Advil (Ibuprofen) vs. Tylenol (Acetaminophen) (2024)

Both Advil (ibuprofen) and Tylenol (acetaminophen) are over-the-counter (OTC) medications that can help reduce pain and lower fever. However, they differ in how they work and how they affect the body.

Ibuprofen, the active ingredient in the brand-name product Advil, is a nonsteroidal anti-inflammatory drug (NSAID) that helps reduce inflammation and pain. Acetaminophen (marketed under the brand name Tylenol) is also a pain reliever. However, unlike ibuprofen, it does not work as an anti-inflammatory and will not reduce swelling.

Determining which medication you should use depends on your needs and any underlying health problems.

This article will cover the similarities and differences between Advil and Tylenol and how to decide which is right for you.

Advil (Ibuprofen) vs. Tylenol (Acetaminophen) (1)

Advil vs. Tylenol: How Are They Different?

Unlike Advil, Tylenol isn't an NSAID, but it does also have analgesic (pain-relieving) and antipyretic (fever-reducing) effects. Although both can temporarily relieve pain and reduce fever, Advil can also help reduce inflammation, including swelling, which Tylenol cannot do.

This is due to the difference in the way Advil works in the body, where it can decrease prostaglandin production by blocking the activity of the enzymes (proteins) cyclooxygenase (COX) 1 and 2.

When prostaglandin production is reduced, it causes the body to have less of a response to pain and it can decrease swelling. For certain disease states like the painful arthritis condition gout, in which swelling can play a serious role in the amount of pain and discomfort, NSAIDs like Advil may be a better choice.

The way Tylenol works is not fully understood. It is thought to act on receptors in the brain and spinal cord that are responsible for processing pain. It also controls temperature by cooling the body to lower a fever.

Is Tylenol (Acetaminophen) an NSAID?

Uses of Advil vs. Tylenol

The Food and Drug Administration (FDA) approved Advil and Tylenol for the following uses:

  • Dysmenorrhea (a painful period)
  • Acute treatment for headaches (taken at the onset of headache symptoms)
  • Minor pain, such as with backaches, toothaches, and general muscle aches
  • Fever reduction

However, unlike Tylenol, Advil can also be used as an anti-inflammatory. Compared with Tylenol, Advil may be better suited for swelling, such as with a sprained ankle, a gout flare-up, or arthritis.

Off-label uses of Advil include:

  • Abnormal uterine bleeding (more bleeding from a period than usual, only used if other treatments are unavailable or not well-tolerated)
  • Gout (used when a flare-up is first noticed)
  • Pericarditis (swelling of the tissue around the heart)

Tylenol is recommended over Advil for treating fever or short-term pain in pregnant people. However, make sure you speak to your healthcare provider before taking Tylenol, as they will need to review your health history before making a recommendation.

Which Is Safer: Advil or Tylenol?

Both Advil and Tylenol are generally considered safe when taken as directed. However, certain risks are present with each medication. Some people may need to avoid taking them altogether.

Side Effects

Side effects of Advil can include:

  • Stomach cramping
  • Skin rash
  • Dizziness
  • Headache
  • Edema (fluid buildup that causes swelling in the legs or face)

Tylenol can cause severe liver damage if taken improperly (too high of a dose) and must be taken as recommended.

Rarely, some people can have allergic skin reactions to Tylenol, which can cause symptoms such as:

  • Skin reddening
  • Blisters
  • Rash

Serious side effects of Advil include:

  • Stomach or intestinal bleeding orulcers
  • Gastrointestinal perforation (tearing of the intestinal tract)
  • The development or worsening of high blood pressure and heart failure
  • The development of an acute kidney injury
  • Liver problems
  • Low levels of hemoglobin (a protein found in the blood)

Factors that can worsen your risk of developing these side effects include:

  • Age 65 or older
  • Taking higher doses
  • Using Advil longer than recommended
  • Use of a blood thinner (anticoagulant) or steroid drug
  • Taking other NSAIDs
  • Previous history of stomach ulcers or bleeding

If you are pregnant, discuss with your healthcare provider if you can use Advil, as there is a risk of harm to the fetus if taking it at 20 weeks or later in pregnancy.

Effects on the Stomach

Ibuprofen contains a warning on the label indicating an increased risk of stomach or intestinal bleeding, especially if you are over 65 and have been diagnosed with peptic ulcer disease (PUD) or have another condition that puts you at risk of bleeding.

Other serious side effects of Advil include:

  • Ulcers
  • Gastrointestinal perforation (tearing of the intestinal tract)

Effects on the Liver

Serious side effects of Tylenol include liver toxicity when Tylenol is taken at too high a dosage or if you have preexisting liver conditions. In this case, the maximum amount you take should be lowered.

Effects of ibuprofen on the liver are rare but may includeliver disorder, abnormal liver function, hepatitis, and jaundice, and usually occur at higher than recommended over-the-counter (OTC) doses.

