Aspirin is a popular over-the-counter pain reliever that many people take for headaches, toothaches, joint and muscle pain, and inflammation. Doctors also often prescribe a daily aspirin regimen to certain people, such as those with chronic coronary artery disease. Doctors may also recommend daily aspirin to reduce the chance of stroke in those who have had a transient ischemic attack or an ischemic stroke.

Aspirin is available over the counter. Taking aspirin once in a while for pain or following a daily aspirin regimen as recommended by your doctor can be beneficial to your health. But there are also several side effects associated with its use. In some cases, these side effects may worsen with alcohol consumption.

Mixing aspirin and alcohol can result in certain types of gastrointestinal distress. Aspirin can cause nausea and vomiting when mixed with alcohol. Aspirin and alcohol can also cause or worsen ulcers, heartburn, or stomach upset. These side effects are usually not serious but can cause extreme discomfort.

According to the U.S. Food and Drug Administration (FDA), people who take aspirin regularly should limit their alcohol consumption to avoid gastrointestinal bleeding. Healthy women of all ages and men over 65 years old shouldn’t have more than one drink a day. Men younger than 65 years old shouldn’t have more than two drinks a day while taking aspirin.

In most cases, if you take the recommended dose of aspirin and don’t drink more than is recommended by the FDA, gastric bleeding is temporary and not dangerous. But in some cases, especially when a person takes more than the recommended dose of aspirin and drinks more than the recommended amount of alcohol, such bleeding can be life-threatening.

For example, in one large study, researchers found that a person’s relative risk of major gastrointestinal bleeding increased by 6.3 times when they consumed 35 or more alcoholic drinks per week. That’s an average or five or more drinks consumed per day, much higher than the FDA’s recommendations.

Gastrointestinal bleeding appears as dark-red or black, tarry stools, or bright-red blood in the vomit, but it’s not always easy to see. It can result in dangerous blood loss and anemia over time. If treated promptly, though, such gastrointestinal bleeding usually doesn’t result in death.

The dose of aspirin that’s best for you depends on your health history. A very low dose of aspirin, often referred to as “baby aspirin,” is 81 milligrams. This is the most commonly prescribed amount for those who have had heart-related health incidents. A regular-strength aspirin tablet is 325 milligrams, and is more typically used for pain or inflammation.

However, no matter your aspirin dose, it’s important to stick to the FDA’s aspirin and alcohol recommendations. Those who drink while on a low dose of aspirin are still at risk of adverse side effects. This is true even if they aren’t otherwise predisposed to gastric bleeding or irritation.

There are no expert recommendations on how long you should wait between aspirin and alcohol consumption. However, research suggests it’s best to space out your aspirin and alcohol consumption as much as possible during the day. In one study, people who had taken 100 milligrams of aspirin one hour before drinking had a much higher blood alcohol concentration than people who drank the same amount but didn’t take aspirin.

If you plan on drinking in the evening, take your aspirin as soon as you wake up in the morning. This may minimize the effects, even if you’re on an extended-release medication.

Aspirin is a medication that’s used by millions, and it’s often safe when used correctly. Some people can experience side effects from aspirin such as nausea, vomiting, stomach upset, heartburn, ulcers, and gastrointestinal bleeding. When aspirin is used with alcohol, the chance of experiencing these side effects goes up. If you decide to drink alcohol while taking aspirin, it’s important to follow the FDA’s recommendations and not drink too much. Also, be sure to talk with your doctor before you drink alcohol while taking aspirin.