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What You Need to Know about Mixing Paracetamol with Caffeine or Alcohol

Date published: 17/11/2021

Last reviewed: 17/11/2021

Last updated: 17/11/2021

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When managing your or your family’s health, including pain management, be sure to read the label and always start with a conversation with your pharmacist or doctor.

What You Need to Know about Mixing Paracetamol with Caffeine or Alcohol

Picture the scene – you’ve just brewed a nice, hot coffee and you’re about to take the first sip. Suddenly, you remember those paracetamol tablets you’d taken an hour before. Will the caffeine interact with the painkillers and make you ill?

Before using painkillers like paracetamol with caffeine, alcohol or other food or drink, the first step is to have a read of the product leaflet or a chat with your doctor. Find out if there are any foods or beverages that you should avoid when taking your medication.

As you may know, paracetamol, also known as acetaminophen, is an effective pain relief medicine often recommended as the first line of treatment for mild to moderate pain. Paracetamol is also available in a combination formulation with caffeine. It’s important to remember that paracetamol with caffeine isn’t recommended for children under twelve.¹ More suitable paracetamol formulations for children are available with dosages designed for them.

Finally, paracetamol is included in many cough and cold formulations so it’s always important to read product information to determine exactly what you taking when you purchase combination products. This will help you to avoid unintended side effects and drug interactions.

To treat it right we’ll cover all your questions about possible drink and food interactions that can have undesired side effects.

Can I Take Paracetamol with Caffeine?

We’re a nation of coffee lovers and wouldn’t swap our morning lattes for anything else! But a common question is, can I take painkillers with my coffee?

Taking paracetamol pills with coffee isn’t a problem in most cases. Keep in mind that some paracetamol tablets also contain caffeine. When used at approved doses this combination is well tolerated. In fact, adding caffeine to painkillers such as paracetamol actually enhances its pain relieving effects. ² However, studies suggest that using a combination of caffeine and paracetamol in large amounts can increase adverse effects including liver damage.

If you are used to drinking a lot of coffee a day, or regularly take painkillers to treat chronic pain, speak to your healthcare provider to find a dosage that works for you.

Taking Painkillers that Contain Paracetamol and Caffeine

You don’t need a prescription to purchase the combination of paracetamol and caffeine and can get it over the counter. This mix of active ingredients usually combines the standard 500mg of paracetamol and 65mg of caffeine. The recommended dose of this product contains about as much caffeine as a cup of coffee. Limit the use of caffeine-containing medications, foods, or beverages while taking this product because too much caffeine may cause nervousness, irritability, sleeplessness, and, occasionally, rapid heartbeat.

Caffeine is not recommended for use during pregnancy.³Keep this in mind when choosing a painkiller and have a chat with your doctor to find a suitable formulation.

Are there any side effects from taking paracetamol with caffeine with your coffee?

Drinking excessive amounts of caffeine combined with painkillers containing caffeine can lead to side effects such as⁴:

Restlessness
Anxiety
Irritability
Difficulty sleeping
Headaches
Palpitations

People with the following conditions should also chat to their doctor before taking paracetamol and caffeine:

People with kidney or liver problems
People who are under weight or malnourished
People who suffer from alcohol dependence⁵

You should not use this product if you are allergic to paracetamol, caffeine, or any other ingredients.⁶

If you’re worried you’ve consumed too much caffeine, be sure to seek medical advice immediately.

Can I Take Paracetamol with Alcohol

Many of us have experienced the need to take painkillers the morning after drinking alcohol⁷, but can paracetamol and alcohol be taken at the same time?

Mixing some medicines and alcohol can cause serious side effects, so always consult the leaflet inside your medicine’s packet to check the ingredients and possible drug interactions.

Taking Paracetamol and Alcohol Together

As a general rule, if you drink alcohol regularly you should check with your doctor before using paracetamol. You may need to avoid using the product altogether or limit consumption to avoid paracetamol and alcohol interactions.

Both alcohol and paracetamol are broken down by the liver so combining high doses of alcohol and paracetamol can cause side effects ranging from minor to severe with the possibility of fatal liver damage.⁸

Studies looking at this particular drug interaction have found the toxic effects from paracetamol in people who drink within the medically recommended amounts of alcohol daily is low, but it is important to consult your doctor before using paracetamol if you regularly drink alcohol.^{9 10}

Can I Take Painkillers like Paracetamol with Food or Milk?

Painkillers like paracetamol can be taken with our without food. In the case of paracetamol, no adverse food interactions have been documented other than with alcohol or large amounts of caffeine. ¹¹

Paracetamol can be taken with food or on an empty stomach.¹² Paracetamol is gentle on the stomach, so in this case the choice is entirely yours whether you want to take medicine with milk or food.

Whatever’s on your mind, we can put it right. Let’s treat it right.

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¹Paracetamol-Caffeine GDS (V7) – P6, accessed 23/08/2021

² Caffeine as an analgesic adjuvant, NIH, https://pubmed.ncbi.nlm.nih.gov/6366275/, accessed 02/09/2021

³Paracetamol-Caffeine GDS (V7) – P8, accessed 23/08/2021

⁴Panadol Extra, Net Doctor, https://www.netdoctor.co.uk/medicines/aches-pains/a7306/panadol-extra-paracetamol-and-caffeine/ accessed 22/06/21

⁵Paracetamol for adults, NHS, https://www.nhs.uk/medicines/paracetamol-for-adults/, accessed 23/08/2021

⁶Paracetamol-Caffeine GDS (V7) – P19, accessed 02/09/2021

⁷Hangover Cures, NHS, https://www.nhs.uk/live-well/alcohol-support/hangover-cures/ accessed 28/06/21

⁸Is it Safe to Mix Acetaminophen and Alcohol? Medical News Today, https://www.medicalnewstoday.com/articles/322813#risks accessed 22/06/21

⁹Is Acetaminophen Safe to Take When You’re Drinking?, https://health.clevelandclinic.org/is-acetaminophen-safe-to-take-when-youre-drinking/, accessed 02/09/2021

¹⁰Mixing Alcohol and Medication, Very Well Mind, https://www.verywellmind.com/mixing-alcohol-and-medication-harmful-interactions-67888, accessed 04/08/21

¹¹Precautions and Considerations when Taking Paracetamol, MyMed, https://www.mymed.com/medication/paracetamol-acetaminophen/precautions-and-considerations-when-taking-paracetamol accessed 23/06/21

¹² Paracetamol for Adults, NHS, https://www.nhs.uk/medicines/paracetamol-for-adults/ accessed 23/06/21

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