Can You Drink Alcohol While Taking Ibuprofen?

Side effects can be intensified by drinking alcohol

Updated on October 15, 2020

Medically reviewed by

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

Man holding a beer — Sally Anscombe / Getty Images

Ibuprofen belongs to a class of medications known as nonsteroidal anti-inflammatory drugs (NSAIDs) used mainly to relieve inflammation and pain. Ibuprofen can also help reduce fever and alleviate minor aches and pain from arthritis, menstrual periods, toothaches, backaches, and the common cold.

Ibuprofen is commonly sold over the counter under the generic name "ibuprofen" or such brand names as:

Addaprin
Advil
Cedaprin
I-Prin
Midol
Motrin
NeoProfen
Profen IB
Proprinal
Ultraprin

Ibuprofen can also be found in prescription drugs like Duexis (famotidine/ibuprofen) used to relieve arthritis pain without stomach upset.

When used a directed, ibuprofen is generally safe, albeit not for everyone. People with peptic ulcers should avoid ibuprofen.

Similarly, those who might otherwise tolerate ibuprofen may experience side effects or complications if alcohol is added to the mix.

Gastrointestinal Bleeding

Ibuprofen can irritate the digestive tract, which is why it should always be taken with food. As with other NSAIDs, ibuprofen is associated with the risk of peptic ulcer disease, particularly when overused. This can lead to gastrointestinal (GI) bleeding or perforation, sometimes serious.

Symptoms of severe GI bleeding include:

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

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 in PLoS One, alcohol potentiates the risk of GI bleeding—most especially upper gastrointestinal bleeding—in users of ibuprofen and other NSAIDs.

People over 60 who take high doses of ibuprofen or have taken ibuprofen over a long period of time are especially vulnerable. The use of blood thinners or steroids further increases the risk.

Liver Injury

Although the use of alcohol and Tylenol (acetaminophen) is most commonly linked to liver injury, NSAIDs like 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

Ibuprofen in particular is associated with the development of hepatic steatosis (fatty liver disease). The drug directly impairs mitochondria (the "powerhouses" of a cell) and makes cells less able to regulate the metabolism of lipids (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 over time.

Kidney Damage

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

The risk of ibuprofen-induce kidney injury is highest in the elderly and people with preexisting kidney disease, but may also affect extreme athletes who are prone to kidney impairment due to the rapid breakdown of muscle tissues.

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

Adding ibuprofen to the mix 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.

Drug Interactions

There are drug interactions associated with ibuprofen and alcohol, some of which overlap and affect both drugs. These include:

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)

Taking ibuprofen and alcohol with any of these drugs can have an additive effect. For instance, ibuprofen can promote GI bleeding, which alcohol can enhance the effects of blood thinners. As such, any bleeding provoked by ibuprofen can be amplified when alcohol and anticoagulant like warfarin are both added to the mix.

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.

Should You Take Ibuprofen for a Cold or Flu?

A Word From Verywell

The answer as to whether you can drink alcohol while taking ibuprofen is, "It depends." The risk depends largely on your age, general health, whether you have a history of ulcers, or whether you have preexisting liver or kidney disease.

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

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