Tylenol vs. Advil: Comparing Acetaminophen and Ibuprofen

You’re standing in your local pharmacy or in the medicine aisle of your neighborhood grocery store, and you’re hurting. Maybe you have a headache or twisted your ankle during your morning workout. Whatever the case may be, you need some relief.

You scan the rows of medications. There are boxes and bottles; tablets and capsules. Which one do you choose? Which one is safest? Aren’t they all the same?

With so many options and types of medication, a seemingly simple choice can get complicated quickly. Two common options for pain relief are Advil (ibuprofen) and Tylenol (acetaminophen). While these two over-the-counter (OTC) medications may seem similar, there are several differences between them. So how do you pick the right one for you?

Are Advil (ibuprofen) and Tylenol (acetaminophen) the same thing?

No, Advil and Tylenol are often used to treat similar conditions, such as fever and mild to moderate pain. But they are two different medications.

But is Advil ibuprofen? Yes, the active ingredient in Advil is ibuprofen. It is a non-opioid pain reliever that belongs to a group of medications known as nonsteroidal anti-inflammatory drugs (NSAIDs). Ibuprofen is also sold under the brand name Motrin.

The active ingredient in Tylenol is acetaminophen. Acetaminophen (often abbreviated APAP) is a non-opioid pain reliever and fever reducer. Unlike Advil, Tylenol is not an NSAID.

While these two medications can treat many of the same conditions and symptoms, the way they work is what makes them different.

EXPERT PICKS: WHAT TO READ NEXT

• Can you combine Tylenol and Advil? Taking Tylenol and Advil together is generally safe for many people and may help provide more pain relief than taking just one of them.

• How do NSAIDs compare? Ibuprofen is one of several available NSAIDs. But each NSAID is slightly different from the others.

• What are some non-medication treatment options for pain? When it comes to pain, there are ways to find relief that don’t involve medications.

What is the difference between Advil and Tylenol?

Both medications are effective for pain and fever. But Advil also reduces swelling, while Tylenol doesn't. There's a downside to this though, since Advil can also cause stomach-related side effects, which isn't an issue with Tylenol. The reason for these differences comes down to how Advil and Tylenol work in the body.

Both medications affect an inflammation (swelling) pathway in the body, known as the cyclooxygenase (COX) pathway. The COX pathway helps create substances that play a role in fevers, pain, and swelling. There are two main COX enzymes (proteins) we’ll mention in this article: COX-1 and COX-2.

NSAIDs, such as Advil, work to relieve fever, pain, and swelling by blocking the actions of COX-1 and COX-2 throughout the body. Advil’s effects on the COX pathway are direct.

The way Tylenol works isn’t fully understood. It’s thought to affect the COX pathway as well. But Tylenol doesn’t directly block the COX-1 or COX-2 enzymes like Advil. This is a key difference when we start talking about side effects below.

Another difference is Tylenol works more in the central nervous system (brain and spinal cord). It doesn’t work as much in the peripheral nervous system (nerves outside the brain and spinal cord). Tylenol also doesn’t help much with inflammation.

When to take Advil (ibuprofen) vs. Tylenol (acetaminophen)

Advil and Tylenol are both effective for treating mild-to-moderate pain and reducing fever. Evidence doesn’t suggest that one works better or faster than the other. Some studies have found Advil to work better. Others have found that there’s no significant difference between the two.

Where you will find a distinction is when it comes to inflammation (swelling). As discussed above, Tylenol doesn’t help much with this issue. So Advil may be a better choice in this case.

Advil is likely more helpful than Tylenol for some health conditions that involve inflammation, such as:

• Osteoarthritis

• Rheumatoid arthritis

• Menstrual cramps

• Carpal tunnel syndrome

• Low back pain

What are the maximum doses of Advil (ibuprofen) and Tylenol (acetaminophen)?

How much medication you can take in a day is another difference between Advil and Tylenol. But as a general rule, taking the lowest dose needed for the shortest time possible is a good practice in order to help limit side effects.

The maximum recommended daily amount of OTC Advil for most adults and adolescents ages 12 and older is 1,200 mg (six 200 mg tablets). A healthcare professional may recommend larger doses of Advil for certain health conditions, such as rheumatoid arthritis. But you should never take higher doses of this medication without a healthcare professional’s OK.

The maximum recommended daily amount of Tylenol is 4,000 mg (eight 500 mg tablets) for most adults and adolescents ages 12 and older. But older adults, children under 12, and people with certain health conditions, such as liver disease, may be advised to take less than this. It’s best to double check with a healthcare professional on the safest dose for you or your child to take.

What are the side effects of Advil (ibuprofen) and Tylenol (acetaminophen)?

Just because Advil and Tylenol are available without a prescription doesn’t mean they are without risks. But most people tolerate both pain relievers well with occasional use at recommended doses.

Common Advil side effects include:

• Nausea

• Heartburn

• Stomach pain

• Dizziness

• Swelling in the arms or legs

Side effects aren’t common for most people taking Tylenol. If you experience side effects from Tylenol, you should contact a healthcare professional.

Which is harder on your stomach, Advil or Tylenol?

Advil can impact the stomach more than Tylenol. As mentioned above, the COX pathway is the major target for both Advil and Tylenol. But Advil directly affects COX enzymes.

