Acetaminophen (Tylenol) and ibuprofen (Advil) are commonly used to relieve different types of pain and fever. However, they differ in their properties, indications, duration of action, and effectiveness, which is why they should always be taken under medical supervision.
Tylenol is an analgesic recommended for mild to moderate pain, while Advil is a nonsteroidal anti-inflammatory drug (NSAID) that works best for pain linked to inflammation.
It is important to consult a primary care doctor or pediatrician before taking either medication, since there are health conditions, such as liver or heart disease, where these drugs may be contraindicated.
When to use acetaminophen (Tylenol)
Acetaminophen, also called paracetamol, is an analgesic and fever reducer (antipyretic) used for mild to moderate pain and fever.
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Brand names: Tylenol
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Indications: relief of headache, back pain, toothache, sore throat, earache, post-surgical pain, fever, and discomfort from colds or the flu
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Maximum daily dose: healthy adults without liver problems should not take more than 4 grams per day. A common dose is 750 mg every 6 hours
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Mechanism of action: acetaminophen reduces pain by blocking the production of prostaglandins, substances released when pain or injury occurs. This lowers pain perception, creating relief. However, it does not block cyclooxygenase in peripheral tissues, so it has no anti-inflammatory effect
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Possible side effects: malaise, low blood pressure, and increased liver enzyme levels
If pain lasts more than 5 days, or if fever continues beyond 3 days, worsens, or new symptoms develop, treatment should be stopped and a doctor consulted.
Contraindications of acetaminophen
Acetaminophen should only be taken under medical guidance in people with liver, kidney, lung, or heart disease, or anemia.
People who drink alcohol excessively or regularly should only use acetaminophen with medical approval, since it may cause severe liver damage.
Pregnant or breastfeeding women should consult a doctor before starting this medication.
It should not be used by people allergic to acetaminophen or any of its ingredients.
When to use ibuprofen (Advil)
Ibuprofen is an NSAID with analgesic, antipyretic, and anti-inflammatory properties.
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Brand names: Advil, Motrin
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Indications: treatment of fever and relief of mild to moderate pain, including migraine, post-surgical pain, fracture pain, arthritis, osteoarthritis, ankylosing spondylitis, and menstrual cramps
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Maximum daily dose: no more than 1600 mg per day, with a common dose of up to 400 mg every 8 hours
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Mechanism of action: like acetaminophen, ibuprofen blocks prostaglandin production. However, it also acts in peripheral tissues, giving it anti-inflammatory effects
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Possible side effects: prolonged use may lead to peptic ulcers, gastrointestinal bleeding, or perforations, especially in older adults. Other side effects include nausea, vomiting, diarrhea, gas, constipation, heartburn, abdominal pain, blood in the stool, mouth ulcers, worsening ulcerative colitis, and Crohn’s disease. Less commonly, gastritis may develop
Because of these gastrointestinal risks, ibuprofen should always be taken with food.
When prescribed for more than one week, a doctor may recommend a stomach-protective medication to reduce side effects.
Contraindications of ibuprofen
Ibuprofen should not be used by pregnant or breastfeeding women without medical approval.
It is also contraindicated in people with severe liver or kidney disease, severe heart failure, ulcers, gastrointestinal bleeding, intestinal perforations, or dengue.
It should not be taken by people with vomiting blood, black stools, bloody diarrhea, blood clotting disorders, or those taking anticoagulants.
People allergic to ibuprofen or any other NSAID must also avoid it.
Can you alternate acetaminophen and ibuprofen?
Alternating acetaminophen and ibuprofen is not recommended for reducing fever, since switching between these medications offers little extra benefit.
It is essential to consider the indications, contraindications, and overall health of the person when deciding between Advil vs Tylenol.
In children, alternating these drugs increases the risk of dosing mistakes by parents or caregivers, which may lead to overdose or poisoning.
The safest option is to consult a pediatrician for children, or a primary care doctor for adults, to determine which medication is best for each individual situation.