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Tuesday, November 10, 2015

Acetaminophen and Alcohol, etc.


     While writing a post for my chess blog on a young chess player who reportedly died after taking a couple of shots of alcohol and four Tylenol tablets for his cold, I was prompted to do some research on over the counter drugs and alcohol, especially pain remedies containing acetaminophen.
      It turns out that combining acetaminophen pain relievers and even light amounts of alcohol can more than double the risk of kidney disease according to new research. Taking the recommended dose of acetaminophen, combined with a small to moderate amount of alcohol, produces a 123 percent increased risk of kidney disease according preliminary studies. There appears to be a harmful interaction between the drug and alcohol even in small amounts.
      Chronic acetaminophen use and chronic alcohol abuse both have been separately linked to kidney and liver disease, said Dr. Martin Zand, medical director of the kidney and pancreas transplant programs at the University of Rochester Medical Center in New York, so combining the two can be very dangerous.
      What has not been well-studied until now is the link between some regular alcohol use and regular acetaminophen use and increasing your risk of kidney disease above the risk of either if they are used separately. It should be pointed out that a study conducted by the U.S. National Health and Nutrition Examination Survey found that neither normal use of acetaminophen nor light to moderate drinking posed a potential threat to kidneys.
     Alcohol can interfere with the gene that regulates the way the body processes acetaminophen. So, to be safe people who regularly use one should not use the other. That begs the question, what about taking acetaminophen for a hangover? The conclusion was that if you are not a regular drinker, it would seem to be OK to take some acetaminophen.
      Over the counter drugs are dangerous to take with alcohol because it is possible that alcohol interaction may decrease the effectiveness or render them useless. In other cases, alcohol interactions may make drugs harmful or even toxic to the body. Even in small amounts, alcohol also may intensify medication side effects. 
     It's also important to remember that herbal remedies are not immune from the same warnings. Manufacturers of herbal products are not required to submit proof of safety and effectiveness to the U.S. Food and Drug Administration before marketing, so the adverse effects and drug interactions associated with herbal remedies are largely unknown.
      Ginkgo biloba extract has been reported to cause spontaneous bleeding and it may interact with anticoagulants and antiplatelet drugs. St. John's Wort may may cause increased levels of serotonin, dopamine and norepinephrine and although it probably does not interact with foods that contain tyramine, it should not be used with prescription antidepressants.
      Ephedrine-containing herbal products have been associated with adverse cardiovascular events, seizures and even death. Ginseng, widely used for its purported physical and mental effects, is generally well tolerated, but it has been implicated as a cause of decreased response to Warfarin.
      Herbal products therefore cannot be marketed for the diagnosis, treatment, cure or prevention of disease. However, these products can legally be labeled with claims about their purported effects. Also, herbal products are not regulated for purity and potency and some of the adverse effects and drug interactions reported for herbal products could be caused by impurities, batch variations, etc.
      When alcohol use is combined with some medications, it may magnify problems, especially in older adults.  Hundreds of commonly used prescription and over-the-counter drugs may adversely interact with alcohol. A list can be found HERE.

The National Institute on Alcohol Abuse and Alcohol Addiction offers a pamphlet on mixing alcohol with medications HERE.

While on the subject of drug interactions, did you know that many foods and supplements can interfere with blood pressure medicine? This article from the American Heart Association may surprise you.


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