Alcohol and acetaminophen — the active ingredient of Tylenol — can negatively affect the liver when taken on their own. When they are mixed, however, the synergistic effect they have on the liver multiplies the potential damage that they can cause. 

Alcohol alone can put a significant strain on the liver. Many types of drugs should not be taken with alcohol because of potential negative interactions, many of which affect the liver. Ultimately, mixing any substance with alcohol is not recommended unless you first consult with your doctor about potential drug interactions and effects.

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What Is Tylenol?

Tylenol is a brand name for the generic drug acetaminophen. Acetaminophen is a pain reliever that can also help to reduce fevers. Some types of Tylenol may include other drugs as part of its formulation — for example, Tylenol PM is a combination of acetaminophen and diphenhydramine.

There are also drugs that contain acetaminophen but are not labeled as Tylenol. Regardless, any drug containing acetaminophen should generally not be mixed with alcohol.

Acetaminophen Side Effects

Acetaminophen use can lead to liver damage, even when alcohol is not used. This is rare in healthy individuals who follow acetaminophen dosage instructions. However, it may occur in people who take acetaminophen in excess or have certain underlying health conditions, especially ones affecting the liver. 

Side effects with acetaminophen are uncommon, but they may include:

  • Nausea
  • Stomach pain
  • Itching
  • Dark urine
  • Yellowing of the skin 
  • Decreased appetite
  • Headache

If you are having side effects with acetaminophen, it is a good idea to consult with your doctor. These effects can sometimes indicate liver damage.

Tylenol and Alcohol Interaction

Tylenol and alcohol are both foreign chemicals to the body, and the body breaks down both of these chemicals by using the liver. While each substance individually puts some strain on the liver, the strain multiplies when both are used together. This makes it harder for the liver to break down these substances, which causes higher levels of each substance to remain in the liver. This can potentially lead to irreversible liver damage.

While light drinking paired with normal Tylenol use may not have a large effect, someone who is using too much Tylenol or drinking heavily or frequently may experience more significant liver problems.

Effects of Alcohol and Tylenol

Liver damage is normally permanent, and the only way to cure it is to get a liver transplant. Some of the symptoms of liver damage include:

  • Yellowing of the skin or whites of the eyes
  • Confusion
  • Changes in stool color
  • Bleeding or bruising easily
  • Swelling in the legs and feet
  • Swelling in the abdomen
  • Itchy skin
  • Dark urine
  • Fatigue
  • Nausea and vomiting

If you are having any of these symptoms, especially after using alcohol and Tylenol together, then you should see a doctor. These can indicate that liver damage has occurred and that you will need medical care.

Alternatives to Acetaminophen

Tylenol is one of two common types of over-the-counter (OTC) pain medications. The other major type of OTC pain medication is non-steroidal anti-inflammatory drugs (NSAIDs). This class of drug includes Aleve, ibuprofen and aspirin. These drugs are normally safer to use with alcohol, but they may cause gastrointestinal discomfort or even bleeding in those with a history of gastrointestinal bleeding. There are also prescription pain medications that may be safer to use with alcohol. 

Ultimately, you should always consult with your doctor before using any medication at the same time as alcohol.


You should consult with a doctor to see what is best in your specific situation, but in most cases, it may be safe to take Tylenol 24 hours or more after using alcohol.

A healthy person may be able to safely use Tylenol while drinking lightly and infrequently, but even then, safety is not guaranteed. Typically, mixing Tylenol and alcohol should be avoided unless instructed by a doctor.

Tylenol and alcohol do not necessarily interact with each other; instead, they both act on the liver. This is what creates the negative effect of combining the two substances.

Get Help

If you or someone you love is facing an alcohol use disorder, The Recovery Village Cherry Hill at Cooper can help. We offer medical detox and comprehensive rehab programs that are tailored to suit your needs.

Cochrane, Zara. “Is It Safe to Drink Alcohol While Taking Acetaminophen?” Healthline, November 13, 2018. Accessed October 15, 2020.

Ogbru, Omudhome. “Tylenol.” RxList, December 4, 2017. Accessed October 15, 2020.

Mayo Clinic. “Liver disease.” 2020. Accessed October 15, 2020. https://www.mayoclinic.org/diseases-conditions/liver-problems/symptoms-causes/syc-20374502

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