If I need to take a painkiller but I've had some alcohol to drink, should I pick: Tylenol, Aspirin or Advil?

Let's address the types of pain relievers separately.

Even if you haven't had any alcohol to drink, certain medications called NSAIDs (Non-Steroidal Anti-Inflammatory Drugs), which include Ibuprofen (Advil) and Naproxen Sodium (Aleve), can have side effects on their own, such as stomach, esophageal and intestinal ulcers, and stomach bleeding, especially when taken on an empty stomach. NSAIDs can also cause liver damage.

Since alcohol is an irritant to the lining of the gastrointestinal tract, when you mix alcohol with these drugs, the risk of getting gastric ulcers or experiencing bleeding of the gastrointestinal tract increases significantly. You also greatly increase your risk of experiencing inflammation of the esophagus (esophagitis) and stomach (gastritis), gastric cancer and even perforation (tearing) of the stomach or esophagus.

Both NSAIDs and alcohol can cause liver damage, so combining the two greatly increases your chance of severe liver damage and developing liver disease. And since women tend to be more sensitive to the effects of alcohol, they are also more susceptible to liver damage.

Asprin thins your blood, and the risks of combining it with alcohol are similar to NSAIDs, particularly with regard to causing bleeding of the gastrointestinal tract.

Even without alcohol, acetaminophen (Tylenol) too has its own negative side effects. Acetaminophen generally impacts the liver more than NSAIDs, and particularly if you take it frequently, it can cause liver toxicity. The medicine is also known to potentially cause minimal kidney problems. Taking acetaminophen with alcohol increases the risk of liver toxicity and kidney damage.

So, in short, each type of painkiller has its own negative side effects that can be very serious when combining the drug with alcohol. Since each person's body reacts the medicine differently, there is no one painkiller that is safer for people to take with alcohol. When dealing with pain, it's important to consult your physician or health care provider to discuss the best treatment.

Please also be aware that the negative side effects I've listed are the main ones that can likely be made worse when combining these medicines with alcohol. But each medicine has other potential negative side effects, which can occur when the medicine is taken on its own or with alcohol, so refer to the product labeling and discuss medications with your physician before taking them.

I'd recommend drinking plenty of water to help flush the alcohol out of the body and wait several hours before taking a conventional pain killer medication. In the meantime, try to find alternative ways to manage any pain you might be experiencing (for example, if you're having menstrual cramps, use a hot water bottle until the alcohol wears off in your system).