately lead to liver failure and even death. The reason for this is as follows: after paracetamol is taken, the active ingredient is added to the body’s metabolism.

Reactions with various enzymes lead to the toxic product N-acetyl-p-benzoquinonimine being produced in small quantities. This is not a problem if paracetamol is taken responsibly and in the recommended quantities. The small amount of the toxic substance can be absorbed in the body by the so-called glutathione (an endogenous antioxidant).

No damage is therefore caused. However, too high a dose of paracetamol or the additional consumption of alcohol increases the formation of the toxic product and the liver is massively damaged. People with a damaged liver, for example in the context of chronic alcohol consumption, should therefore avoid taking paracetamol and use alternatives such as ibuprofen.

In general, paracetamol is considered a well-tolerated active substance. With regard to the gastrointestinal tract, the intake of paracetamol is harmless. There are no relevant side effects in contrast to other painkillers such as ibuprofen.

In cases of damage to the gastrointestinal tract or gastroenteritis, paracetamol is therefore a good alternative to active ingredients such as ibuprofen to relieve the pain. Alcohol and paracetamol in combination have no relevant effects on the gastrointestinal tract. There are theories on the effect of paracetamol on serotonin receptors and the body’s own pain-inhibiting endocannabinoid system.

Influencing these systems results in pain-inhibiting effects of paracetamol in the body. These mechanisms are very complicated and are still being researched by specialized scientists. However, the influence of the simultaneous consumption of alcohol is not related to these modes of action.

The effects of alcohol on the nervous system are a separate chapter in themselves. It is therefore very difficult to establish a connection. However, in the context of poisoning with paracetamol, there are severe negative effects on the nervous system, which are further intensified by alcohol.

Alcohol and paracetamol damage the liver. If the damage is very severe, liver failure occurs. When the liver, which is a very important detoxification organ, no longer functions, toxic substances such as ammonia accumulate in the body and especially in the brain. This severe brain damage leads to disturbances of consciousness up to coma.