Unknown safety and efficacy of alcohol hangover treatments puts consumers at risk

It is important that hangover products are both safe and effective. The aims of the current study were to evaluate (a) the ingredients of currently marketed hangover treatments, (b) whether companies make disease modification claims for these products, and (c) the extent and quality of any independent scientific evidence on their efficacy and safety. Of eighty-two hangover products identified, the most common ingredients were vitamin B, vitamin C, milk thistle extract (silymarin), dihydromyricetin (DHM), and N-acetyl L-cysteine (NAC), often in combination. Fifty-one products (62.2% of the 82 evaluated products) contained one or more vitamins of which the dose exceeded the corresponding daily recommended intake level. For 9 (28.1%) of 32 products that reported the dose of Vitamin B3 and 2 (8.0%) of 25 products that reported the dose of Vitamin B9 the corresponding tolerable upper intake level was exceeded. Further, in many other cases the dose of other ingredients was not reported (e.g., dosages of DHM and NAC were not reported by 59% and 73% of the products containing these ingredients), and corresponding tolerable upper limits are unknown. A review of scientific literature revealed no peer-reviewed human data demonstrating either safety or efficacy of any of the 82 evaluated hangover products. Further, the product name and/or package/insert included explicit disease modification claims in 64.6% of the products. Finally, 45.1% of the products contain NAC as an ingredient. As NAC is registered as a drug by the US Food and Drug Administration (FDA), it is prohibited as an ingredient in dietary supplements or foods. We conclude that, in the interest of consumers, independent research supporting the safety and efficacy of hangover treatments should be a minimum requirement for hangover treatment claims irrespective whether the products are registered as medicinal drugs or dietary supplements.