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Short answer: It depends on how much and how often you drink. Ibuprofen and alcohol both irritate the stomach lining, and together they raise the risk of stomach ulcers and bleeding. The warning on over-the-counter ibuprofen says the chance of severe stomach bleeding is higher if you have 3 or more alcoholic drinks every day while using it. If you drink regularly, have had ulcers, are 60 or older or take a blood thinner, ask a pharmacist or doctor before you combine them.
Ibuprofen is one of the most common pain relievers in the medicine cabinet, so it often comes up after a night out, a headache at dinner or sore muscles at a party. Here is what the official warnings and the research say about mixing it with alcohol, who should be most careful, which symptoms need care right away, and how it compares with acetaminophen.
What you'll learn
- What actually happens in your stomach when you mix ibuprofen and alcohol
- What the "3 or more drinks every day" label warning means
- Who has the highest risk of stomach bleeding
- How ibuprofen and acetaminophen differ when you have been drinking
- The warning signs of stomach bleeding that need medical care
Can you take ibuprofen with alcohol?
Ibuprofen and alcohol are not an outright forbidden mix, but they are a risky one, and the risk grows with how much you drink. The federal rule for over-the-counter pain relievers requires ibuprofen labels to carry a stomach bleeding warning, and one of the listed risk factors is having 3 or more alcoholic drinks every day while using the product (FDA, 21 CFR 201.326).
NIAAA lists ibuprofen among the common medicines that interact with alcohol, with possible reactions that include stomach upset, bleeding and ulcers (NIAAA). MedlinePlus adds that the risk of ulcers and bleeding from ibuprofen is higher for people who drink large amounts of alcohol while taking it (MedlinePlus). If you are not sure whether your drinking or your health puts you at risk, a pharmacist can check for you (NIAAA).
What happens when you mix ibuprofen and alcohol?
Both put stress on the same place: your stomach. Like alcohol, ibuprofen can increase acid release and irritate the lining of the stomach (NIAAA). NSAIDs such as ibuprofen can cause ulcers, bleeding or even holes in the esophagus, stomach or intestine at any point during use, and these problems can happen without warning symptoms (MedlinePlus).
| Concern | What it means | Source |
|---|---|---|
| Stomach irritation | Ibuprofen and alcohol both increase acid and irritate the stomach lining | NIAAA |
| Ulcers and bleeding | Listed as possible reactions when ibuprofen is mixed with alcohol | NIAAA |
| Bleeding without warning | NSAID-related bleeding can start without early symptoms | MedlinePlus |
| Liver damage | Mainly a concern with acetaminophen, not ibuprofen | NIAAA |
| Heart attack and stroke | A risk of NSAIDs other than aspirin, higher with long-term or higher-dose use | MedlinePlus |
Long-term use of NSAIDs such as aspirin and ibuprofen is one of the main causes of peptic ulcers, and avoiding alcohol is one of the steps that helps ulcers heal (MedlinePlus).
How much alcohol raises the risk with ibuprofen?
The clearest line comes from the label: 3 or more alcoholic drinks every day while using the product (FDA, 21 CFR 201.326). A US standard drink has 14 grams of alcohol (NIAAA), so a large pour of wine or a strong craft beer can count as more than one. See how much alcohol is in wine.
The research behind that warning is older and limited. In a US and Swedish study of 1,224 people hospitalized for major bleeding in the upper digestive tract and 2,945 neighbors without it, drinking alone raised the risk, to 2.8 times at 21 or more drinks a week compared with less than one (Kaufman et al., 1999). Among drinkers, regular ibuprofen use was linked to 2.7 times the risk of bleeding, while occasional use was not clearly linked (an estimate of 1.2) (Kaufman et al., 1999). The authors noted that the ibuprofen data were limited and that bleeding was most common in heavy drinkers who also used aspirin or ibuprofen (Kaufman et al., 1999). This was an observational study, so it shows links rather than proof of cause.
Who should be most careful with ibuprofen and alcohol?
The label says the chance of severe stomach bleeding is higher if you (FDA, 21 CFR 201.326):
- Are 60 or older
- Have had stomach ulcers or bleeding problems
- Take a blood thinner (anticoagulant) or a steroid drug
- Take other NSAIDs, such as aspirin or naproxen, prescription or over the counter
- Have 3 or more alcoholic drinks every day while using it
- Take more, or for longer, than the label directs
The label also says to ask a doctor before use if you have high blood pressure, heart disease, liver cirrhosis, kidney disease, asthma or a history of stroke, if you take a diuretic, or if you take aspirin for heart attack or stroke, because ibuprofen may reduce that benefit of aspirin (Drug Facts label). Older adults face a higher risk of harmful alcohol and medicine interactions in general (NIAAA). Alcohol itself can affect bleeding too; see is alcohol a blood thinner.
How long should you wait between alcohol and ibuprofen?
There is no official waiting time we can point to, so we do not give one. NIAAA notes that alcohol and medicines can interact even if they are not taken at the same time (NIAAA). If you want to take ibuprofen after drinking, or drink after taking it, ask a pharmacist, who can look at your other medicines and health history (NIAAA). For how long alcohol itself takes to clear, see how long alcohol stays in your system.
Can you take ibuprofen for a hangover?
Be cautious. NIAAA says aspirin and ibuprofen can increase acid release and irritate the stomach lining, as alcohol does, and advises caution when using these medicines before or after drinking (NIAAA). No hangover remedy has been proven to work, and only time lets the body recover (NIAAA).
