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Advil, Aleve and Tylenol: What’s the difference?

An assortment of red pills spread out over a white background.

You wake up with a terrible headache, a sore muscle or yesterday’s sunburn is bothering you, and shuffle your way to your medicine cabinet. You open the cabinet, hoping to find something to help with the pain and discomfort, but find yourself faced with three choices: Advil, Aleve and Tylenol. Which one should you take? What are the differences to consider before taking?

“All of these pharmaceuticals are useful to treat pain and reduce fever, which is why they’re such common occurrences in households,” said David E. Potter, Ph.D., professor and chair of pharmaceutical sciences with the Texas A&M Health Science Center Irma Lerma Rangel College of Pharmacy. “However, there are some instances where one of these medicines may work better than its counterparts.”

To help navigate when to choose which of these common over-the-counter medications, Potter offers the following information about each pain and fever-reducer:

Tylenol (acetaminophen)

Acetaminophen (Tylenol’s generic name) is a popular option for treating cold and flu-like symptoms, but Potter cautions that users need to be aware of how much they take in a day. Since acetaminophen is often combined with other over-the-counter cold medications that contain fever-reducing ingredients, people may end up taking multiple doses and exceeding the daily limitations.

“More than Advil and Aleve, Tylenol has a definite dosage ceiling of 325 milligrams per pill or capsule. Additionally, people should avoid taking more than 3000 milligrams per day, or they might begin to experience liver toxicity,” Potter warned.

People with liver disease, or who have consumed alcohol regularly, should be especially wary of the dosage they consume as unintentional overdosing can result in severe liver damage or even failure. Fortunately, these serious complications can be avoided if treated within 24 hours. Potter explains that the most common symptoms of acetaminophen overdose are lethargy (a sluggish state) and nausea or vomiting. If an individual exhibits these symptoms, they should seek medical attention within 24 hours, if possible.

Unlike its counterparts, acetaminophen does not possess any anti-inflammatory effects. For injuries like a sprain or discomfort from arthritis, Tylenol will not treat the pain as effectively as Advil or Aleve.

However, in the case of viral infections in young children and infants, acetaminophen’s can lower temperature effectively. In these situations, Tylenol is a better option to reduce fever than aspirin, Advil or Aleve. In all cases, be sure to adjust the dosage accordingly for the child’s age.

Advil (ibuprofen) and Aleve (naproxen sodium)

As far as anti-inflammatories go, ibuprofen and naproxen sodium have almost identical attributes. The main discriminating factors between the two are the active duration of each dose – Aleve is advertised as lasting almost four hours longer than Advil – and that naproxen causes a higher instance of photosensitivity (sensitivity to light).

For injuries or inflammatory symptoms, either ibuprofen or naproxen can both reduce inflammation or swelling and manage the pain. However, in the case of prolonged exposure to the sun or tanning, ibuprofen is probably a better alternative to naproxen.

Although most people have these medications or are aware of them, Potter suggests that not everybody should use these as their primary form of pain management.

“With ibuprofen and naproxen, there are higher incidences of gastrointestinal (GI) bleeding or ulcers that can occur in people predisposed to peptic ulcer disease. When taking either medication, it’s recommended that individuals take them with food to help with any GI discomfort. People who are predisposed to GI disorders should generally try to avoid ibuprofen or naproxen so as not to exacerbate symptoms and damage to the intestinal lining,” Potter said.

So if you wake up with a headache, any one of the three will help manage pain. If you’re combating sore muscles or arthritis, either ibuprofen or naproxen are your best bet to treat inflammation; and if that sunburn is bothering you, or you like to use suntan beds, stick with ibuprofen or acetaminophen.

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