Ibuprofen and Alcohol: Is the Combination Safe?

Medications containing ibuprofen are associated with some potentially serious side effects, including gastrointestinal bleeding, kidney damage, and liver problems. The risk may be further increased if you mix ibuprofen and alcohol.

This article discusses the side effects associated with mixing ibuprofen and alcohol. It also covers other drug interactions associated with ibuprofen and alcohol.

Risks of Mixing Ibuprofen and Alcohol

Individuals who might otherwise tolerate ibuprofen may experience side effects or complications if alcohol is also consumed. When ibuprofen and alcohol are mixed, alcohol may worsen or increase the risk of:

• Gastrointestinal (GI) tract bleeding
• Liver injury
• Kidney damage
  

Gastrointestinal Bleeding

Ibuprofen can irritate the digestive tract. Especially when overused, ibuprofen is associated with the risk of peptic ulcer disease, which describes when acid from the digestive tract eats away at the stomach and/or part of the small intestine. This can lead to GI bleeding or perforation, which is when a hole forms in the stomach or intestines.

There is evidence that alcohol can increase the risk and/or severity of GI bleeding in ibuprofen users. According to a 2016 review of studies, alcohol potentiates the risk of GI bleeding—most especially upper GI bleeding—in users of ibuprofen and other nonsteroidal anti-inflammatory drugs (NSAIDs).

Symptoms of severe GI bleeding include:

• Stomach pain
• Heartburn
• Bloody vomit
• Vomit that looks like coffee grounds
• Blood in stool
• Black or tarry stools

Liver Injury

Ibuprofen is associated with the development of fatty liver disease. The drug directly impairs mitochondria (the "powerhouses" of a cell) and makes cells less able to regulate the metabolism of lipids, or fats, in the blood. Alcohol, a major contributor to fatty liver disease, not only adds to this effect but may increase the risk of cirrhosis, or extensive liver scarring, over time.

Ibuprofen can also harm the liver by causing a backflow of bile into the liver or directly damaging liver cells. In severe cases, this can lead to acute liver failure.

Symptoms of drug-induced liver injury can include:

• Extreme fatigue and weakness
• Left-sided abdominal pain just under the ribs
• Jaundice (yellowing of the skin and eyes)
• Loss of appetite
• Dark urine
• Pale stools

Kidney Damage

Research has shown the long-term use of ibuprofen can harm the kidneys by inhibiting the production of hormones called prostaglandins that are needed to ensure normal urine output. This can lead to the onset of acute kidney injury (AKI), also known as acute renal failure.

Signs and symptoms of AKI include:

• Decreased urine output
• Peripheral edema (fluid retention in the legs)
• Shortness of breath
• Fatigue and weakness
• Nausea
• Arrhythmia (irregular heartbeat)
• Chest pain or pressure

Alcohol can exacerbate AKI by directly damaging the filters of the kidneys, called the glomeruli. As much as 10 percent of alcohol is excreted in its original form, placing extreme stress on the glomeruli and associated structures. Over time, this can cause these structures to scar, harden, and narrow (referred to as nephrosclerosis).

Mixing ibuprofen and alcohol increases the risk of nephrosclerosis and a condition called acute tubular necrosis, where the tiny ducts within the kidneys begin to collapse due to tissue death.

Other Drug Interactions

There are drug interactions associated with ibuprofen and alcohol, some of which overlap and affect both drugs. Taking ibuprofen and alcohol with any of these drugs can have an additive effect:

• Anticoagulants, including Coumadin (warfarin) and Plavix (clopidogrel)
• Oral corticosteroids, including prednisone
• Other NSAIDs, including aspirin, Aleve (naproxen), and Celebrex (celecoxib)
• Selective serotonin reuptake inhibitors, including Prozac (fluoxetine) and Zoloft (sertraline)
• Serotonin-norepinephrine reuptake inhibitors, including Effexor (venlafaxine) and Cymbalta (duloxetine)
  

Ibuprofen can also cause drowsiness, dizziness, and blurred vision in some people. In these individuals, ibuprofen may amplify the effects of alcohol, leading to increased sleepiness, loss of coordination, and slowed reaction times.

Summary

Mixing ibuprofen and alcohol can lead to serious side effects, including GI bleeding, kidney damage, and liver problems. There are also drug interactions associated with ibuprofen and alcohol that can cause an additive effect.

A Word From Verywell

Whether you can drink alcohol while taking ibuprofen depends on various factors like your age, general health, and your medical history.

If alcohol is consumed in moderation—no more than one drink per day for assigned females and two drinks per day for assigned males—you will likely be OK if you take an occasional ibuprofen. The same may not apply if you take ibuprofen regularly or in high doses.

If in doubt, it's best to avoid mixing ibuprofen and alcohol together. Better yet, speak with your healthcare provider about the amount of ibuprofen and alcohol you consume. Your healthcare provider can help you assess your actual risk so that you are not placed in harm's way.