Both alcohol and paracetamol (acetaminophen) are processed by the liver. At recommended doses and with light, occasional alcohol use, most healthy people tolerate the combination without harm. The concern is the combination of higher paracetamol doses with heavy or chronic drinking, which can significantly increase the risk of serious liver injury.
If you regularly drink alcohol, have liver disease, or are malnourished, you are more vulnerable to paracetamol-related liver harm even at standard doses, so talk to a pharmacist or doctor about what is safe for you. Never take more than the labelled maximum amount in 24 hours.
Seek urgent medical care if, after taking paracetamol, you develop nausea and vomiting, pain in the upper right abdomen, yellowing of the skin or eyes, or confusion. A suspected paracetamol overdose is an emergency even if you feel well at first, because liver damage can be delayed.