Will ibuprofen and alcohol kill you?

Risky Business

Most people know better than to mix alcohol with opioids, anti-depressants or other prescription drugs. However, they might think nothing of popping a couple of Advil or Motrin while drinking alcohol. Making a habit of that could be dangerous or even fatal.

Don’t wait until your next hangover to take this seriously. If you drink — even in modest amounts — while regularly using ibuprofen, you could be at greater risk for health problems than you think.

What Is Ibuprofen, and How Does It Work?

Ibuprofen is a non-steroidal anti-inflammatory drug, or NSAID. It’s an all-around pain reliever. It’s a go-to remedy for everything from sore throat to menstrual cramps to tennis elbow. People use it in the short term to relieve fever and reduce inflammation. If you sprain an ankle or have oral surgery, ibuprofen is your best friend.

The magic happens in certain brain pathways that promote fever, inflammation and pain so that you know you’re sick or injured. Ibuprofen temporarily slows production of the brain chemicals that send those signals.

You can take it in tablet, capsule or liquid form. You can even apply it topically. It’s sold over the counter unless a doctor prescribes an unusually high strength. A typical adult dose for mild to moderate pain is 400 milligrams every four to six hours as needed.

The “as needed” part shouldn’t be overlooked. That’s how well-intentioned people get into trouble, especially if they routinely take ibuprofen before or after happy hour.

Downsides

For all its benefits, ibuprofen is not without risks and downsides. Unpleasant side effects, especially with excessive doses, include the following:

• Headache
• Dizziness
• Stomachache
• Indigestion
• Nausea
• Hypertension
• Racing heart
• Fluid retention
• Irritation/damage to the stomach lining
• Bleeding stomach ulcers
• Kidney toxicity
• Liver toxicity (toxic hepatitis)

Also, ibuprofen is incompatible with many drugs. They include some medications for diabetes, high blood pressure and depression. Steroid-containing drugs and certain antibiotics don’t mix well with ibuprofen either.

In the U.S. alone, around 30 billion doses of ibuprofen are consumed annually. Its wild popularity has prompted scientists to take a closer look. Their chief concern is ibuprofen’s threat to the liver, especially when it’s taken with alcohol.

The Importance of a Well-functioning Liver

Simply put, the liver is a very big deal. It’s the second-largest organ after your skin, and it has almost as many uses as a Swiss Army knife. Here are some of its most important jobs:

• Producing enzymes and bile for digestion
• Storing sugar for energy
• Making the proteins that aid in blood clotting
• Helping you metabolize, eliminate and detoxify drugs like alcohol
• Helping your body eliminate waste

All kinds of things can go wrong if your liver fails. Fluid buildup in your brain, known as cerebral edema, can cause brain fog, disorientation or seizures. When the liver can’t keep up with its clotting function, gastrointestinal bleeding results. Liver failure often leads to kidney failure, another dire condition. The liver also plays a role in preventing infections, so a sluggish liver leaves you susceptible to various illnesses throughout the body.

Thankfully, it’s a resilient organ. If you treat it well, it will do its part to keep you healthy. It also has a reputation for bouncing back from abuse. Just a few diet and lifestyle changes can make an astonishing difference in liver function.

Ibuprofen, Alcohol and the Liver

There are several substance-related liver diseases.

Hepatotoxicity refers to liver damage caused by a drug, chemical or dietary supplement. Even organic supplements, like aloe vera and cascara, can harm the liver. Drug-induced liver injury, or DILI, is another all-too-common condition. Antibiotics, acetaminophen, aspirin — and yes, ibuprofen — are often to blame in hepatotoxicity and DILI. In other words, a drug needn’t be illicit to pose a threat.

Mind you, alcohol is a drug. Alcoholic liver disease, or ALD, ranks high among the leading causes of death. Alcohol abuse is linked to liver cirrhosis, fatty liver, hepatitis B and C, gallstones, severe infections and liver cancer.

Since both ibuprofen and alcohol can damage the liver, using them together is playing with fire. A 2021 study concluded that prolonged use of the two substances in combination, even at very low concentrations, triggers liver toxicity. Just imagine the danger for heavy drinkers.

Ibuprofen and alcohol were never intended to go hand in hand; double-teaming your liver forces it to work that much harder to detoxify your system. In fact, that’s a potentially deadly combination. The cardio equivalent might be a sedentary lifestyle and a steady diet of chicken and waffles — you could get by with that combo now and then, but it would eventually catch up to you.

There are other reasons to use caution.

For one, alcohol can impair your judgement and memory. You might not remember how much ibuprofen you’ve taken or if you’ve taken any at all. Confusion could result in overdose. At the very least, ibuprofen might not work if you take it with alcohol. One drug of any kind can alter the effects of another.

The results of mixing drugs are wildly unpredictable depending on your age, gender, weight and overall health. Have you eaten anything? Are you rested? Are you drinking a dark liquor or a clear one? Does substance abuse run in your family?

Many factors come into play, and the risks are different for everyone.

A Tragic Example

In 1975, at a friend’s birthday party, Karen Ann Quinlan had a couple of mixed drinks and took a Valium. She also took aspirin, another largely safe, over-the-counter pain reliever. Blood tests later showed that all the drugs in her system were within normal range. Quinlan didn’t party excessively or struggle with substance abuse. However, she was dieting and hadn’t had much to eat in a couple of days.

Quinlan suddenly felt faint and went to bed. She lapsed into a coma and persistent vegetative state without ever regaining consciousness.

That’s an extreme example of the danger of mixing substances, but you get the point.

Will it kill you to take ibuprofen with a margarita or glass of wine? You’re better off not finding out. If you habitually use alcohol and ibuprofen together, you’re pushing your luck.

Addressing Core Issues

Increasingly, health professionals struggle to justify even moderate alcohol use. No one argues that the risks far outweigh the benefits. This is especially true if you have certain risk factors, like a family history of substance abuse, or if you have another mental issue such as depression or eating disorder.

Does drinking limit the types of pain relievers you can safely take? Yes, but that’s the least of your worries. Alcohol addiction sneaks up without warning. It affects relationships, careers and all other aspects of life.

If you’re worried about your drinking habits — or simply want to know more — reach out to one of our experienced counselors.

FAQ

Citations

https://www.niaaa.nih.gov/publications/alcohol-and-brain-overview

https://online.regiscollege.edu/blog/deadly-truth-behind-painkillers/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7164802/

https://www.nytimes.com/1975/11/11/archives/excerpts-from-judge-muirs-decision-in-the-karen-quinlan-case.html