Ibuprofen and alcohol isn’t recommended because they can both irritate your stomach lining and help cause ulcers. If you don’t already have gastric issues, it’s almost certainly fine
Acetaminophen/Tylenol and alcohol can cause serious liver damage, but only if you are taking more than recommended amounts.
Alcohol thins your blood by decreasing the production of platelets, these little sticky bits in the blood that clump together and help to stop bleeding, and it makes them stick together less. As a result, you’re more prone to bruising, and bleeding may take longer to stop.
Ibuprofen belongs to a class of drugs called NSAIDs, which decrease the inflammation that is causing pain, but they also decrease some of the normal functions of the body, including the clumping of platelets.
If you take both alcohol and NSAIDs, you’re combining the effects of both drugs on platelets and blood clotting, which can lead to dangerous bleeding in your stomach. This bleeding can be (but isn’t always) fatal.
I’m just a medical student, so don’t take this as medical advice.
Ibuprofen inhibits cyclooxygenase, which has two forms (COX-1 and COX-2).
COX-2 stimulates the synthesis of prostaglandins that cause inflammation.
COX-1, however, stimulates the production of prostaglandins that protect the stomach and intestines.
The inhibition of COX-1 means the stomach and intestines are more susceptible to damage, and alcohol causes inflammation and erosion in the stomach and intestines.
So together they increase the risk of peptic ulcers, which in addition to bleeding increase the risk of stomach cancer.
There are also effects on the liver, kidneys and heart, but AFAIK the big sticking point for ibuprofen is the stomach and intestines.
It’s generally safe to take ibuprofen with alcohol. However, acetaminophen with alcohol is not recommended because both alcohol and acetaminophen are metabolized by the liver. Taking both together can increase the risk of liver damage or even lead to acute liver failure.
You can actually damage your liver to the point of death by consuming a large amount of alcohol and acetaminophen even just once.
Ibuprofen is processed in the kidneys and alcohol is processed in the liver mostly so you can definitely mix the two. You don’t want to mix Tylenol and booze since both are processed in the liver so you could overburden your liver. I had a family member who died because of this – granted they were taking Tylenol for years and drinking.
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