If you have a headache, back pain or some other type of pain, browsing the pain-relieving medicines at your local pharmacy can prove to be overwhelming. Advil, Aleve and Tylenol are all popular pain medications and have important similarities and differences, but which one should you choose?
Here’s what you should know about these popular over-the-counter pain medications and which one is best for headaches, fever, back pain and other aches and pains.
[Read: Meditation for Pain Relief.]
Tylenol vs. Advil vs. Aleve
Advil (ibuprofen) and Aleve (naproxen) are non-steroidal anti-inflammatory drugs. They work by inhibiting an enzyme in the body called cyclooxygenase, or COX for short. COX is involved in the process of making prostaglandins, which are hormone-like substances that can contribute to pain. While both are nonsteroidal anti-inflammatory drugs (NSAIDs), Aleve may be longer-lasting than Advil.
Unlike Advil and Aleve, Tylenol (acetaminophen) is not an NSAID. Instead, Tylenol inhibits the production of prostaglandins.
Which Is Better: Tylenol, Advil or Aleve?
Whether you should take Tylenol, Advil or Aleve depends on the type of pain you’re experiencing.
“In general, any of these medications can potentially be helpful for aches and pains,” says Dr. Harrison A. Linder, a board-certified pain management specialist with The Center for Interventional Pain Medicine at Mercy Medical Center in Baltimore.
If inflammation is involved, Advil or Aleve may work better.
“By inhibiting the production of prostaglandins, which contribute to inflammation, these medications help reduce pain and swelling, improving joint mobility and quality of life for individuals with arthritis,” says Dr. Sue Ojageer, a pharmacist and founder of PharmaSue in the Dallas-Fort Worth area.
Tylenol is often the treatment of choice for anything where inflammation isn’t involved, such as:
— Isolated fever.
— Headaches.
— Sore throats.
— Minor aches and pains.
— Small injuries like cuts.
Advil or Aleve will work best for:
— Muscle strains.
— Trauma injuries.
— Arthritis.
Before giving any over-the-counter pain medication to children, check with their pediatrician or another trusted health care provider. Guidelines may differ for each type of medication and based on the child’s age or weight.
[READ: 17 Best Anti-Inflammatory Foods]
Which Lasts Longer?
At 12 hours, Aleve lasts longer than Tylenol and Advil. Tylenol and Advil typically last four to six hours. However, each of these medicines has different formulations, like 12-hour Advil and 8-hour Tylenol that last a longer amount of time than the regular formulation.
Once you take them, all of these medications typically work within a half hour to an hour.
Can You Combine These Medications?
Some of these pain medications can be combined together. Here’s the scoop on which can be combined and which cannot.
Can you take Advil and Tylenol together?
Yes, you can take Advil and Tylenol together. That’s because they are different types of medications. Just make sure to read any instructions carefully to make sure you aren’t taking too much of either or both medications, Ojageer cautions.
Can you take Aleve and Tylenol together?
You can take Aleve and Tylenol together. Again, this is because they are different types of medications.
Some people will take both an NSAID like Advil or Aleve and Tylenol together as it helps their pain relief more, Linder says. Others prefer to alternate Tylenol and an NSAID with each subsequent dose.
Can you take Aleve and Advil together?
You shouldn’t take Aleve and Advil together because they are both in the same group of medications called NSAIDs.
If you try one pain reliever and you’re not finding relief, it’s OK to try a different type, so long as you’re not overlapping doses of the same type of medicine, Linder says. For example, don’t take two Advils and then pop an Aleve just two hours later.
If you’re taking any combination medications, such as for a cold or the flu, read all packaging to make sure you aren’t unintentionally taking too much of a medication like Tylenol, advises Dr. Tochi Iroku-Malize, board chair of the American Academy of Family Physicians and professor of family medicine for the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell in Hempstead, New York. These combination medications often will have an added pain reliever such as Tylenol to treat your symptoms.
[SEE: 11 Foods Not to Mix With Prescription Medications.]
Dosage
Always read packaging instructions to confirm the right dosage. The dosage may depend on whether the product is used for an adult or child. It also may depend on what type of product you’re using.
Here are some guidelines for the regular strength version of Advil, Aleve and Tylenol:
— Advil (200 milligrams per tablet): Take one tablet every four to six hours while you have symptoms. You can use two if your pain or fever doesn’t respond to one. Don’t use more than six tablets/caplets/gel caplets in 24 hours unless directed by a health care provider.
— Aleve (220 milligrams per tablet): Take one every 8 to 12 hours while you’re having symptoms. You may need to take two pills in the first hour for your first dose. Don’t take more than two in 12 hours or three in 24 hours. Drink a glass of water with each dose.
— Tylenol (325 milligrams per tablet): Take two tablets every four to six hours while you have symptoms. Don’t take more than 10 tablets (3,250 milligrams) in 24 hours unless directed by a health care professional.
If you have dosing questions or any questions about using these medications, ask a health care provider or pharmacist.
Side Effects
Always consider potential side effects with any medications you take, including these pain-relieving medications.
“Just because they’re available over the counter does not mean they are completely safe or without side effects,” Linder says.
Tylenol side effects
The biggest side effect of Tylenol is liver damage if used too much.
“Acetaminophen overdose can lead to acute liver failure, which can be fatal if not promptly treated,” Ojageer says.
However, this would come from chronically exceeding the recommended daily dose.
It’s also possible to have an allergic reaction to acetaminophen, which would show up as a skin rash or itching or swelling.
Advil and Aleve side effects
Because Advil and Aleve are in the same medication class, their potential and more serious side effects are similar. These include:
— Allergic reactions.
— GI bleeding when NSAIDs are used in a high dose.
— Cardiovascular events like heart attack and stroke, especially if you have pre-existing cardiovascular conditions.
— Kidney damage as NSAIDs can affect kidney dysfunction. This is especially a concern if you have pre-existing kidney disease or dehydration.
These side effects aren’t typically associated with the occasional use of these pain medications. These would be bigger concerns if you’re using these medicines chronically or at higher doses than recommended.
Pain medications also may have more minor side effects, such as stomach irritation or heartburn, which are associated with NSAIDs.
Always talk to your health care provider if you have pre-existing conditions such as cardiovascular disease, kidney disease or liver disease to confirm which pain reliever is best for you, Iroku-Malize advises. You should also talk to your health care provider first if you use a blood thinner or have a history of stroke.
Precautions
In addition to keeping potential side effects in mind, there are a few other precautions to consider when you use these medicines:
— Always read the package instructions.
— Drink water when you take these medications. As NSAIDs sometimes can cause an upset stomach, you may want to take them with food.
— If you drink alcohol regularly, speak with a health care provider before using Tylenol. Both alcohol and Tylenol are processed in the liver, which could raise the risk for liver damage if you use too much Tylenol.
— Contact a health care professional if your pain is staying the same or getting worse after you’ve used these pain-relieving medications for a week.
— Always check with a health care provider before using any pain reliever if you’re pregnant/breastfeeding, age 65 and older or you’re giving the medication to a child. Dosages or what you’re able to use may differ if you fall in one of these special population groups.
— Keep track of all medications you’re using. Make a list that includes OTC medications, prescription medications and supplements. This can help you prevent accidental overdoses, identify potential drug interactions and be able to share your usage easily with a health care provider.
— Seek medical care if you have any new unusual symptoms that could be related to medicine use, such as changes to your urine, GI discomfort or an allergic reaction.
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