Table of ContentsView AllTable of ContentsCombining Tylenol With AleveHow Tylenol WorksHow Aleve WorksDifferencesSide EffectsDosage
Table of ContentsView All
View All
Table of Contents
Combining Tylenol With Aleve
How Tylenol Works
How Aleve Works
Differences
Side Effects
Dosage
TakingTylenol (acetaminophen)together 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 Aleve and Tylenol together safely.
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It is generally considered safe to take Tylenol together with Aleve or another NSAID. These two medications belong to different drug classes, which means they work in different ways inside your body. They are also metabolized differently.
Some experts warn that certain side effects (digestive, for example) may be worse when you take both drugs together.But you may want to take Aleve and Tylenol together if just one is not providing you the relief you need. Be sure to adhere to recommended dosages when you combine these medications, and discuss their use with your healthcare provider.
On the other hand, if you have underlyingkidney impairmentor liver disease (likehepatitis 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.
NSAIDs for Chronic Pain: Risks of Long-Term Use
Tylenol works onprostaglandins(hormone-like substances) in the brain and spinal cord to reduce pain and inflammation. This also makes Tylenol a good choice for relieving fever.
Researchers, however, continue to study the exact mechanisms of Tylenol in the body. NSAID pain relievers act oncyclooxygenase(COX)compounds that the body needs to make prostaglandins; Tylenol has shown some comparatively weak ability to act as a COX inhibitor, too, but studies haven’t demonstrated clear evidence for this.
Tylenol is primarily broken down in the liver and is known for liver-related risks and complications.
How Does Tylenol Work?
Aleve and other NSAID drugs can cause kidney damage and, in some cases, chronic disease.It also is implicated in rare cases of liver damage.
How Tylenol and NSAIDs Differ
There are key differences between Tylenol (acetaminophen), Advil (ibuprofen), and Aleve (naproxen).
TylenolActive drug: acetaminophenPain reliever (analgesic) and fever reducer (antipyretic)Used for headaches, fever, muscle aches, backache, toothache, coldsAnti-InflammatoriesActive drug: ibuprofen, naproxen sodium, or aspirinReduces pain, fever,andinflammationUsed for conditions such as arthritis, bursitis, and tendinitis
TylenolActive drug: acetaminophenPain reliever (analgesic) and fever reducer (antipyretic)Used for headaches, fever, muscle aches, backache, toothache, colds
Active drug: acetaminophen
Pain reliever (analgesic) and fever reducer (antipyretic)
Used for headaches, fever, muscle aches, backache, toothache, colds
Anti-InflammatoriesActive drug: ibuprofen, naproxen sodium, or aspirinReduces pain, fever,andinflammationUsed for conditions such as arthritis, bursitis, and tendinitis
Active drug: ibuprofen, naproxen sodium, or aspirin
Reduces pain, fever,andinflammation
Used for conditions such as arthritis, bursitis, and tendinitis
Some differences between the two drugs are related to how they work, with Tylenol having lesser action as a COX inhibitor than Aleve does.
Can You Take Meloxicam and Tylenol Together?
Tylenol and NSAID 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 causeheartburn, stomach pain, andpeptic 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, causeserious liver damageif used in excess (more than 3,000 milligrams per day, or sixTylenol Extra Strengthcaplets) 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’tdouble up on NSAIDsbecause 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 (like taking Aleve and Tylenol together) may provide pain relief when either medication alone is not enough.Be sure to use the correct doses when doing so.
How Much Tylenol Extra Strength Is Safe to Take?
These are the typical adult dosages for Aleve when used for inflammation and pain relief:
Maximum doses of Aleve per day can vary based on circumstances, including:
Tylenol may be a better option if looking for a drug with shorter action. Dosages include:
The maximum dose of Tylenol for an acute episode is 3,200 mg per day, and lower (2,400 mg per day) for chronic pain.
Summary
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.
Stick to the recommended dosages and talk to your healthcare provider first if you have a kidney or liver condition.