If your stomach already feels raw after drinking, adding ibuprofen can make that worse. The label says to take it with food or milk if stomach upset occurs (Drug Facts label). For what helps your body recover, see how long a hangover lasts and what to eat for a hangover.
Is ibuprofen or acetaminophen safer with alcohol?
Neither is risk-free; they carry different risks. Ibuprofen's main alcohol-related risk is stomach bleeding (FDA, 21 CFR 201.326). Acetaminophen's is the liver: its label warns that severe liver damage may occur if you have 3 or more alcoholic drinks every day while using it (FDA, 21 CFR 201.326), and NIAAA notes that the combination can be toxic to the liver (NIAAA).
Which one fits you depends on your stomach, liver, heart and kidney health and your other medicines, so this is a good question for a pharmacist. If you drink heavily, read more about alcohol and liver disease.
What are the warning signs of stomach bleeding?
Stop using ibuprofen and ask a doctor if you feel faint, vomit blood, have bloody or black stools, or have stomach pain that does not get better (Drug Facts label).
Call 911 or go to the nearest emergency room if you have black, tarry stools, a lot of blood in your stool, vomit blood or material that looks like coffee grounds, feel lightheaded or dizzy from bleeding, or have chest pain or trouble breathing (MedlinePlus). If someone has taken more ibuprofen than directed, get medical help or contact Poison Control right away at 1-800-222-1222 (Drug Facts label).
When should you talk to a doctor or pharmacist?
Before you take it, not after a problem starts. Check with a pharmacist or doctor first if you drink most days, have had an ulcer or stomach bleeding, take blood thinners, steroids, other pain relievers or a diuretic, or have heart, kidney or liver disease (FDA, 21 CFR 201.326) (Drug Facts label). Also check in if you need a pain reliever often after drinking, since needing one regularly is a reason to look at both the pain and the drinking (NIAAA).
Common myths (quick reality check)
Myth: Taking ibuprofen before drinking prevents a hangover. Reality: No hangover remedy has been proven to work, and NIAAA advises caution with ibuprofen before or after drinking because both irritate the stomach (NIAAA).
Myth: Ibuprofen is easy on the liver, so it is fine with any amount of alcohol. Reality: Liver damage is mainly an acetaminophen concern, but ibuprofen carries its own stomach bleeding warning for people who have 3 or more drinks a day (FDA, 21 CFR 201.326).
Myth: If your stomach feels fine, there is no bleeding. Reality: Ulcers and bleeding from NSAIDs can happen without warning symptoms (MedlinePlus).
Frequently asked questions (FAQ)
Can you take ibuprofen with alcohol in your system?
Alcohol and ibuprofen can interact even when they are not taken at the same time. If you drink regularly or have stomach, heart, kidney or liver problems, ask a pharmacist first.
Can you take Advil with alcohol?
Advil and Motrin are brand names for ibuprofen, so the same stomach bleeding warning applies. The risk is higher with 3 or more drinks a day.
Is taking ibuprofen with alcohol one time dangerous?
In one older study, occasional ibuprofen use among drinkers was not clearly linked to stomach bleeding, but that does not make it risk-free. Both can upset the stomach, and some people have extra risk factors.
Can you take ibuprofen after drinking before bed?
Use caution. Ibuprofen and alcohol both irritate the stomach lining, and no pill has been proven to prevent a hangover.
Does ibuprofen with alcohol damage your liver?
Liver damage is mainly linked to acetaminophen with alcohol. The main concern with ibuprofen and alcohol is the stomach: ulcers and bleeding.
Can you take aspirin or naproxen with alcohol?
Aspirin and naproxen are also NSAIDs and carry the same stomach bleeding warning, including for people who have 3 or more drinks a day.
What should I do if I already mixed ibuprofen and alcohol?
Watch for black or bloody stools, vomiting blood or material that looks like coffee grounds, fainting or stomach pain that does not go away, and get medical care right away if any appear.
Related guides
- Is alcohol a blood thinner?
- How long does a hangover last?
- Best food for a hangover
- How long does alcohol stay in your system?
- Alcohol and liver disease
- Why do I get diarrhea after drinking?
- Does alcohol kill brain cells?
- Why do Asians get Asian flush?
Disclaimer and when to seek help
This article is for general education and is not medical advice. These statements have not been evaluated by the Food and Drug Administration. Our products are not intended to diagnose, treat, cure, or prevent any disease. Always read and follow the Drug Facts label. Talk to a pharmacist or doctor before combining any medicine with alcohol, especially if you have stomach, heart, kidney or liver problems or take other medicines. Call 911 for signs of serious bleeding.
References
- Kaufman DW, et al. "The risk of acute major upper gastrointestinal bleeding among users of aspirin and ibuprofen at various levels of alcohol consumption." American Journal of Gastroenterology, 1999;94(11):3189-3196. doi:10.1111/j.1572-0241.1999.01517.x
- US Food and Drug Administration. 21 CFR 201.326: Over-the-counter drug products containing internal analgesic/antipyretic active ingredients; required warnings and other labeling
- DailyMed, US National Library of Medicine. Ibuprofen 200 mg coated tablet: Drug Facts label
- MedlinePlus Drug Information. "Ibuprofen"
- National Institute on Alcohol Abuse and Alcoholism. "Harmful Interactions: Mixing Alcohol With Medicines"
- National Institute on Alcohol Abuse and Alcoholism. "Hangovers"
- MedlinePlus Medical Encyclopedia. "Gastrointestinal bleeding"
- MedlinePlus. "Peptic Ulcer"
- National Institute on Alcohol Abuse and Alcoholism. "What Is A Standard Drink?"
