And Now a Word from a Concerned Commenter


I will correct this: Ibuprofen DOES NOT harm the liver. Ibuprofen (and the related naproxen) are nasty to your stomach and small intestine.

Tylenol is the liver toxic drug. Very toxic. And tylenol is in all sorts of crap, unannounced. (Like cold medicines, headache drinks, etc, etc). Alcohol + tylenol (acetomenophen) is a bad combo. Ibuprofen might make you barf, but won't kill your liver.

The 2nd year med student should study a bit more before step 1.
From everything I've heard from med students and doctor friends, tylenol is quite a bit riskier than ibuprofen. The difference between a regular dose of tylenol and an overdose is much slimmer than it is for ibuprofen, and the damage is permanent liver damage. As I understand it, the danger of ibuprofen is actually more ulcers, etc., from long term usage, rather than from specific overdoses.
@1 & 2: correctamundo!
Agreed! Crazy med student...
#1 is right. THANKS
You should never take Ibuprofen on an empty stomach. Even one cracker will be better than nothing. But it's not especially hard on the liver like Tylenol.

ps Alka Seltzer Rules (asprin + baking soda).
Given the lengths to which McNeil Labs went to keep this quiet (though everybody knew about it for years and years - wink wink), it's no surprise there's confusion about this. But it's only Tylenol, a/k/a acetominophen, which causes problems.
I don't understand why acetaminophen is legal. It's really harmful in doses just a tiny bit more than the recommended one. Yet it's the one my doctor always tries to prescribe to me (which is just a frigging scam, since I can buy it anywhere for much less than my "insurance rate" prescription).

I take aspirin and only aspirin for ordinary pain.

For hangovers, the only thing that really works is massive quantities of water and sugar, and maybe grease if your stomach is rough. If you keep drinking water/sodapop/juice as fast as you can get it down (which might not be very fast) until you start peeing every ten minutes, your hangover will piss itself out in no time. My favorite rehydrator these days is orange, grape, or strawberry sodapop. Your body desperately need that sugar too.
In addition to water and sugar, I recommend a vitamin-B rich breakfast and working out. Sweating that shit out speeds the process nicely.
I could see one situation where Ibuprofen + alcohol could be a nasty combo: if you get dehydrated. Ibuprofen (and naproxen) are tough on the kidneys. In combo with dehydration (from alcohol and/or barfing), I could see one getting a bit of acute tubular necrosis.

So, hydration. (as per fnarf). I like oral rehydration solution--such as pediolyte.
why sugar (scientifically)?
Unless you're allergic to aspirin, it's actually the best choice.

But you really really need to do the Pho thing - or any hot broth - drink plenty of liquids etc. Most of the problem is the alcohol that's still having fun in your body.
The real key, I should note, is to hydrate while drinking. You can circumvent the hangover altogether if you pace yourself right.
Dear Science, as always, has the answer.
best advice to avoid the hangover in the first place, other than drinking less, is to drink water when you get home and urinate a few times before sleeping. If you're likely to throw up, you may want to make sure there's a clean toilet or sink somewhere in your room/house/condo/apt/dorm. And sleep on your stomach, as it suggested.
My remedy: Hope
One has to Hope, it gets better, almost like how the preachers say it will be in heaven.

either that or oral retardation, I'm Not gonna be a full-on Pill Junkie!
SLOG. Because what other blog keeps a physician on call 24-7, for your safety?

