The 10% alcohol in this is less concerning than the absolute quantity of acetaminophen in the bottle. Acute co-ingestion of APAP and alcohol isn’t especially dangerous. Alcohol and APAP both deplete liver stores of glutathione, which one’s body uses to neutralize toxic metabolites of both substances as you mentioned. Chronic co-ingestion can cause fulminant liver failure pretty suddenly, as can acute co-ingestion of both substances in large enough quantities.
Some people are able to take what should be lethal doses of acetaminophen for prolonged periods of time with no issues, other people are uniquely susceptible to the toxic effects. The only way to find out which camp you’re in is if you end up with liver damage!
Ibuprofen has its own risks and is not nearly as benign as it’s made out to be. It won’t cause acute liver failure but taken at usual doses for long enough will give you an ulcer and utterly shred your kidneys. People who are hypocoagulable (on blood thinners/various psych meds or have an inborn or acquired bleeding disorder) shouldn’t or can’t take NSAIDs. They’re contraindicated in kidney failure, too.
All that to say the ease with which one can acquire lethal amounts of OTC painkillers in North America is a problem! If this were a saner country this wouldn’t be on the market, APAP wouldn’t be available in any combination products, and there would be quantity limits on how much you could buy at a time.
I’ve had the displeasure of almost needing a liver transplant from acetaminophen poisoning. Two weeks in the ICU in indescribable pain, then my liver decided it was fine, actually. I recovered with my factory liver intact and no sequelae but it’s not worth risking, ever.
The 10% alcohol in this is less concerning than the absolute quantity of acetaminophen in the bottle. Acute co-ingestion of APAP and alcohol isn’t especially dangerous. Alcohol and APAP both deplete liver stores of glutathione, which one’s body uses to neutralize toxic metabolites of both substances as you mentioned. Chronic co-ingestion can cause fulminant liver failure pretty suddenly, as can acute co-ingestion of both substances in large enough quantities.
Some people are able to take what should be lethal doses of acetaminophen for prolonged periods of time with no issues, other people are uniquely susceptible to the toxic effects. The only way to find out which camp you’re in is if you end up with liver damage!
Ibuprofen has its own risks and is not nearly as benign as it’s made out to be. It won’t cause acute liver failure but taken at usual doses for long enough will give you an ulcer and utterly shred your kidneys. People who are hypocoagulable (on blood thinners/various psych meds or have an inborn or acquired bleeding disorder) shouldn’t or can’t take NSAIDs. They’re contraindicated in kidney failure, too.
All that to say the ease with which one can acquire lethal amounts of OTC painkillers in North America is a problem! If this were a saner country this wouldn’t be on the market, APAP wouldn’t be available in any combination products, and there would be quantity limits on how much you could buy at a time.
I’ve had the displeasure of almost needing a liver transplant from acetaminophen poisoning. Two weeks in the ICU in indescribable pain, then my liver decided it was fine, actually. I recovered with my factory liver intact and no sequelae but it’s not worth risking, ever.