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 iStock In one word or less: Yes. If you have a bad headache and find both Tylenol (acetaminophen) and Advil (ibuprofen) in your medicine cabinet, go ahead and reach for both. “Since the medications work differently and are processed in the body by different organs, it is safe for otherwise healthy individuals to use both concurrently, or by alternating medications with each dose,” says John Raimo, M.D., chair of medicine at Long Island Jewish Forest Hills in Queens, NY. Robert Glatter, M.D., an emergency physician at Lenox Hill Hospital in New York City, takes it a step further. “Taking them together has an additive or synergistic effect on pain relief,” says Dr. Glatter. Plus, both can help bring a fever down. In fact, the drugs work so well together that in March 2020 the FDA approved the first over-the-counter combination of acetaminophen and ibuprofen, marketed as Advil Dual Action. So how does each drug work? Let’s take a look. How Does Advil Work?Advil is what’s called an NSAID, or a non-steroidal anti-inflammatory drug. This type of drug, which also includes aspirin and Aleve (naproxen), prevents certain enzymes in your body from producing chemicals called prostaglandins. These are hormones that trigger inflammation. They also help produce the pain you feel when you have an injury. NSAIDs like Advil offer relief by interrupting this process. How Does Tylenol Work?That’s less clear. Acetaminophen has been around for nearly 150 years, and it has been sold as Tylenol since 1955. About 50 million Americans take it each week, according to the manufacturer. It might come as a surprise, therefore, to learn that experts still are uncertain the exact mechanism at play that makes the drug so effective. Some evidence, says Dr. Glatter, suggests that it targets the central nervous system, tamping down nerve signals that cause you to feel pain. One thing is clear: Unlike Advil and other NSAIDs, Tylenol does not reduce inflammation. “Although acetaminophen can have a similar effect [on pain and fever], it works through a different pathway,” says Dr. Raimo. Is Advil or Tylenol Better for Pain?Ibuprofen is the clear winner, says Dr. Glatter. “While it may be used to treat mild to moderate pain, Tylenol is used to treat fever primarily,” he says. “Ibuprofen is a more effective approach for treating sprains and contusions to soft tissue and muscles. In adults, as well as young children and infants over 3 months, ibuprofen is also adept at treating strains, headaches, and fever.” Just because it’s safe to take Advil and Tylenol together doesn’t necessarily mean you should, though. The combo can cause some people experience an upset stomach, cautions Dr. Glatter. “If this is the case for you, it’s better to alternate times when you take each medication, spacing out the dosing,” he recommends. And finally, take note: These over-the-counter meds may not need a doctor’s prescription, but they can still be dangerous if you overdo it. Excessive use of Advil and other NSAIDs can boost your blood pressure and raise your risk of a heart attack or stroke, for example. Too much Tylenol damages your liver, and that can be fatal or require a liver transplant. Make sure to take no more than the recommended dose. For Advil, that’s 1,200 mg per day, or six tablets total. Doses should be spaced four to six hours apart. Don’t take more than 3,000 mg of Tylenol per day. Space doses four to six hours apart for regular strength and six hours apart for extra strength. Dr. Glatter advises parents to check with their doctor before giving either medication to children under 12. The Bottom LineIf you’re dealing with a fever, grab the Tylenol. Strained your back? Try Advil. If the pain doesn’t get better after 24 hours, take both—but better yet, give your doctor a call to see if there’s something bigger going on with your health. Meet Our Writer Matt McMillen Matt McMillen has been a freelance health reporter since 2002. In that time he’s written about everything from acupuncture to the Zika virus. He covers breaking medical news and the latest medical studies, profiles celebrities Acetaminophen and ibuprofen are over-the-counter painkillers. Acetaminophen helps relieve pain and fever. Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that can help reduce pain and inflammation. People may take acetaminophen to ease the symptoms of cold and flu. People may take ibuprofen for body aches, headaches, or chronic health conditions, such as arthritis or lupus. This article will discuss if people can safely take these over-the-counter (OTC) drugs together, the recommended dosages, and potential side effects.
