Drug & supplement interaction

Beer + Acetaminophen, Aspirin, Caffeine

Acetaminophen, Aspirin, Caffeine brand names: Excedrin Migraine, Excedrin, Excedrin Extra Strength.

Major Interaction
Medically reviewed by · Updated September 2026
The bottom line Major

Acetaminophen, Aspirin, Caffeine falls into 3 drug categories that Beer can interact with; the most serious is rated major. Concomitant use may increase the risk of gastrointestinal (GI) bleeding.

Read the full interaction report
SeverityMajor
LikelihoodProbable
Interactions3
EvidenceC
What do Severity, Likelihood & Evidence mean?
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Interaction report

Beer and Acetaminophen, Aspirin, Caffeine

These two interact in 3 distinct ways. Each one is explained separately below.

Why Are There 3 Interactions?

Beer interacts with whole categories of medication. Acetaminophen, Aspirin, Caffeine falls into 3 of those categories, so it can interact with Beer in 3 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Major).

Major

NONSTEROIDAL ANTI-INFLAMMATORY DRUGS (NSAIDs)

1 of 3

Why this applies to Acetaminophen, Aspirin, Caffeine

Acetaminophen, Aspirin, Caffeine falls under NONSTEROIDAL ANTI-INFLAMMATORY DRUGS (NSAIDs) — the group Beer interacts with.

Concomitant use may increase the risk of gastrointestinal (GI) bleeding.
Concomitant use of NSAIDs with alcohol can increase the risk of GI bleeding.
Severity Major Likelihood Probable Evidence C

Interaction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports..

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the thing about Excedrin: it contains aspirin, which is an NSAID, and aspirin can irritate the lining of your stomach. Beer adds to that problem. Alcohol on its own can wear away the stomach's protective layer, so when you mix it with aspirin, you stack two irritants together. That raises your odds of stomach bleeding, which can show up as belly pain, dark or tarry stools, vomiting that looks like coffee grounds, or feeling unusually weak and lightheaded.

There's also a second concern. The acetaminophen in Excedrin is processed by the liver, and regular drinking puts extra stress on the liver too. An occasional beer with an occasional dose is usually low risk, but pairing them often is where trouble adds up. If you take Excedrin regularly, please run it by your pharmacist or doctor.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Fraser AG. Pharmacokinetic interactions between alcohol and other drugs. Clin Pharmacokinet 1997;33:79-90. PubMed
Major

HEPATOTOXIC DRUGS

2 of 3

Acetaminophen, Aspirin, Caffeine also falls under HEPATOTOXIC DRUGS.

Concomitant use of alcohol with hepatotoxic drugs may increase the risk of hepatotoxicity.
Concomitant use of excessive amounts of alcohol with potentially hepatotoxic drugs can increase the risk of liver damage.
Severity Major Likelihood Probable Evidence B

Interaction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports..

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the part that matters most with Excedrin: it contains acetaminophen, and your liver does the heavy lifting of breaking that down. When you drink beer regularly, your liver gets pulled in two directions at once. Alcohol can shift acetaminophen's breakdown toward a byproduct that's harder on liver cells, so pairing the two raises your risk of liver injury. The aspirin in this combo can also be tougher on your stomach when alcohol is in the mix, raising the chance of stomach upset or bleeding.

This concern is strongest with heavier or daily drinking, not a rare single beer, but the safest move is to keep them apart. Watch for nausea, belly pain, yellowing skin or eyes, or unusual tiredness, and check with your pharmacist or doctor about what's right for you.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Fraser AG. Pharmacokinetic interactions between alcohol and other drugs. Clin Pharmacokinet 1997;33:79-90. PubMed
  2. Thummel, K. E., Slattery, J. T., Ro, H., Chien, J. Y., Nelson, S. D., Lown, K. E., and Watkins, P. B. Ethanol and production of the hepatotoxic metabolite of acetaminophen in healthy adults. Clin Pharmacol Ther 2000;67(6):591-599. PubMed
Moderate

ASPIRIN

3 of 3

Acetaminophen, Aspirin, Caffeine also falls under ASPIRIN.

Concomitant use may increase the risk of gastrointestinal (GI) bleeding.
Concomitant use of aspirin with alcohol can increase the risk of GI bleeding. Conversely, some clinical research suggests that beer can significantly decrease the area under the curve (AUC) and maximum plasma concentration of aspirin, indicating decreased bioavailability.
Severity Moderate Likelihood Possible Evidence B

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the main thing to know about combos like Excedrin (which mixes acetaminophen, aspirin, and caffeine) with beer: the aspirin part is what matters most. Aspirin already irritates the stomach lining and thins the blood a little, and alcohol does the same. Put them together regularly and you raise the odds of stomach upset, ulcers, and GI bleeding. Warning signs would be black or tarry stools, vomit that looks like coffee grounds, or belly pain.

