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Liver & Pancreas Disorders Message Board

Liver & Pancreas Disorders Board Index

I have a question about taking acetaminophen with alcohol.

For about the past 4 months or so ive had a problem taking perscrption painkillers. There have been a few times when i have gone to a bar with some friends after taking 4-5g of acetaminophen that is contained in the painkillers. Not until recently did i know the risks involved. Ive stopped taking anything with acetaminophen in it but im worried about the damage that i may have already done. Could someone please tell me what the chances are that ive done any severe damage to my liver and if i should see a doctor.


If you are concerned and can afford it I would say check it out with the doctor. He can do an exam on your right lower ribs/right upper abdomen and also a simple blood test will tell him how you are doing. :wave:
Well, you probably haven't done much damage (well, at least irreversible damage) to your liver as surprising as it is mostly because #1 you are young (or at least I'm guessing you are), #2, you're healthy enough to be typing a message here on Healthboards. Usually liver damage done with large doses of Tylenol cause severe liver damage fairly quickly. HOWEVER, that said, you should probably be careful from now on, and not mix the two. I'll explain why tylenol and alcohol are not a good mix.

When tylenol goes to your system, it is eliminated by your liver in three ways.

The first two ways, the liver adds a molecule to the tylenol molecule to make it more water-soluble and you pee it out. The third way is a little different. In this way, the liver's enzymes first metabolize the liver to a toxic compound known as NAPQI (I can't remember right now what that stands for). NAPQI is toxic to your liver, but luckily, we have something stored in there called glutathione to help deactivate NAPQI and help you pee it out. The trouble with taking high doses of tylenol is that eventually you run out of glutathione and the NAPQI hangs around and damages your liver. People at risk for this are those who take high doses of tylenol, the elderly, alcoholics or people who are malnourished.

So, after that whole explanation, why does alcohol make things worse? Well, alcohol is metabolized in the liver by the same enzyme (let's call it tylenolase) which change Tylenol in to NAPQI. When you take both tylenol and alcohol together, your liver gets the signal to make a ton more of "tylenolase" and this means there is more tylenol being changed to NAPQI. Because there is more NAPQI being made, you are using up glutathione faster, and thus, you run out of it faster and thus, you put yourself at a higher risk of liver toxicity.

Does that make sense?

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