Occasionally taking the recommended dose of ibuprofen with alcohol typically isn’t a cause for concern. But regularly doing so can take a toll on your stomach and kidneys.

Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID). This medication is designed to relieve pain, swelling, and fever. It’s sold under a variety of brand names, such as Advil, Midol, and Motrin. This drug is sold over the counter (OTC). That means it doesn’t require a doctor’s prescription. However, some prescription-strength medications may also contain ibuprofen.

When you have pain, you may need to reach only as far as your medicine cabinet for a pill. Be careful not to mistake convenience for safety. OTC drugs such as ibuprofen may be available without a prescription, but they’re still strong medications. They come with the risk of harmful side effects, especially if you don’t take them correctly. That means you’ll want to think twice before you take ibuprofen with a glass of wine or a cocktail.

Read more: Best ways to manage your pain, including exercise, relaxation, and massage »

The fact is, mixing medication with alcohol can be dangerous to your health. Alcohol can interfere with some drugs, making them less effective. Alcohol can also intensify the side effects of some medications. This second interaction is what can happen when you mix ibuprofen and alcohol.

In most cases, consuming a small amount of alcohol while taking ibuprofen is not harmful. However, taking more than the recommended dosage of ibuprofen or drinking a lot of alcohol raises your risk of serious problems significantly.

Gastrointestinal bleeding

One study of 1,224 participants showed that regular use of ibuprofen raised the risk of stomach and intestinal bleeding in people who consumed alcohol. People who drank alcohol but only used ibuprofen occasionally did not have this increased risk.

If you have any signs of stomach problems, call your doctor right away. Symptoms of this problem can include:

Kidney damage

Long-term use of ibuprofen can also damage your kidneys. Alcohol use can harm your kidneys, too. Using ibuprofen and alcohol together can greatly increase your risk of kidney problems.

Symptoms of kidney issues can include:

Decreased alertness

Ibuprofen causes your pain to go away, which can make you relax. Alcohol also causes you to relax. Together, these two drugs raise your risk of not paying attention while driving, slowed reaction times, and falling asleep. Drinking alcohol and driving is never a good idea. If you drink while taking ibuprofen, you definitely should not drive.

If you use ibuprofen for long-term treatment, check with your doctor before you have a drink. Your doctor will let you know if it’s safe to drink from time to time based on your risk factors. If you take ibuprofen only on occasion, it may be safe for you to drink in moderation. Know that having even one drink while you’re taking ibuprofen may upset your stomach, though.

Ibuprofen can irritate the lining of your stomach. This can lead to a gastric or intestinal perforation, which can be fatal (cause death). If you take ibuprofen, you should take the lowest dosage needed to ease your symptoms. You should not take the drug for longer than you need to, either. Following these precautions can lower your risk of side effects.

Learn more: Gastrointestinal perforation causes, symptoms, and diagnosis »

According to the ibuprofen drug facts label, the risk of stomach bleeding is greater if you:

  • are older than 60 years
  • take a high dosage of ibuprofen
  • use the drug long-term
  • take blood thinning drugs or steroid drugs
  • have had stomach bleeding problems in the past

Besides stomach bleeding, other possible side effects of ibuprofen include:

If you have asthma, ibuprofen can make your asthma symptoms worse. High doses or long-term use of ibuprofen may also lead to kidney failure, heart attack, or stroke.

If you breastfeed or take other prescription or over-the-counter medications, ask your doctor if it’s safe to take ibuprofen. Using ibuprofen during pregnancy may harm your unborn baby. Make sure you read the entire label before taking the drug.

Taking ibuprofen from time to time while drinking in moderation may be safe for you. But before you decide to combine alcohol with ibuprofen, think of your health and understand your risk of problems. If you’re still concerned or unsure about drinking while taking ibuprofen, talk to your doctor.