Paracetamol and alcohol: why joint use is dangerous?

, medical expert
Last reviewed: 16.04.2020

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Paracetamol refers to painkillers and antipyretic drugs, which is why it is taken for headaches, toothaches, menstrual periods, rheumatic pains, to relieve a febrile illness with flu and colds. The instructions for use contain a warning regarding its combined intake with alcohol, their interaction is regarded as undesirable.

Paracetamol and Alcohol Compatibility

Drinking a little alcohol while taking paracetamol is usually safe. [1],  [2] Even therapeutic doses of paracetamol have adverse reactions, including increased activity of liver enzymes. The negative effect of alcohol on the body is also beyond doubt. [3]

Everyone knows that liver cells under the influence of ethyl alcohol are replaced by connective tissue, hepatosis, cirrhosis develops. Many alcoholics die precisely from such a diagnosis. There are many clinical cases of liver damage from taking the recommended strict dose of paracetamol in people belonging to this category. [4], [5]

What will happen if you drink paracetamol and alcohol?

The drug is converted in the liver to various metabolites, one of which N-acetyl-p-benzoquinoneimine is very toxic. It is neutralized by the hepatic enzyme glutathione. But it is also used by the body to remove alcohol, or rather acetaldehyde, into which it is converted in the liver. [6], [7]

Its reserves are very limited and after 3-4 servings of alcohol are running out. In the absence of glutathione or a decrease in its content below 30%, hepatocyte damage occurs. [8]

Toxic damage with paracetamol while taking alcohol occurs in several phases:

  • 1st — general weakness, malaise, nausea, vomiting;
  • 2nd - the symptoms are aggravated, there is pain in the right hypochondrium;
  • 3rd — there is yellowness of the skin and sclera, periods of drowsiness, alternating with excitement, confusion, sometimes convulsions;
  • 4th — recovery 3 weeks after therapy.

How long can I drink?

To avoid the harmful effects of paracetamol on the liver under the influence of alcohol, you need to dilute their intake on time for a day. Systematically drinking people need to reduce the dosage of the drug, because even small doses can lead to liver failure.

Lethal dose

Paracetamol toxicity develops at 7.5-10 g / day or 140 mg / kg. It was recorded that the ingestion of 250 mg of the drug per kilogram of body weight in half of the patients caused severe organ damage, and 350 mg in everyone, and this even without interaction with alcohol. [9]Surely, alcoholics will die from a lower dose, and this happens in the third phase of the development of toxic hepatitis if life saving measures have not been taken in a timely manner: gastric lavage, intake of absorbents, use of N-acetylcysteine - an antidote for this poisoning. It reduces its toxicity, increases the supply of glutathione, but does not restore previously damaged liver cells.

It is important to know!

Nobody knows when alcohol has appeared, but it has firmly entered our life. Many people badly imagine the celebration of various events without alcoholic drinks and just resort to it to relax, cheer up, chat with friends. Read more..

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