As a parent, I had this fear of aspirin beat into me. I guess it's bad for children, but not adults?
How about telling us what OTC we CAN take for muscle pain or headache?
Naproxen and Aspirin are both out (the labels clearly instruct to consult a doctor before use if more than three alcoholic drinks have been consumed), to prevent "stomach bleeding."
Tylenol, aspirin, ibuprofen ,

to young people and others who never regularly need these things, they're all just headache medicine.

maybe best just to avoid them all (after drinking); they're too easy to mix up
@7 Apple Soda (the Sidral Mundet brand is available at Mexican restaurants and grocery stores with decent "ethnic" sections) is my absolute favorite sugar-water hangover beverage.
2nd yr med student better be cautious with who he gives bad medical advice, or he risks being sued by 2nd yr law student.
Eric @16: I only take ibuprofen, and have never had any problems. If you want to do aspirin instead, Bufferin really is much easler on your stomach.
I recommend a Bloody Mary.
Bufferin is really just buffered aspirin. Generics work just as well. Or you could just eat something like rice at the same time.
This is why I only take fentanyl for my hangovers. Safe, cheap and effective. Ask your doctor if fentanyl is right for you.
Pffft! I haven't had a normal functioning liver in years, and I manage to imbibe just fine without even getting headaches! HA!
Yeah, I'm pre-med and I know that's wrong. Review your p-450 enzymes, dude.
Aspirin in conjunction with a fever is correlated with Reye's Syndrome in the young (which will damage your liver, and your brain while it's at it). I'd avoid aspirin until you're, say, 21.

Of course, a hangover != fever, but if you're going to only have one pain reliever around and you're a college freshman/sophomore, I'd make it ibuprofen or naproxen.
@10 Your liver can't do it's normal glucose synthesis with alcohol on-board. So you gotta eat it or you'll feel like crap.
its, not it's...fucking iPhone
Ibuprofen is metabolized through your kidneys, not your liver. You should check your medical books before offering advice.
@1: YES that is what I thought but I don't have the credentials to speak up about it. I'm glad that this got addressed.

I'm also glad the NO TYLENOL thing got addressed. LIVER KILLER.
@7 - I've been told by friends in medicine that it's so popular because it's least likely to cause an adverse reaction. It's hell on your kidneys, but very few are allergic to it.

Last time I was prescribed hydrocodone (Vicodin, etc.), my doctor mentioned to be careful due to its high level of acetaminophen (your pills should have numbers like 10/650, which will be 10mg hydrocodone/650mg acetaminophen), which is more dangerous than the active opiate ingredient.
3 aspirin prior to bed is the best for me.

well, besides not drinking congener-laced hard liquor. but i do love red wine & cognac so...
You also should beware aspirin overdose.

Had a friend who tried to treat the flu with aspirin and bed rest alone. After several days she went to the emergency room, where a doctor asked her if she was trying to commit suicide, "You've taken nearly a leathal dose."

"Aspirin overdose or salicylism can be acute or chronic. In acute poisoning, a single large dose is taken; in chronic poisoning, higher than normal doses are taken over a period of time. Acute overdose has a mortality rate of 2%. Chronic overdose is more commonly lethal with a mortality rate of 25%; chronic overdose may be especially severe in children.[1] Symptoms may range from mild nausea and vomiting, abdominal pain, lethargy, tinnitus, and dizziness to severe such as seizure or cerebral edema depending on the dose consumed...

The acutely toxic dose of aspirin is generally considered greater than 150 mg per kg of body mass.[5] Moderate toxicity occurs at doses up to 300 mg/kg, severe toxicity occurs between 300 to 500 mg/kg, and a potentially lethal dose is greater than 500 mg/kg.[6] Chronic toxicity may occur following doses of 100 mg/kg per day for two or more days.[6]"…

The hangover cure is water, lots and lots of water. Hangovers happen because alcohol is a diuretic and using it in excess causes the body to become dehydrated. Just drink water until you feel better.
Acetaminophen is a safer drug than ibuprofen for the general public. It is certainly possible to overdose on the former but simply following the instructions on any OTC bottle will prevent that. It should be avoided in patients with liver problems but is generally safe for everyone else and has an extremely low incidence of side effects, even when taken longterm.

