Tylenol and Hangovers: A Dangerous Mix?

By Brian Lemay 6 comments

Should tylenol be avoided as a morning- after cure for night-before drinking? Acetaminophen – the active drug in Tylenol – is bad news for the liver
if you take too much of it. The same is true for alcohol. So together, do they join forces to really
mess things up for you? In many cases the answer is:
“yes,” but interestingly, the science behind this drug cocktail
combination is not as obvious as you might think. Both acetaminophen and ethanol – the active ingredient in alcoholic
drinks – are removed from your body through the process of metabolism. When faced with a substance
that’s hard to handle, your body produces enzymes to
transform it into chemicals that are easier to get rid of.
And as we’re rather efficient organisms, it’s not surprising that there are
usually multiple metabolic pathways for getting rid of tough substances
like acetaminophen and ethanol. The trouble is some of these pathways
lead to intermediate chemicals that are in themselves harmful. This is what happens with acetaminophen.
Acetaminophen is metabolized in the liver quite effectively through three different pathways. One
of these involves an enzyme named CYP2E1 – as you can see, toxicologists have a flair for
the dramatic when naming substances! As CYP2E1
metabolizes acetaminophen it forms the rather toxic
compound NAPQI – this is not something you want to have
floating around your body. Fortunately, the NAPQI is rapidly dealt with by
a powerful antioxidant – going by the name of glutathione
or GSH. This is all good news anyone taking
tylenol. But the kicker is that the body can only produce so
many of these antioxidants. And so when the antioxidant
GSH is all used up, the toxic in a NAPQI
begins to build up, And liver cells start to die.
So what has this got to do with alcohol consumption? Ethanol is similarly dealt with in the
liver by the same CYP2E1 enzyme. Which means that if you have both
ethanol and acetaminophen in your system, there are competing demands for a
limited supply of the enzyme. And this is where things
get interesting. If you Aren’t a regular drinker,
when you do have a drink your liver will start
using CYP2E1 to get rid of the ethanol. Now, if you pop a
couple of Tylenol a few hours later to take the edge off a hangover, the
chances are that there is not going to be that much CYP2E1 left to handle it,
as the ethanol has mopped up most of what your body can produce. Instead, the alternative acetaminophen metabolic pathways kick in. As a result, less if the toxic NAPQI is produced,
and some other toxic side effects of acetaminophen are suppressed. In other words, the science indicates
that the occasional drink may actually decrease the very real dangers of acetaminophen overdose. But if you drink a lot and drink regularly, things look very different. In this case, you’ve trained your body to produce
more CYP2E1 and to produce it more regularly. which means that at any given time,
there’s more of it likely to be around to transform acetaminophen into the harmful NAPQI. Even worse, ethanol reduces
the rate at which the NAPQI-reducing GSH
is produced, and liver damage becomes more likely. The bottom line is that taking
multiple drugs together can have complex and not
always obvious consequences. In this case, the science suggests that
an occasional night of social drinking with friends might actually curb the potential harm
associated with taking too much acetaminophen. On the other hand, combining
acetaminophen with a chronic drinking habit or binge drinking is most definitely bad
news for you liver. Of course, as a safer
alternative you could always ditch the tylenol for
some other painkiller. Or even ease back on the ethanol.
Now there’s a radical idea!


Cataluna Lilith

Dec 12, 2013, 3:30 am Reply

Mostly this is just scary this newly-legal potential drinker from drinking at all

Selma R

Dec 12, 2013, 8:13 am Reply

will have a pharmacology and toxicology exam tomorrow about the acetaminophen metabolism in our liver. thank you for making it easier to understand! šŸ˜€

Mad Elf x

Oct 10, 2015, 1:47 pm Reply

And yet you didn't correct the spelling mistake at 0:19 (WITLESS, not "whitless")!

Brooke Resch

Mar 3, 2017, 5:50 am Reply

great explanation!


May 5, 2017, 3:25 am Reply

this is so cool

ashlyn is panicing

Sep 9, 2019, 6:30 am Reply

damn.. im gonna die

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