Medical Edge Newspaper Column

Use Pain Medications Cautiously

Feb. 18, 2007
Readers:
You may not realize that the combination of over-the-counter pain relievers and alcohol can pose health risks.

When taken as directed, pain medications are generally considered safe. However, problems can arise when they are taken more frequently or in larger doses than recommended or taken in combination with other drugs -- including alcohol.

Consider these factors before deciding if it's safe to drink an alcoholic beverage while taking pain medications.

• Do you take pain relievers or drink alcohol often? The risk of side effects from combining pain relievers and alcohol is greater if you take medication frequently or drink alcohol frequently.
• Do you take high doses of pain medication? The risk of serious side effects from alcohol use increases when you take a high dose of a pain reliever.
• Does the medication cause side effects? If you're already experiencing side effects from pain medication, such as stomach upset or drowsiness, alcohol will only make these side effects worse.
• What's your age? People over age 65 are at increased risk of adverse side effects from pain relievers. Also, with age, your body processes alcohol more slowly, prolonging its effects.
• Can you stop at one drink? It's probably best to avoid alcohol altogether if you have difficulty stopping after one drink. The more you drink, the greater the risk.

Being cautious doesn't necessarily mean you can never have alcohol while you take pain medications. The amount you can safely drink varies. For example, the Food and Drug Administration (FDA) reports adults who take more acetaminophen than recommended -- more than 4,000 milligrams a day (eight 500-milligram tablets) -- and who drink three or more alcoholic drinks a day may be at increased risk of liver damage. The FDA also reports that people who take nonsteroidal anti-inflammatory drugs and drink more than three alcoholic drinks a day may be at increased risk of gastrointestinal bleeding.

The best advice is caution. The less often you combine a pain reliever and alcohol, the better. Because prescription pain relievers contain more potent medication than do nonprescription pain relievers, it's generally recommended that you avoid alcohol when taking prescription pain medication.