Drug & supplement interaction

Wine + Acetaminophen, Codeine

Acetaminophen, Codeine brand names: Tylenol w/ Codeine, Tylenol No.3.

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

Acetaminophen, Codeine falls into 3 drug categories that Wine can interact with; the most serious is rated major. Concomitant use may increase sedative and other adverse effects.

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

Wine and Acetaminophen, Codeine

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

Why Are There 3 Interactions?

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

Major

CNS DEPRESSANTS

1 of 3

Why this applies to Acetaminophen, Codeine

Acetaminophen, Codeine falls under CNS DEPRESSANTS — the group Wine interacts with.

Concomitant use may increase sedative and other adverse effects.
Concomitant use of alcohol with CNS depressants can increase sedative and other adverse effects, potentially through inhibition of the metabolism of certain CNS depressants.
Severity Major Likelihood Likely Evidence C

Well-controlled human studies have demonstrated the likely existence of this interaction.

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

Mixing wine with Tylenol with Codeine is one combination I'd really steer you away from. Both alcohol and codeine slow down your brain and breathing, so putting them together doesn't just add up, it can pile on. That means more drowsiness, dizziness, confusion, and in the worst cases dangerously slow or shallow breathing. Alcohol can also slow how your body clears the sedating effects, making them feel stronger and last longer.

There's another wrinkle: this product contains acetaminophen (Tylenol), and regular drinking puts extra stress on your liver, which is the same place acetaminophen is processed. Please don't combine wine with this medicine, and talk with your pharmacist or doctor about a safe plan.

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, Codeine 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 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 main concern with Tylenol with Codeine: the acetaminophen part is hard on your liver, and so is alcohol. When you regularly drink wine and take acetaminophen, your liver has to process both, and that combination can raise your risk of liver damage. This is well agreed upon among experts, especially with heavier or daily drinking. An occasional glass with an occasional dose is a different story than nightly wine plus regular dosing.

One extra note: the codeine here is a sedative, and so is alcohol. Together they can leave you extra drowsy, foggy, or slow to breathe. To be safe, please check with your pharmacist or doctor about how much (if any) wine is okay while you're on this medication.

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
Moderate

NARCOTIC DRUGS

3 of 3

Acetaminophen, Codeine also falls under NARCOTIC DRUGS.

Concomitant use of large amounts of alcohol may decrease the metabolism of narcotic drugs.
Concomitant consumption of large amounts of alcohol can decrease the metabolism of narcotic drugs.
Severity Moderate Likelihood Possible Evidence C

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 thing with Tylenol with Codeine and wine. The codeine part is an opioid, and your body normally clears it over time. When you drink a lot of alcohol, that clearing process can slow down, so the codeine can hang around longer and hit harder. On top of that, alcohol and codeine both calm the nervous system, so together they can really pile up. That can mean heavy drowsiness, dizziness, slowed or shallow breathing, and in serious cases dangerous sedation.

There's another worry too. This product contains acetaminophen, and regularly mixing acetaminophen with alcohol is hard on the liver. The safest move is to skip the wine while you're taking this, but please 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

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

Wine Also Interacts With Other Medications

Wine has 657 major, 270 moderate known drug interactions in our database — the Acetaminophen, Codeine one above is among them. If you take anything else, check it against the full list below.

Major 657 Moderate 270 No known interaction 1,903 (incl. Acetaminophen, Codeine)
Taking anything else?

Check Another of Your Medications Against Wine

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

Everything else you take

See Every Supplement That Interacts With Acetaminophen, Codeine

This page covers Wine only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Acetaminophen, Codeine page lists 240 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: 1,4-butanediol (major), Activated Charcoal (major), Asarabacca (major), Beer (major) and Gamma-hydroxybutyrate (ghb) (major).

By severity: 9 major · 191 moderate · 40 minor.

From our pharmacist’s overview on the Acetaminophen, Codeine page

“People usually take Tylenol No. 3 (acetaminophen with codeine) for short-term pain, often while still drinking wine with dinner or reaching for an herbal sleep aid.”

Reviewed by 2 · Jul 18, 2026

Open the Acetaminophen, Codeine interaction page

One more smart check

Taking Wine as Part of a Dietary Supplement Product? Check It for Interactions

We hold 8 real supplement products containing Wine, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Wine. Your product may carry other ingredients that interact with Acetaminophen, Codeine too, on top of Wine — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Wine and Acetaminophen, Codeine 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 Wine
Top half

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

29 days ago today
Medication Acetaminophen, Codeine
Top 10%

#248 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 Wine

What is Wine?

  • Social and relaxation use
  • Heart health (popular belief)
  • Antioxidant intake
  • Aiding digestion (traditional use)
  • Culinary flavoring

Wine is an alcoholic beverage made from fermented grapes and is not a true dietary supplement or medicine. Despite popular claims about heart benefits, the alcohol it contains carries real health risks, and no amount of drinking can be recommended to improve health. If you drink, do so in moderation, and avoid alcohol entirely during pregnancy or if you have certain medical conditions.

Read the full Wine monograph & all interactions
Keep checking

Other Drugs & Wine

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

657Major
270Moderate
0Minor
1,902No known interaction
657 Major 270 Moderate 1,902 No interaction
Major

657 interactions

Showing 60 of 657 major interactions — see all 657 on the Wine page.

Moderate

270 interactions

Showing 60 of 270 moderate interactions — see all 270 on the Wine page.

No interaction 1,902 drugs checked — show the list

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

Showing the 60 most looked-up of 1,902 medications checked with no known interaction — see the full Wine list.

See the full Wine interactions page
See every supplement checked against Acetaminophen, Codeine, 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
Wine monograph › Uses, safety, and every drug interaction in one place Acetaminophen, Codeine supplement interactions › Every supplement checked against Acetaminophen, Codeine, 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 Wine and Acetaminophen, Codeine Together: Common Questions

Can you take Wine with Acetaminophen, Codeine?
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 Wine and Acetaminophen, Codeine?
Acetaminophen, Codeine belongs to more than one drug category, and Wine 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 Wine and Acetaminophen, Codeine 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

Still Have a Question About Acetaminophen, Codeine and Wine?

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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.