COX-1 and COX-2 enzymes are present all throughout your body, including the lining of your stomach. Although both enzymes are present in your stomach, COX-1 is more plentiful. COX-1 is also associated with maintaining the stomach’s protective lining.

When NSAIDs, like Advil, block COX-1 in the stomach, it can weaken this protective lining. This can raise the risk for stomach ulcers and bleeding.

To help lower the impact of Advil on the stomach, you should eat before taking the medication. It doesn’t have to be a full meal — just a small snack or some crackers.

Which is worse for your liver, Advil or Tylenol?

Tylenol can impact the liver. Because Tylenol is broken down by the liver, there’s a risk of it causing liver damage. In fact, Tylenol accounts for more than half of all acute (sudden) liver failures in the U.S.

Most of these liver injuries are caused by one of two things:

1. People take more acetaminophen than recommended. This could be because a person thinks the recommended dose isn’t working well enough.

2. People take too much acetaminophen without realizing it.

It’s easy to take too much Tylenol by accident. Many OTC and prescription medications combine acetaminophen (Tylenol’s active ingredient) with other medications. Be sure to check the label on combination cough and cold medications for this ingredient. Acetaminophen can also be combined with many prescription pain medications, such as opioids and some migraine medications.

It’s important to include acetaminophen from all sources when figuring out how much you’re taking per day. Remember: 4,000 mg is the most anyone should take per day. And some people should take lower daily doses than this.

On the other hand, Advil doesn’t usually affect the liver. This is typically only a concern for people with existing liver conditions, such as chronic hepatitis C. Advil-related liver damage for people without liver problems is very rare.

Is Advil or Tylenol worse for your kidneys?

Advil can impact the kidneys. We mentioned earlier that COX-1 is found in the stomach’s protective lining. COX-1 is also involved in how the kidneys work to make urine. This helps get rid of waste from the body.

When Advil blocks COX-1 enzymes, it can lower blood flow to the kidneys. This makes it harder for the kidneys to do their job.

People who already have kidney problems should be careful taking NSAIDs like Advil. This is especially important if you also take other medications that put strain on the kidneys, like lisinopril (Qbrelis, Zestril) or furosemide (Lasix).

Tylenol is safer for your kidneys. It’s broken down by the liver, so the risk to the kidneys is low.

Take our quiz: Advil or Tylenol?

When should you stop taking Advil (ibuprofen) or Tylenol (acetaminophen)?

The first scenario for when you should stop taking Advil or Tylenol is probably the most common. If your fever, pain, or swelling has gone away, you can stop taking the medication. These medications are typically only taken as needed.

The second situation would be if you start experiencing any excessive or bothersome side effects. If this happens, stop taking the medication and contact a healthcare professional. They’ll let you know what steps you should take next.

But what if your fever, pain, or swelling doesn’t go away? While every situation is unique, it’s a good idea to have a plan in mind if things don’t get better or start getting worse.

When self-treating with OTC Advil, it’s recommended to only take it for pain relief for up to 10 days or for fever up to 3 days. If you’re not feeling better after then (or if symptoms get worse during this time), it’s time to see a healthcare professional.

For Tylenol, the length of time is the same as Advil for adults (10 days for pain, 3 days for fever). But for children under 12 years old, Tylenol should only be taken for pain for 5 days. After that time, or if symptoms get worse, contact a healthcare professional.

Can you take Advil (ibuprofen) and Tylenol (acetaminophen) together?

Yes, you can take Advil and Tylenol together. Because the two medications work and are broken down differently in the body, they can be taken together. To help limit side effects and stay within recommended dose limits, healthcare professionals often recommend rotating which pain reliever you take next.

For example, your first dose of medication might be Tylenol. When you’re due for your next dose, you’d take Advil instead of Tylenol. Your third dose would be with Tylenol again. You would continue this pattern until your symptoms resolve or until you felt it necessary to get additional medical care.

How to save on Advil (ibuprofen) and Tylenol (acetaminophen)

Advil and Tylenol are both available as brand-name OTC pain relievers. They also both have generic options, which can help you save money. And if a healthcare professional writes a prescription for Advil or Tylenol, GoodRx can help you save money too.

The price for 30 tablets of generic ibuprofen 200 mg at certain pharmacies is as low as $4.11 with a free GoodRx discount. The price for 30 tablets of generic acetaminophen 325 mg at certain pharmacies is as low as $3.01 with a free GoodRx discount.

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Written by:

Clay M. Cooper, PharmD

Clay Cooper, PharmD, has over 10 years of pharmacy practice experience in a variety of healthcare settings, including in independent community pharmacy, retail pharmacy, and long-term care pharmacy. He is a licensed pharmacist in Tennessee, Mississippi, and Alabama.

Edited by:

Christina Aungst, PharmD

Christina Aungst, PharmD, is a pharmacy editor for GoodRx. She began writing for GoodRx Health in 2019, transitioning from freelance writer to editor in 2021.

Reviewed by:

Joshua Murdock, PharmD, BCBBS

Joshua Murdock, PharmD, BCBBS, is a licensed pharmacist in Arizona, Colorado, and Rhode Island. He has worked in the pharmacy industry for more than 10 years and currently serves as a pharmacy editor for GoodRx.

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