Here’s Why You Should Avoid Mixing Ibuprofen and Alcohol

Taking pain relievers to prevent a hangover sounds good in theory, but it comes with risks when drinking.
Why You Shouldnt Mix Ibuprofen and Alcohol According to Doctors
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It probably doesn’t come as a shock that many medications don’t pair well with alcohol, a substance that impacts everything from your brain to your liver. Ibuprofen and alcohol, though, is an off-limits combination that might be a bit more surprising.

Most people don’t think twice before popping an ibuprofen or two—after all, it’s a pretty standard over-the-counter medication that can help with a lot of everyday aches and pains, including those that tend to accompany a brutal hangover.

The thing is, ibuprofen isn’t completely risk-free. Like any drug, it poses potential side effects, and alcohol can compound them if you take the two closely together.

In fact, ibuprofen, acetaminophen, and aspirin come with potential dangers if you make a habit of taking them with alcohol. “All have risks if you take them, period, as do all medications, but the risks for all three increase if you take them when you drink,” Debra E. Brooks, MD, an urgent care physician at GoHealth Urgent Care, tells SELF. This also goes for popping a pill immediately after you get home from a night out, when you’re trying to preemptively treat the headache you know will hit in the a.m.

Here’s why taking ibuprofen and alcohol at or around the same time is a bad idea and what experts recommend instead if you need pain relief before or after you have a drink (or two).

First, a primer on how ibuprofen works in your body.

Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID). It’s used as a pain reducer and—you guessed it!—to reduce inflammation.

Ibuprofen works by blocking an enzyme called cyclooxygenase (COX), which plays a key role in your body’s inflammatory response. This makes the medication effective at easing aches and pains, but it comes with a downside: COX also supports kidney function, promotes blood platelet aggregation (when blood cells clump together to form necessary clots), and helps maintain the lining of your gastrointestinal (GI) tract.1

This means that regular or prolonged ibuprofen use can cause irritation to the lining of the stomach that can lead to ulcers and bleeding, kidney damage, and issues with blood clotting, Dr. Brooks says.2

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So why shouldn’t you drink alcohol with ibuprofen?

Alcohol on its own is a known irritant to the stomach lining, and drinking too much of it too frequently is a cause of gastritis, or inflammation in the stomach lining, which can trigger the development of stomach ulcers and bleeding.3 It can also damage the kidneys and thin the blood. Adding ibuprofen into the mix can amplify these effects.4

The possible GI consequences are especially concerning, Pooja Patel, PharmD, a clinical assistant professor at the Irma Lerma Rangel School of Pharmacy at Texas A&M University, tells SELF. “Taking alcohol and NSAIDs together really puts patients at risk of having an upper GI bleed,” Dr. Patel says, adding that this effect is the most troubling because it can become fatal. Kidney damage is more likely to impact you cumulatively over time, whereas a GI bleed can happen out of nowhere and quickly become a medical emergency, she says.

Of course, how much you drink and ibuprofen you take influences your risk of GI bleeding. “It could happen with any amount of alcohol, but it is typically dose dependent, so the more you drink or the higher dose you have, the higher the chance for that bleeding to happen,” Dr. Patel says. If you stick to what’s considered moderate drinking—two standard drinks in one sitting for men and one in one sitting for women—the risk won’t be as high as if you drink five or six drinks in one sitting, or if you drink every single day, Dr. Patel adds.

Anyone taking ibuprofen and alcohol at the same time is at risk, but it’s even riskier if you have a condition or take other meds that make you more prone to GI bleeds. For example, if you have a history of stomach ulcers, have taken NSAIDs long-term to manage an inflammatory condition like rheumatoid arthritis, are taking blood thinners, or have any existing kidney damage, then you’ve got an increased risk of bleeding, and then mixing ibuprofen and alcohol is all the more dangerous, Dr. Patel says.

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Is it safe to take aspirin or acetaminophen with alcohol instead?

Aspirin is also an NSAID and additionally works as a blood thinner. “It is an antiplatelet medicine, which means it makes it harder for blood to clot,” Dr. Brooks says. That’s why it’s sometimes recommended as a preventive medication for people at high risk of heart disease. Its effects on the liver and kidneys are similar to ibuprofen, and it can also cause bleeding in the GI tract. “Alcohol multiplies the blood-thinner effects of aspirin,” Dr. Brooks explains, “and heavy drinkers are already at risk of bleeding due to previous damage to the stomach and liver, so they are at far greater risk of bleeding.” Basically, it’s probably best to avoid aspirin when drinking too.

“Acetaminophen is completely different, and its analgesic effects have a different mechanism,” Dr. Brooks says. It doesn’t affect your blood’s clotting abilities nor does it hurt your stomach lining. But acetaminophen can damage the kidneys, is more toxic to the liver, and is more often associated with liver failure than NSAIDs, Dr. Brooks notes.

When you’re drinking, you’re already sending a toxic substance to your liver and making it work overtime to filter it out. Adding acetaminophen puts additional stress on the organ, increasing the risk of damage. However, the greater concern here is more about pairing the two substances regularly over time, Dr. Patel notes.

“For someone who chronically drinks, acetaminophen might not be a good option because it affects the liver, and alcohol affects the liver,” Dr. Patel says. But if you’re not a heavy drinker and your liver is in good shape, it’s generally a safer option to take acetaminophen before or after a drink or two every now and then, in lieu of an NSAID, Dr. Patel says: “In this situation, it would be safer to use acetaminophen because we wouldn’t be worried about the stomach.”

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So how long should you wait to drink after taking ibuprofen?

“It depends on the formulation and dose,” Dr. Patel says. In general, “you’d be in the clear” to drink two or three days after taking ibuprofen. If you took a rapid-release version, it should theoretically be out of your system sooner, so in that case you should be good a day or two after, she adds.

When it comes to popping a pain reliever the morning after drinking, the potential health risk is dependent on so many factors, including how much you drank and how much alcohol is still in your body.

“If someone had a drink or two, it’s okay to take ibuprofen as a one-off thing,” Dr. Patel says. (Meaning, try not to make a habit of it.) “If you drink anything beyond that, you want to be careful about it and probably wait it out for at least a day,” especially if you have any of the other risk factors for GI bleeding mentioned above.

Overall, if you’re relatively healthy, and have no existing problems like gastritis, stomach ulcers, or issues with your kidneys or liver, “taking any of these if you are going out to dinner and having one drink is most likely safe,” Dr. Brooks says. If you have a choice, you should reach for acetaminophen to be safest—though limiting this habit is still a good idea. Food also seems to buffer the effects of alcohol on the GI tract, so eating something at the same time may help mitigate potential side effects if you’re not drinking heavily.4

If you have to take pain medication during or after imbibing, try to curb your drinking. If you’re popping pills in anticipation of the morning after, it’s best to prevent a hangover the old-fashioned way: by chugging lots of water and eating a solid meal. Or just don’t drink enough to be hungover in the first place—your body will thank you.

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  1. StatPearls, Ibuprofen
  2. British Journal of General Practice, The Dangers of NSAIDs: Look Both Ways
  3. Institute for Quality and Efficiency in Health Care, Gastritis
  4. Plos One, ​​A Prospective Study of Alcohol Consumption and Smoking and the Risk of Major Gastrointestinal Bleeding in Men