Can You Take Tylenol With an Anti-Inflammatory Like Aleve?

Taking Tylenol (acetaminophen) with anti-inflammatory drugs like Aleve (naproxen) or Advil (ibuprofen) is generally considered safe, as long as you don't exceed recommended dosages. 

Acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs) have different compositions and actions. They are also eliminated from the body in different ways, which means taking them together won't put too much stress on the liver or kidneys in most cases.

This article discusses the simultaneous use of Tylenol and anti-inflammatories for pain relief. It also provides information about how you can take these two medicines safely.

Doctor giving patient pills
RUNSTUDIO / Getty Images

Combining Tylenol With an Anti-Inflammatory

It is generally considered safe to take Tylenol together with Aleve or another NSAID. In fact, there is some evidence that taking these two medications together may provide better pain relief than taking them separately.

These two medications belong to different drug classes, which means they work in different ways inside your body. They are also metabolized differently.

Tylenol is eliminated through the liver, while NSAIDs are eliminated by the kidneys. For this reason, taking them together won't overwork either one of these organs.

You may want to take both medications together if, for example, your Advil or Aleve is not providing you the arthritis relief you need. It is important, however, to make sure to adhere to recommended dosages when you combine these medications. Both drugs can cause harmful side effects when you take too much of them.

On the other hand, if you have underlying kidney impairment or liver disease (like hepatitis B or C), you will need to work with your healthcare provider to either tailor your usage or find alternatives that won't contribute to organ damage.

How Tylenol and NSAIDs Differ

There are many people who believe that Tylenol is pretty much the same thing as aspirin, Advil (ibuprofen), or Aleve (naproxen), but there are key differences.

  • Active drug: acetaminophen

  • Pain reliever (analgesic) and fever reducer (antipyretic)

  • Used for headaches, fever, muscle aches, backache, toothache, colds

  • Active drug: ibuprofen, naproxen sodium, or aspirin

  • Reduces pain, fever, and inflammation

  • Used for conditions such as arthritis, bursitis, and tendinitis

While its exact mechanism of action is still unclear, Tylenol is believed to inhibit an enzyme called COX-2 in a milder way than NSAIDs. By doing so, it prevents the brain from releasing chemicals that activate pain receptors.

NSAIDs temper the production of prostaglandin, a hormone-like compound that promotes inflammation. Prostaglandins also have the distinction of protecting the stomach from the damaging effects of digestive acids.

Tylenol and NSAID Side Effects

The utility of Tylenol and anti-inflammatories is largely defined by their side effects.

The side effects of Tylenol are typically minor and may include stomach upset, nausea, loss of appetite, and headache. On occasion, itchiness and rash can also develop.

One of the major challenges of NSAIDs is their effect on prostaglandin. As prostaglandin levels decrease so, too, does the protective benefit to the stomach. This is why NSAIDs can cause heartburn, stomach pain, and peptic ulcers.

Long-term or excessive use can affect blood pressure and clotting and increase the risk of:

Because Tylenol has less effect on prostaglandin, its gastrointestinal side effects are far less severe. It is not associated with peptic ulcer risk or cardiovascular risk.

It can, however, cause serious liver damage if used in excess (more than 3,000 milligrams per day, or six Tylenol Extra Strength caplets) or taken with alcohol.

While NSAIDs can also hurt the liver if used in excess, the risk is far smaller. The same applies to the kidneys but usually only when there is an underlying kidney disorder.

As a rule, you wouldn't double up on NSAIDs because of the increased risk of gastrointestinal and cardiovascular side effects. Similarly, you wouldn't want to make a habit of doubling your Tylenol dose because of the risk of liver toxicity.

But combining normal doses of the two medications may provide pain relief when either medication alone is not enough.


It is generally considered safe to take a normal dose of Tylenol together with a normal dose of an NSAID like Aleve or Advil, as long as you're otherwise healthy. These medications belong to different drug classes and work differently in the body.

You may want to take both medications together if either one doesn't provide the relief you need on its own.

Be sure to stick to the recommended dosages and talk to your healthcare provider first if you have a kidney or liver condition.

4 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.
  1. Derry CJ, Derry S, Moore RA. Single dose oral ibuprofen plus paracetamol (acetaminophen) for acute postoperative pain. Cochrane Database Syst Rev. 2013;6: CD010210. doi:10.1002/14651858.CD010210.pub2

  2. Scheiman J. NSAID-induced gastrointestinal injury: a focused update for clinicians. J Clin Gastroenterol. 2016;50(1):5-10. doi:10.1097/MCG.0000000000000432

  3. Bally M, Dendukuri M, Rich B, et al. Risk of acute myocardial infarction with NSAIDs in real-world use: a Bayesian meta-analysis of individual patient data. BMJ. 2017;357:j1909. doi:10.1136/bmj.j1909.

  4. Yoon E, Babar A, Choudhary M, et al. Acetaminophen-induced hepatotoxicity: a comprehensive update. J Clin Transl Hepatol. 2016;4(2):131-42. doi: 10.14218/JCTH.2015.00052

By Carol Eustice
Carol Eustice is a writer covering arthritis and chronic illness, who herself has been diagnosed with both rheumatoid arthritis and osteoarthritis.