The short answer
- Nurofen (ibuprofen) + alcohol: small amounts are OK; heavy drinking raises the risk of stomach bleeding and kidney strain.
- Panadol (paracetamol) + alcohol: normal doses are OK with moderate drinking; regular heavy drinkers need lower doses because of liver risk.
- Nurofen Plus, Panadeine, co-codamol (codeine) + alcohol: avoid. Both cause drowsiness and together can depress breathing.
Painkillers and alcohol, medicine by medicine
| Painkiller |
Occasional drink (1–2) |
Heavy drinking / binge |
Main concern |
| Ibuprofen (Nurofen, Advil) |
Generally OK with food |
Avoid |
Stomach irritation and bleeding; dehydration and kidneys |
| Paracetamol (Panadol, Tylenol) |
OK at normal doses |
Lower dose; ask a pharmacist |
Liver: chronic heavy use depletes the liver’s protective glutathione |
| Aspirin (pain dose) |
Use caution |
Avoid |
Stomach bleeding |
| Naproxen, diclofenac |
Generally OK with food |
Avoid |
Stomach bleeding |
| Nurofen Plus (ibuprofen + codeine) |
Avoid |
Avoid |
Sedation, slowed breathing, plus stomach risk |
| Panadeine, co-codamol (paracetamol + codeine) |
Avoid |
Avoid |
Sedation, breathing, liver |
| Tramadol, oxycodone (Endone) |
Avoid |
Avoid |
Sedation, breathing, overdose |
Ibuprofen and alcohol
Both alcohol and ibuprofen irritate the stomach lining, and together they increase the chance of gastritis and bleeding. Alcohol also dehydrates you, and ibuprofen reduces blood flow to the kidneys, which is a poor mix after a big night or during gastro. If you take ibuprofen after drinking, use a single normal dose with food and water, and avoid it if you have vomited a lot. See which ibuprofen is easiest on the stomach.
Paracetamol and alcohol
The NHS says you can drink alcohol while taking paracetamol at normal doses, but it may not be suitable for people who are dependent on alcohol or binge drink. Long-term heavy drinking increases the liver’s production of a toxic paracetamol by-product and reduces the glutathione that neutralises it, so people who drink heavily, are malnourished or have liver disease may need a lower maximum (for example 2–3 g a day) on advice from a doctor or pharmacist. Never take extra doses to “get ahead of” a hangover.
Codeine products and alcohol
Codeine is an opioid. With alcohol, the sedative effects multiply: drowsiness, poor coordination and, in larger amounts, slowed breathing. The NHS advises not to drink while taking co-codamol until you know how it affects you, and many pharmacists advise avoiding alcohol entirely. In Australia all codeine products are prescription-only; in the UK low-dose codeine combinations are pharmacy medicines limited to 3 days because of dependence risk. See Endone or codeine with Nurofen.
What to take for a hangover
- Water or an oral rehydration solution, and sleep.
- Ibuprofen with food for a headache, if your stomach is settled and you’re not vomiting.
- Paracetamol is also fine for most people at normal doses, but not if you drink heavily every day.
- Avoid codeine products and sedating “night” medicines after drinking.
Get help if someone who has been drinking and taking painkillers is very drowsy, confused, vomiting repeatedly or breathing slowly. If you’ve taken more paracetamol than the label allows, contact a poisons information centre (Australia 13 11 26, US 1-800-222-1222) or NHS 111 straight away, even without symptoms.
Frequently asked questions
How long after drinking can I take ibuprofen?
There is no fixed waiting time. For a single normal dose after moderate drinking, take it with food and water. After heavy drinking or vomiting, wait until you are rehydrated and eating, or choose paracetamol at a normal dose.
Can I drink alcohol with Nurofen Plus?
It’s best not to. The codeine in Nurofen Plus adds to alcohol’s sedation, and the ibuprofen adds to its stomach irritation.
Can I take Panadol after a night out?
A normal dose is fine for most people. People who drink heavily on a regular basis should ask a pharmacist about a lower maximum dose.
Is it safe to drink while taking antibiotics and painkillers?
Most antibiotics (amoxicillin, doxycycline) don’t interact with moderate alcohol, but metronidazole and tinidazole do. The painkiller rules above still apply.
Sources and further reading
CanforaMedicine Guide