Ibuprofen, on the other hand, has a reasonably high potential to cause stomach irritation and even bleeding when taken as instructed. Additionally, it can be extremely dangerous to those with any renal (kidney) injury, which is a common feature of many diseases (infection, pancreatitis, diarrhea) and one that a patient may not even realize he's currently suffering from.
@36 - Sound advice, especially in the prevention phase where you're basically just diluting the poison, but not totally accurate as a cure.

Dehydration is only one component of a hangover, other symptoms, which can be caused by impurities—some additives, and some naturally occurring in the fermentation process—in the booze, and some caused by toxicity of the ethanol being metabolized.
Oops, I meant @35.
@34, huh? A typical aspirin tablet is 300 mg. You're saying that if I take a hundred of them, which is how many kg I weigh, I might have problems? Yeah, I imagine so.

Most people take rather fewer than a hundred aspirins. More like two or three.
@20 ftw.
Alka-Seltzer is my favorite cure - aspirin for my head, and sodium bicarbonate for my sour stomach.
Going to reiterate the thing with Ibuprofen and Naproxen: EAT. Even if you're taking the OTC label dose on a consistently empty stomach it'll fuck you up in less than a day - I learned that one the hard way.
I started taking aspirin for muscle/head pain at maybe 14 or so... oops? I've probably got undiagnosed brain damage.

I've never had a hangover. I use the Don Draper hangover cure: drink steadily all day and never stop.

Actually, I just make sure that I drink at least a liter of water as soon as I get home, and stay awake long enough to sober up a bit. A cup of tea to follow up that liter of water may not do anything to ward off the hangover, but it makes me feel less like the walking dead.
This is actually important stuff to tell the college students in your life, in particular because the common hangover advice that I've heard floating around campus and elsewhere is to take Tylenol before bed, every time you drink. Since alcohol plus Tylenol is a toxic combination, especially if mixed frequently, this is terrible, terrible advice.

Five glasses of water and 2-4 aspirin before going to bed has always worked for me.
When I was on chemo I was told to take only tylenol for headaches etc. Then I found out what both tylenol and chemo (and alcohol--I still drank a bit when I was on chemo) do to your liver and I was aghast.
Only aspirin forever for me.
i worry about athletes and ibuprofen. especially college and high school athletes. they eat that stuff like crazy and think they can abuse their bodies in any way they want and then just take ibuprofen for it. they call it Vitamin I.
This post and all following comments have made me paranoid. I take a lot of Ibuprofen, not because I love it, but because I love to drink red wine but my head does not.
One time my boyfriend went drinking and skipped eating dinner. The next morning his blood sugar was so low (which IIRC caused low blood pressure) that the paramedics decided they needed to rush him "lights and sirens" to the hospital. They gave him a banana bag and he was fine in a few hours. You'd think someone would market those as a hangover drink.
@27 if you have a hangover and you're not old enough to drink, then taking an aspirin still won't save your endangered liver.

Because, quite frankly - YOU are an ALCOHOLIC.
@35 for the safest win.


Urinate. Drink water. Urinate more. Then go to bed.

In the morning, repeat.
@39 normal dosage is 325 mg. baby aspirins are 81 mg. Basically a 325 mg cut in four with a buffer coat. If you take 3 aspirins that's not even 1 gram. There are 1000 grams in a kilogram (2.2 pounds), so a pound of aspirin is about 1500 aspirins. At that point, if your stomach isn't full, you are a freak.
Acetominophen is still legal for people like me, who are allergic to the NSAIDS and wouldn't have access to any kind of OTC pain medication if it weren't.

About two years ago, ibuprofen started making me break out in hives and have trouble breathing. Aspirin does it too, and my allergist tells me I probably shouldn't bother trying naproxen.

So, yeah. If I get a splitting headache, or if I sprain an ankle, or if I have severe gastritis - all of which are things that have happened to me in the last year or two - I'm going to take some Tylenol. I can steer clear of alcohol for a day or two. I'm a big boy. It's worth it. It's not perfect but it's all I've got.