Comparing Advil (Ibuprofen) vs. Tylenol (Acetaminophen)

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.

Advil blocks a substance called prostaglandin. Prostaglandin production is a natural substance that contributes to inflammation, which worsens swelling and pain. The way Tylenol functions is not well known, but it is thought to work in the brain to reduce pain. It also controls temperature by cooling the body to lower a fever. 

Advil, which belongs to a medication class known as nonsteroidal anti-inflammatory drugs (NSAIDs), can also reduce swelling, whereas Tylenol cannot.

Determining which medication you should use will depend on your individual 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 vs Tylenol: How They Work

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.

Uses of Advil vs. Tylenol

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.

Safety and Side Effects of Advil

Side effects of Advil can include:

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

Serious side effects of Advil include:

• Stomach or intestinal bleeding or ulcers
• 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.

Safety and Side Effects of Tylenol

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

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.

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

• Adults and children 12 years and older without liver disease: Maximum is 4,000 milligrams a day.
• Children 6 to 11 years old: Maximum is 1,625 milligrams a day.
• Children under 6: Dosing is based on weight, so the maximum amount will vary.
• Adults 65 and older, those at increased risk for liver damage, and people who drink three or more alcoholic beverages per day: Avoid or use a lower dose, a maximum of 2,000 milligrams.
  

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.
• 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.