What is better to take ibuprofen or tylenol

Over-the-counter painkillers have earned their spot in your medicine cabinet. You reach for them to lower a fever, banish a headache or ease those monthly cramps.

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Both acetaminophen (such as Tylenol®) and ibuprofen (Advil® or Motrin®) are used to treat fevers and pain. But they’re not exactly interchangeable. Which should you choose? Here family medicine specialist Matthew Goldman, MD, discusses what you should know about which med makes the most sense for your aches and pains.

Ibuprofen basics

Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID). As the name suggests, it tends to be most helpful for discomfort that goes hand in hand with inflammation, which can include redness, swelling, heat, pain and/or loss of function at the site or source. That makes it a smart pick for pain such as:

• Back and neck pain.
• Earache.
• Menstrual cramps.
• Muscle sprains and strains.
• Sinus infections.
• Toothache.

Acetaminophen basics

Acetaminophen is a type of drug called an analgesic. Translation: It reduces pain signals within the nervous system and not at the site itself. That makes it a good choice for pain such as:

• Headaches.
• Joint pain/arthritis.
• Sore throat.

Pain medication side effects

Both acetaminophen and ibuprofen carry a risk of side effects, so follow the dosage info on the labels. Here’s what to look out for when you’re taking these painkillers.

Ibuprofen side effects

Common side effects of ibuprofen include:

• Constipation.
• Heartburn.
• Nausea.
• Stomach pain (so it’s important to take with food).

Taking ibuprofen for a long time or at high doses can also increase the risk of more serious side effects, such as:

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• Blood clots.
• Heart attack.
• Kidney damage.
• Stomach bleeding (ulcers).
• Stroke.

Acetaminophen side effects

Side effects of acetaminophen are minimal, but some people experience problems including:

• Nausea.
• Vomiting.
• Headache.

Ibuprofen is metabolized by the kidneys and therefore is not a great option for those with kidney issues. Acetaminophen is metabolized by the liver and is not a great option for those with liver issues. For those who have neither kidney nor liver issues, sometimes we alternate acetaminophen and ibuprofen to avoid overdosing as well as attacking pain and inflammation from two different approaches.

Acetaminophen can also be hiding in several over-the-counter medicines, including cough and cold medications. If you’re taking more than one medication, read drug labels carefully so that you don’t go over the recommended dosage. For example, it may not be safe to take cold medicine and Tylenol at the same time.

Which painkiller should you pick?

So which pain med reigns supreme? While there’s no right answer, these pointers can help you decide.

Fever

Most research suggest acetaminophen and ibuprofen have similar results in controlling fevers, so pick what works for you.

Stomach trouble

If you have a sensitive stomach or find that ibuprofen causes heartburn or nausea, give acetaminophen a whirl.

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Period pains

Ibuprofen reduces your body’s production of prostaglandins. These are the chemicals that trigger the uterus to contract and start periods each month. Ibuprofen can ease menstrual cramps and may also make menstrual bleeding lighter.

Other meds

Both ibuprofen and acetaminophen can interact negatively with some prescription and over-the-counter drugs. If you’re taking medication, talk to your provider doctor or pharmacist before reaching for the painkillers.

Persistent pain

If you’re taking painkillers over several days, consider alternating ibuprofen and acetaminophen to lower the risk of side effects.

Kids

Both ibuprofen and acetaminophen can control pain in kids. But ibuprofen tends to work better as a fever reducer. Be sure to follow the dosage guidelines on the label for your little one’s age and weight.

What’s the takeaway? When used responsibly, ibuprofen and acetaminophen are safe choices for turning down the dial on fever and pain. And isn’t it good to have options?

Advil (ibuprofen) and Tylenol (acetaminophen) are two of the most commonly used pain relievers. They share some similar features, but have several key differences.

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You’re standing in your local pharmacy or in the medicine aisle of your neighborhood grocery store, and you’re hurting. Maybe you have a headache or twisted your ankle during your morning workout. Whatever the case may be, you need some relief.

You scan the rows of medications. There are boxes and bottles; tablets and capsules. Which one do you choose? Which one is safest? Aren’t they all the same?

With so many different options and types of medication, a seemingly simple choice can get complicated quickly. Two common options for pain relief are Advil (ibuprofen) and Tylenol (acetaminophen). But how do you pick between these over-the-counter (OTC) medications?

Let’s take a look at Advil and Tylenol and learn how they compare.

Are Advil (ibuprofen) and Tylenol (acetaminophen) the same thing? 

No. Advil and Tylenol are often used to treat similar conditions, such as fever and mild to moderate pain. But they are two different medications.

The active ingredient in Advil is ibuprofen. It belongs to a group of medications known as non-steroidal anti-inflammatory drugs (NSAIDs). Ibuprofen is also sold under the brand name Motrin.

The active ingredient in Tylenol is acetaminophen. Acetaminophen (often abbreviated APAP) is a non-opioid pain reliever and fever reducer.

While these two medications can treat many of the same conditions, the way they work in the body is what makes them different.

What is the difference between Advil (ibuprofen) and Tylenol (acetaminophen)?

The main difference between Advil and Tylenol is how they work in the body to relieve pain or lower a fever. Both medications affect an inflammation (swelling) pathway in the body, known as the cyclooxygenase (COX) pathway. The COX pathway helps create substances that play a role in fevers, pain, and swelling. There are two main COX enzymes (proteins) we’ll mention in this article: COX-1 and COX-2.

NSAIDs, such as Advil, work to relieve fever, pain, and swelling by blocking the actions of COX-1 and COX-2 all over the body. Advil’s effects on the COX pathway are direct.