Effects on the Kidneys

Heavy or long-term use of some pain relievers, including Advil and Tylenol, can cause chronic kidney disease known as chronic interstitial nephritis. The warning labels tell you not to use Advil for more than l0 days for pain and more than three days for fever. If you have pain and/or fever for a longer time, you should talk to your healthcare provider.

Effects on the Heart

You should not take NSAIDs right before or after coronary artery bypass graft (CABG) surgery, also known as heart bypass surgery. There is also a label warning of increased risk of cardiovascular events, such as a heart attack or stroke, when taking ibuprofen.

When Is Tylenol a Safer Option?

Tylenol might be a better option to use for fever or pain relief if:

  • You have had previous cardiovascular events (such as a heart attack,stroke, or blood clotting).
  • You have uncontrolled high blood pressure.
  • You are currently on medication that can increase your risk for bleeding.
  • You are pregnant.

Always talk to your healthcare provider before taking any OTC medications to ensure no interactions exist with medications you already take.

How to Take Advil vs. Tylenol

Both Advil and Tylenol are taken by mouth in the following units: tablets, chewable tablets, capsules, or liquid.

For Advil, the recommended dosage is 200 to 400 milligrams (one to two units) ibuprofen every four to six hours or 600 to 800 milligrams (three to four units) every six to eight hours, as needed.

The maximum amount of Advil you can take in 24 hours is 3,200 milligrams for adults and adolescents 12 years and older. The maximum dose for younger children depends on their body weight (check package labeling).

Each unit of regular-strength Tylenol contains 325 milligrams of acetaminophen. The recommended dosage is 325 to 650 milligrams (one to two units) every four to six hours as needed, or 1,000 milligrams (equivalent to about three regular-strength Tylenol or two Extra-Strength Tylenol, containing 500 milligrams of acetaminophen in each unit) every six hours up to four times per day.

Maximum Doses

These are the maximum daily doses of Tylenol for the following groups:

Maximum Daily Dose in Milligrams (mg)
Adults and children age 12 and older with no liver disease4,000 mg
Children 6 to 11 years old1,625 mg
Children under 6 years oldDosing based on weight
Adults 65 years and older2,000 mg
People at increased risk for liver damage2,000 mg
People who drink 3 or more alcoholic beverages daily2,000 mg

Combining Advil and Tylenol

Taking Advil and Tylenol together at low doses may be relatively safe if needed for additional pain relief. However, it's important to be careful with your dosage to ensure you take less than the maximum daily dose for each medication.

If you intend to use both medications, space them out according to your healthcare provider's instructions, making sure to alternate between them.

How Long Tylenol Takes to Work and How Long It Lasts

Drug Interactions With Advil vs. Tylenol

Interactions that may occur with Advil include:

  • Lithium: Taking NSAIDs such as Advil with lithium can lead to an increased level of lithium in the blood, causing unwanted side effects likeconfusion, tremor, slurred speech, and vomiting.
  • Anticoagulants: Anticoagulants, or blood thinners, taken with Advil can cause an increased risk of internal bleeding. It is not recommended to take them together. Examples include heparin, Jantoven (warfarin), Xarelto (rivaroxaban), Eliquis (apixaban), Savaysa (edoxaban), and Lovenox (enoxaparin).
  • Other NSAIDs: Medications, such as Aleve (naproxen), ketorolac, and Mobic (meloxicam), are all in the same drug class as Advil and can increase the risk of unwanted side effects when taken simultaneously. Also, be mindful that Advil and Motrin (ibuprofen) have the same active ingredient, so they should not be taken together.
  • Alcohol: Avoid regular alcohol use with Advil to prevent liver damage.

Interactions that may occur with Tylenol include:

  • Other acetaminophen-containing medications: Do not take Tylenol with other acetaminophen products, including some for coughs and colds.
  • Alcohol: Do not drink alcohol while taking Tylenol, as it can cause serious liver injury.
  • Antiepileptics: These medications include Dilantin (phenytoin), Tegretol (carbamazepine), and Trileptal (oxcarbazepine). Taking them with Tylenol can cause an increased risk of developing liver damage.
  • Probenecid: Probenecid is a medication used for gout. It can cause an increase in acetaminophen in your body, which can increase the risk of liver damage.

This is not a full list of interactions with Tylenol or Advil. It is important to talk to your healthcare provider about all the medications you take before using either medication.

Summary

Both Tylenol and Advil can be used for pain relief and fever, but their differences are seen more in their interactions with other medications and how they affect the body.

For pain associated with swelling, Advil is the preferred medication because it can reduce swelling. While Tylenol can provide pain relief, it does not help with swelling.

Moreover, Advil and Tylenol also differ in their safety risks, especially regarding underlying health conditions and other factors, such as pregnancy. Other medications you are taking may also affect your decision. Read the labeling carefully for each product and ask a healthcare provider or pharmacist to determine which is the best fit for you.

21 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

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