Advil and Tylenol are both medications used to relieve pain and reduce fevers. Advil also has anti-inflammatory properties, so it is used for treating arthritis or joint pain. There are differences in the mechanisms of action and side effects of the two drugs.
The active ingredient in Advil is ibuprofen, whereas in Tylenol it is acetaminophen. Children should not take Advil if they are vomiting, dehydrated, or not eating much; they should only take Advil if they have eaten something.
High or long-term doses of Advil may damage the stomach lining or kidneys. On the other hand, too much Tylenol can damage the liver.
|Generally preferred for||Fever, menstrual cramps, sinusitis, sore muscles, toothaches, earaches, back pain, sports injuries.||Headache, arthritis|
|Dosage||200-800 mg per dose||325-650 mg per dose|
|Forms||Advil is available in the form of tablets, chewable tablets, capsules, gelcaps, suspensions and oral drops.||Tylenol is available in liquid suspension, chewable tablets, gelcaps, geltabs, and suppositories.|
|Side effects||Nausea, dizziness, gastrointestinal bleeding||Kidney, liver, organ damage, reacts if taken with alcohol|
|Mechanism of action||Acts by inhibiting cyclooxygenases (COX-1 and COX-2)||Tylenol is considered a weak inhibitor of cyclooxygenases COX-1 and COX-2, but possibly inhibits a third variant COX-3.|
|Brand owned by||Pfizer (formerly Wyeth)||McNeil Consumer Healthcare, subsidiary of Johnson & Johnson.|
|FDA approval||1974||May 26, 1976|
|Benefits||Relief from body ache (including arthritis), fever reduction, anti clotting||Relief from body and muscle ache, relief from headache, fever reduction.|
|Available over the counter||Yes||Yes|
Active ingredient in Tylenol vs Advil
The active ingredient in Advil is ibuprofen, which is a non-steroidal anti-inflammatory drug. On the other hand, the active ingredient in Tylenol is acetaminophen (also known as paracetamol), an analgesic and an antipyretic agent.
What Acetaminophen and Ibuprofen are Best Suited For
Both ibuprofen and acetaminophen are anti-pyretic (fever reducing drugs). However, some studies indicate that ibuprofen has a slight edge in this area.
Ibuprofen (Advil or Motrin) is also better for certain types of pain and inflammation — back pain, menstrual cramps, sore muscles, toothaches and earaches. A review published in the British Medical Journal concluded that:
- paracetamol [aka acetaminophen or Tylenol] is ineffective in reducing pain and disability or improving quality of life in patients with low back pain.
- paracetamol [aka acetaminophen or Tylenol] offers a small but not clinically important benefit for pain and disability reduction in patients with hip or knee osteoarthritis
- patients taking paracetamol [aka acetaminophen or Tylenol] are nearly four times more likely to have abnormal results on liver function tests compared with those taking oral placebo
Tylenol is preferred for headaches and arthritis pain.
Mechanism of action
Advil acts by inhibiting cyclooxygenases (COX-1 and COX-2), and thus prostaglandins, which are produced by the body in response to injury and inflammation. Acetaminophen (the active ingredient of Tylenol) is a weak inhibitor of the synthesis of prostaglandins.
The mechanism of action of Tylenol is different from that of Advil because Tylenol is considered to be a weaker inhibitor of COX-1 and COX-2. The possibility of it inhibiting a third variant COX-3 is being investigated by scientists.
Tylenol and Advil are both metabolized in the liver, broken down into non-toxic products and then excreted by the kidneys through urine.
The adult dose for Advil is around 200mg to 800mg per dose, a maximum of four times a day. In children the dose is 5-10 mg/Kg. In case of an overdose, consult your physician.
For adults, the dose for Tylenol is 325-650 mg every 4 to 6 hours. In children, this dose is less - about 7mg per pound of body weight. Taking an overdose of Tylenol can cause side effects and should be avoided.
Risks and Side Effects
The common side effects of Advil at high doses include nausea, gastrointestinal bleeding, stomach ulcers, diarrhea, constipation, headache, dizziness, salt and fluid retention and hypertension. Other rare side effects include esophageal ulcers, heart failure, renal impairment, and confusion.
Side effects due to overdose of acetaminophen (Tylenol) include risk of stomach bleeding, kidney or liver damage, stomach pain, or severe allergic reaction like swelling, dizziness, difficulty breathing and other reactions.
When to avoid (Contraindications)
Ibuprofen (Advil) should be avoided before and after heart surgery because of the risks of all NSAIDs (non-steroidal anti-inflammatory drugs) to the cardiovascular system. If you are allergic to other NSAIDs like aspirin or naproxen, you may also be allergic to ibuprofen.
One-off use of NSAIDs like Advil (ibuprofen) and Motrin is generally considered safe in the first two trimesters of pregnancy. Ibuprofen is a category C drug i.e., Risk not ruled out -- animal studies had found adverse effects in fetuses; there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.
Acetaminophen (Tylenol) is also associated with problems and is also a Category C drug. A study published in JAMA Pediatrics in 2016 concluded that
Children exposed to acetaminophen prenatally are at increased risk of multiple behavioral difficulties, and the associations do not appear to be explained by unmeasured behavioral or social factors linked to acetaminophen use insofar as they are not observed for postnatal or partner’s acetaminophen use. Although these results could have implications for public health advice, further studies are required to replicate the findings and to understand mechanisms.
Tylenol has been recalled twice. The 1982 Chicago Tylenol murders caused a huge scare in the United States and caused the company to recall 31 million bottles of tablets. This was an immense blow to the brand but it recovered and was gradually rebuilt over several years.
There was another Tylenol recall in January 2010. On January 15, 2010, 20 months after first receiving consumer complaints, Johnson & Johnson announced a voluntary recall of several hundred batches of popular medicines, including Benadryl, Motrin, Rolaids, Simply Sleep, St. Joseph Aspirin and Tylenol. The recall was due to complaints of a musty smell which is suspected to be due to contamination of the packaging with the chemical 2,4,6-tribromoanisole.
Advil has never been the subject of a recall so it certainly has a better track record than Tylenol in this respect.
Advil is available in the form of tablets, chewable tablets, capsules, suspensions and oral drops. Tylenol is available in liquid suspension, chewable tablets, gelcaps, geltabs, and suppositories.
Advil taken with other drugs such as aminoglycosides or warfarin may cause side effects and should be avoided. Drugs such as carbamazepine, isoniazid, rifampin, and cholestyramine reduce the effect of Tylenol.