The way Tylenol works isn’t fully understood. It’s thought to affect the COX pathway as well. But Tylenol doesn’t directly block the COX-1 or COX-2 enzymes like Advil. This is a key difference when we start talking about side effects below. 

Another important difference is Tylenol works more in the central nervous system (brain and spinal cord). It doesn’t work as much in the peripheral nervous system (nerves outside the brain and spinal cord). Tylenol also doesn’t help much with inflammation.

Maximum doses of Advil (ibuprofen) and Tylenol (acetaminophen)

How much medication you can take in a day is another difference between Tylenol and Advil.

The maximum recommended daily amount of Tylenol is 4,000 mg for most adults. But older adults, children, and people with certain health conditions may be advised to take less than this. It’s best to double check with your healthcare provider on the safest dose for you to take.

The maximum recommended daily amount of OTC Advil for most adults is 1,200 mg. A healthcare provider can prescribe larger doses of Advil for certain health conditions, such as rheumatoid arthritis. But you should never take higher doses of this medication without your provider’s OK.

Side effects of Advil (ibuprofen) and Tylenol (acetaminophen)

Just because Advil and Tylenol are available without a prescription doesn’t mean they are without risks. But most people tolerate both pain relievers well with occasional use at recommended doses.

Common Advil side effects include stomach upset, dizziness, and heartburn. Side effects aren’t common for most people taking Tylenol. If you experience side effects from Tylenol, you should contact your healthcare provider.

Which is harder on your stomach, Advil or Tylenol?

Advil is harder on the stomach than Tylenol. As mentioned above, the COX pathway is the major target for both Advil and Tylenol. But Advil directly affects the COX enzymes.

COX-1 and COX-2 enzymes are present all over your body, including the lining of your stomach. Although both enzymes are present in your stomach, COX-1 is more plentiful. COX-1 is also associated with maintaining the stomach’s protective lining.

When NSAIDs, like Advil, block COX-1 in the stomach, it can weaken this protective lining. This can raise the risk for stomach ulcers and bleeding.

To help lower the impact of Advil on the stomach, you should eat before taking the medication. It doesn’t have to be a full meal — just a small snack or some crackers.

Which is worse for your liver, Advil or Tylenol?

Tylenol is harder on the liver. Because Tylenol is broken down by the liver, there’s a risk of it causing liver damage. In fact, Tylenol accounts for almost half of all acute (sudden) liver failures in the U.S. 

Most of these liver injuries are caused in one of two ways: 

1. People take more acetaminophen than is recommended. This could be because a person thinks the recommended dose isn’t working well enough.

2. People take too much acetaminophen without realizing it.

It’s easy to take too much Tylenol by accident. Many OTC and prescription medications combine acetaminophen (Tylenol’s main ingredient) with other medications. Be sure to check the label on combination cough and cold medications for this ingredient. Acetaminophen can also be combined with many prescription pain medications, such as opioids and some migraine medications.

It’s important to include acetaminophen from all sources when figuring out how much you’re taking per day. Remember: 4,000 mg is the most anyone should take per day. 

Is Advil or Tylenol worse for your kidneys?

Advil is worse for the kidneys. We mentioned earlier that COX-1 is found in the stomach’s protective lining. COX-1 is also involved in how the kidneys work to make urine. This helps get rid of waste from the body.

When Advil blocks COX-1 enzymes, it can lower blood flow to the kidneys. This makes it harder for the kidneys to do their job.

People who already have kidney problems should be careful using NSAIDs like Advil. This is especially important if you also take other medications that are hard on the kidneys, like lisinopril (Prinivil, Zestril) or furosemide (Lasix).

Tylenol is safer for your kidneys. It’s broken down by the liver so the risk to the kidneys is low.

When should I stop taking Advil or Tylenol?

The first scenario for when you should stop taking Advil or Tylenol is probably the most common. If your fever, pain, or swelling has gone away, you can stop taking the medication.

The second situation would be if you start experiencing any excessive or bothersome side effects. If this happens, stop taking the medication and contact your healthcare provider. They’ll let you know what steps you should take next.

But what if the fever, pain, or swelling doesn’t go away? While every situation is unique, it’s a good idea to have a plan in mind if things don’t get better or start getting worse. 

For OTC Advil, it’s recommended to only take it for pain relief for up to 10 days or for fever up to 3 days. If you’re not feeling better after then, it’s time to see your healthcare provider. Likewise, if your symptoms get worse while taking Advil, contact your provider.

For Tylenol, the length of time is the same for adults (10 days for pain, 3 days for fever). But for children under 12 years old, Tylenol should only be used for pain for 5 days. After that time or if symptoms get worse, contact a healthcare provider.

Is it bad to mix Advil and Tylenol?

No, this combination isn’t bad. Because Advil and Tylenol work and are broken down differently in the body, they can be used together. To help limit side effects and stay within recommended dose limits, healthcare providers often recommend rotating which pain reliever you take next.

For example, your first dose of medication might be Tylenol. When you’re due for your next dose, you’d take Advil instead of Tylenol. Your third dose would be with Tylenol again. You would continue this pattern until your symptoms resolve or until you felt it necessary to get additional medical care.

The bottom line

Both Advil and Tylenol are pain relievers available without a prescription. Both these medications work to relieve pain and fever. They provide similar effects but are two different medications with two different ingredients. Advil can be harder on the stomach and kidneys, while Tylenol is harder on the liver.

Overall, Advil and Tylenol are safe for most people when used correctly. Be sure to read the labels of all your medications to make sure you’re not taking too much of either. If you have to take them for longer than a few days, it’s a good idea to follow up with your healthcare provider.

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