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.
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