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12 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Institute of Diabetes and Digestive and Kidney Diseases.Nonsteroidal Antiinflammatory Drugs (NSAIDs).LiverTox: Clinical and Research Information on Drug-Induced Liver Injury. Bethesda (MD) 2020. PMID: 31643926.Harvard Medical School.Heart-safer NSAID alternatives.National Health Service.Taking or using ibuprofen with other medicines and herbal supplements.Ayoub SS.Paracetamol (acetaminophen): A familiar drug with an unexplained mechanism of action.Temperature (Austin). 2021 Mar 16;8(4):351-371. doi:10.1080/23328940.2021.1886392.Gunaydin C, Bilge SS.Effects of nonsteroidal anti-inflammatory drugs at the molecular level.Eurasian J Med. 2018;50(2):116-121. doi:10.5152/eurasianjmed.2018.0010National Kidney Foundation.Pain Medicines (Analgesics).National Institute of Diabetes and Digestive and Kidney Diseases.Naproxen.LiverTox: Clinical and Research Information on Drug-Induced Liver Injury. 2020. PMID: 31643488.Scheiman J.NSAID-induced gastrointestinal injury: a focused update for clinicians.J Clin Gastroenterol.2016;50(1):5-10. doi:10.1097/MCG.0000000000000432Bally 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.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.2015.00052University of Connecticut Student Health.How to alternate Acetaminophen and Ibuprofen.UpToDate.Nonsteroidal antiinflammatory drugs (NSAIDs) and acetaminophen (paracetamol): usual oral dosing for adults with pain or inflammation and selected characteristics.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
National Institute of Diabetes and Digestive and Kidney Diseases.Nonsteroidal Antiinflammatory Drugs (NSAIDs).LiverTox: Clinical and Research Information on Drug-Induced Liver Injury. Bethesda (MD) 2020. PMID: 31643926.Harvard Medical School.Heart-safer NSAID alternatives.National Health Service.Taking or using ibuprofen with other medicines and herbal supplements.Ayoub SS.Paracetamol (acetaminophen): A familiar drug with an unexplained mechanism of action.Temperature (Austin). 2021 Mar 16;8(4):351-371. doi:10.1080/23328940.2021.1886392.Gunaydin C, Bilge SS.Effects of nonsteroidal anti-inflammatory drugs at the molecular level.Eurasian J Med. 2018;50(2):116-121. doi:10.5152/eurasianjmed.2018.0010National Kidney Foundation.Pain Medicines (Analgesics).National Institute of Diabetes and Digestive and Kidney Diseases.Naproxen.LiverTox: Clinical and Research Information on Drug-Induced Liver Injury. 2020. PMID: 31643488.Scheiman J.NSAID-induced gastrointestinal injury: a focused update for clinicians.J Clin Gastroenterol.2016;50(1):5-10. doi:10.1097/MCG.0000000000000432Bally 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.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.2015.00052University of Connecticut Student Health.How to alternate Acetaminophen and Ibuprofen.UpToDate.Nonsteroidal antiinflammatory drugs (NSAIDs) and acetaminophen (paracetamol): usual oral dosing for adults with pain or inflammation and selected characteristics.
National Institute of Diabetes and Digestive and Kidney Diseases.Nonsteroidal Antiinflammatory Drugs (NSAIDs).LiverTox: Clinical and Research Information on Drug-Induced Liver Injury. Bethesda (MD) 2020. PMID: 31643926.
Harvard Medical School.Heart-safer NSAID alternatives.
National Health Service.Taking or using ibuprofen with other medicines and herbal supplements.
Ayoub SS.Paracetamol (acetaminophen): A familiar drug with an unexplained mechanism of action.Temperature (Austin). 2021 Mar 16;8(4):351-371. doi:10.1080/23328940.2021.1886392.
Gunaydin C, Bilge SS.Effects of nonsteroidal anti-inflammatory drugs at the molecular level.Eurasian J Med. 2018;50(2):116-121. doi:10.5152/eurasianjmed.2018.0010
National Kidney Foundation.Pain Medicines (Analgesics).
National Institute of Diabetes and Digestive and Kidney Diseases.Naproxen.LiverTox: Clinical and Research Information on Drug-Induced Liver Injury. 2020. PMID: 31643488.
Scheiman J.NSAID-induced gastrointestinal injury: a focused update for clinicians.J Clin Gastroenterol.2016;50(1):5-10. doi:10.1097/MCG.0000000000000432
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.
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
University of Connecticut Student Health.How to alternate Acetaminophen and Ibuprofen.
UpToDate.Nonsteroidal antiinflammatory drugs (NSAIDs) and acetaminophen (paracetamol): usual oral dosing for adults with pain or inflammation and selected characteristics.
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