People can safely take acetaminophen and ibuprofen together. Research has shown that it is safe to take acetaminophen and ibuprofen on their own or together for short-term use, as long as people follow the correct dosage. OTC drugs containing acetaminophen include:
OTC drugs containing ibuprofen include:
People may take both acetaminophen and ibuprofen if they have chronic or severe pain. However, they should talk to a doctor before doing so. Dosages for acetaminophen and ibuprofen for infants and children will depend on their age and weight. Anyone considering giving either of these OTC medications to a child must always consult a doctor beforehand if the child is 2 years of age or younger. A person can follow instruction labels carefully or consult a pharmacist if they are unsure about the correct dosage. Adults should follow the instructions of the particular medication they are taking. AcetaminophenIn a single dose, the maximum amount of acetaminophen an adult can take is 1,000 milligrams (mg). A person should not take more than 4,000mg in 24 hours. According to the National Health Service (NHS), the typical dose is 1 or 2 tablets of 500 mg up to four times a day. A person should leave at least 4 hours between each dose. Those with chronic pain, which may need higher doses of acetaminophen, can check with their doctor first. Dosage can vary, depending on the product type. People should always follow instructions on the label and consult their pharmacist or doctor if they are unsure. IbuprofenAn adult can take OTC doses of 800–1,200 milligrams per day (mg/day) to treat minor pain, including:
If a doctor prescribes ibuprofen, a person can typically take 1,800–2,400 mg/day to treat:
A pediatric patient can take 2–10 milligrams per kilogram (mg/kg) every 6–8 hours to treat pain and fever. Adults should not take ibuprofen tablets for more than 10 days, or any gel form of ibuprofen for more than 2 weeks, without talking to their doctor first. Both ibuprofen and acetaminophen have side effects. A person should seek medical help if they experience:
AcetaminophenPeople with liver conditions should avoid taking acetaminophen. This is because the liver breaks it down, and it can cause liver disease. The U.S. Food and Drug Administration (FDA) warns that acetaminophen can cause rare but dangerous reactions of the skin. Skin reaction symptoms include:
Stevens-Johnson Syndrome is an extremely rare but potentially life threatening condition that results in the top layer of skin separating from the layer beneath. Some experts, including the FDA, have associated it with taking certain medications, including acetaminophen and ibuprofen. Some research has highlighted gastrointestinal concerns with chronic use of acetaminophen, and people should discuss these with their doctor. IbuprofenIbuprofen can increase the risk of strokes and heart attacks. Those who have cardiovascular disease are at a higher risk. Ibuprofen may also cause damage to the kidneys. People with existing kidney conditions may need to consult their doctor before taking ibuprofen. Taking ibuprofen daily over a long time may irritate the stomach and intestines, or increase the risk for gastrointestinal problems. Issues may range from an upset stomach to stomach bleeding or ulcers. For this reason, people should take ibuprofen with food to avoid any stomach upsets. Other possible side effects of ibuprofen include:
For those taking ibuprofen for chronic conditions, proton pump inhibitors may help reduce these risks. Taking both together togetherTaking acetaminophen and ibuprofen together can cause the same side effects people may experience by taking one or the other. There are currently no reports of negative side effects from combining both acetaminophen and ibuprofen within safe doses. Benefits of acetaminophen and ibuprofen include: AcetaminophenAcetaminophen does not typically aggravate the lining of the stomach or the intestines in the way that NSAIDs can. This means acetaminophen may be suitable for people who have health conditions that affect the stomach or intestines. Side effects of acetaminophen are rare when people take the correct dosage. IbuprofenIt takes a larger dose of ibuprofen than acetaminophen to cause an overdose. Consequently, there is less risk of accidentally taking too much ibuprofen than acetaminophen. Ibuprofen has less risk than some other NSAIDs of causing stomach issues. This is because the drug is a fast pain reliever, and so it does not need to stay in the body for longer than necessary. Benefits when taken togetherCombining acetaminophen with ibuprofen may provide greater pain relief than using one or the other on their own. Taking medication that combines both drugs may also make it easier and simpler for people to stick to correct timings and dosage. Acetaminophen and ibuprofen are safe to take together for most people. Possible risks of combining the two include taking more than the recommended dosage by accident. Acetaminophen and ibuprofen are present in a range of pain relief, cold, and flu medications. Their presence in these OTC products can make it easy to take more than necessary by accident. People should take care to read medication labels to check which drugs each product contains. Carefully checking the dose of acetaminophen and ibuprofen in each product can help avoid an accidental overdose. Symptoms of an acetaminophen overdose include the following:
Symptoms of an ibuprofen overdose include the following:
Certain medications interact with other drugs and can cause negative side effects. People should check with a doctor before taking acetaminophen or ibuprofen if they are taking any of the following: Acetaminophen interactions
Ibuprofen interactions
People should stop using medication and see a doctor straightaway if they notice any of the following during or after taking acetaminophen or ibuprofen:
People should also check with their doctor before taking acetaminophen or ibuprofen if they currently have, or have a history of any of the following:
People can also check with a doctor if they are taking other medications that may interact, such as blood thinners or corticosteroids. Pregnant women, or women who are trying to get pregnant, should consult with their doctor before taking acetaminophen or ibuprofen. Acetaminophen and ibuprofen are safe to take together within the recommended dosage. People with any existing health conditions or taking other medications may need to check with a doctor first. If people think they have taken an overdose, or have any severe side effects from taking either medication, they should seek medical help immediately. How soon after taking ibuprofen can you take Tylenol?In this case, it's better to alternate when you take each medication. For example, you could take ibuprofen first, followed by acetaminophen four hours later, and then repeat this process as needed. You could also alternate days. For example, if you take ibuprofen on Monday, take acetaminophen on Tuesday and so on.
Can you alternate Tylenol and ibuprofen every 2 hours?Ibuprofen (Advil, Motrin) and acetaminophen (Tylenol) are over-the-counter pain relievers that work differently. It's generally safe to combine them as follows: Take ibuprofen and Tylenol together every 4 to 6 hours. Take ibuprofen and Tylenol alternating every 2 to 3 hours depending on the dose.
Can I alternate Tylenol and ibuprofen every 3 hours?For very high or stubborn fevers, alternate between Acetaminophen and Ibuprofen every three hours (i.e., give a dose of Acetaminophen then three hours later give Ibuprofen then three hours later Acetaminophen, ect.) These two medications are safe to use together like this.
What happens if you take 2 ibuprofen and 2 Tylenol together?Studies have shown that taking acetaminophen and ibuprofen at the same time is safe and even provides greater pain relief. This is because acetaminophen and ibuprofen work differently in the body, and are eliminated by different organs. The liver removes acetaminophen, while the kidneys eliminate ibuprofen.
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How many hours apart can you take tylenol and ibuprofen
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