There's also a wrinkle with acetaminophen: drinking heavily while taking it adds extra stress on the liver. One occasional beer with an occasional dose is usually low risk, but frequent or heavy drinking is the real concern. Please check with your pharmacist or doctor before pairing these.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Fraser AG. Pharmacokinetic interactions between alcohol and other drugs. Clin Pharmacokinet 1997;33:79-90. PubMed
  2. Odou, P., Barthelemy, C., and Robert, H. Influence of seven beverages on salicylate disposition in humans. J Clin Pharm Ther 2001;26(3):187-193. PubMed

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Beer Also Interacts With Other Medications

Beer has 653 major, 272 moderate known drug interactions in our database — the Acetaminophen, Aspirin, Caffeine one above is among them. If you take anything else, check it against the full list below.

Major 653 Moderate 272 No known interaction 1,905 (incl. Acetaminophen, Aspirin, Caffeine)
Taking anything else?

Check Another of Your Medications Against Beer

Covers the 2,830 medications we’ve checked against Beer. Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With Acetaminophen, Aspirin, Caffeine

This page covers Beer only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Acetaminophen, Aspirin, Caffeine page lists 371 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Asarabacca (major), Danshen (major), Ephedra (major) and Grapefruit (major).

By severity: 13 major · 312 moderate · 46 minor.

From our pharmacist’s overview on the Acetaminophen, Aspirin, Caffeine page

“Excedrin (acetaminophen, aspirin, and caffeine) packs three drugs into one tablet, which multiplies the ways supplements can collide with it, so treat this list with real care. Most entries involve the aspirin: hundreds of herbs add to its blood-thinning effect and raise bleeding risk, and even beer or wine earns a major rating for sto…”

Reviewed by 2 · Jul 18, 2026

Open the Acetaminophen, Aspirin, Caffeine interaction page

How much people look this up

Where Beer and Acetaminophen, Aspirin, Caffeine Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Beer
Top 25%

#319 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Acetaminophen, Aspirin, Caffeine
Top 25%

#364 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Beer

What is Beer?

Beer
  • Social and recreational drinking
  • Relaxation
  • Heart health (popular belief)
  • Bone health (popular belief)
  • Source of antioxidants and B vitamins

Beer is an alcoholic beverage that contains some minerals, B vitamins, and plant compounds from hops and grain, but it is not a health supplement. Any possible benefits come only from light-to-moderate intake, and they are easily outweighed by the well-known harms of alcohol. The safest amount of alcohol for health is none, and beer should be avoided in pregnancy and breastfeeding.

Read the full Beer monograph & all interactions
Keep checking

Other Drugs & Beer

Browse every other medication we’ve checked against Beer — both the ones with a known interaction and the ones without. Select any drug for the full detail.

653Major
272Moderate
0Minor
1,904No known interaction
653 Major 272 Moderate 1,904 No interaction
Major

653 interactions

Showing 60 of 653 major interactions — see all 653 on the Beer page.

Moderate

272 interactions

Showing 60 of 272 moderate interactions — see all 272 on the Beer page.

No interaction 1,904 drugs checked — show the list

We also checked Beer against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 1,904 medications checked with no known interaction — see the full Beer list.

See the full Beer interactions page
See every supplement checked against Acetaminophen, Aspirin, Caffeine, ranked by severity
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

Keep exploring
Beer monograph › Uses, safety, and every drug interaction in one place Acetaminophen, Aspirin, Caffeine supplement interactions › Every supplement checked against Acetaminophen, Aspirin, Caffeine, ranked by severity Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Beer and Acetaminophen, Aspirin, Caffeine Together: Common Questions

Can you take Beer with Acetaminophen, Aspirin, Caffeine?
This is rated a major interaction, so the combination is best avoided unless your doctor or pharmacist has specifically told you otherwise. Read the full details on this page and confirm with your pharmacist before combining them.
Why are there 3 interactions listed for Beer and Acetaminophen, Aspirin, Caffeine?
Acetaminophen, Aspirin, Caffeine belongs to more than one drug category, and Beer interacts with each of those categories a little differently. We list every one so nothing is missed — your overall risk is driven by the most serious of them.
How serious is the Beer and Acetaminophen, Aspirin, Caffeine interaction?
We rate it Major. This is a clinically significant combination that is generally best avoided, or used only under the direct supervision of your physician or pharmacist.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.