Paracetamol and alcohol is actually not a dangerous combination at all as far as the liver is concerned. That is why there is no warning against combining the two in the information leaflet that comes with it. Paracetamol is not toxic, but its intermediate metabolite NAPQI is. The enzyme that converts paracetamol into NAPQI is the same that breaks down alcohol, and it has a higher affinity for alcohol meaning that it will be too busy working on the alcohol to turn the paracetamol into toxic NAPQI.

Long-term alcohol abusers will develop more of this enzyme, so they are more likely to get liver damage from paracetamol though.