Written by Stacia Woodcock, PharmD | Reviewed by Joshua Murdock, PharmD, BCBBS Updated on November 10, 2022
Key takeaways:
- Acetaminophen (Tylenol) and ibuprofen (Advil, Motrin) are both over-the-counter (OTC) medications for pain.
- Acetaminophen and ibuprofen work differently in the body. They are also cleared from the body by different organs. This makes it safe to use them together for additional pain relief if one alone doesn’t do the trick.
- You should never take more than the recommended daily amount of OTC pain medication. If your pain isn’t relieved, talk to your healthcare provider for other options.
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Is it safe to take acetaminophen (Tylenol) with ibuprofen?
The simple answer? Yes, you can safely take acetaminophen and ibuprofen together. And it may surprise you that taking these two medications together actually works better to relieve pain than taking them separately.
Studies have shown that ibuprofen (Advil, Motrin) and acetaminophen (Tylenol) together work well to relieve certain types of pain, and with few side effects. In fact, for moderate to severe dental pain, this combination often works better than many opioid pain medications.
Although it’s generally safe to take acetaminophen and ibuprofen together, there are still some details to consider before you do.
Why is the combination safe?
Acetaminophen and ibuprofen work differently, and they’re cleared from the body by different organs. Acetaminophen is a pain reliever, but it isn’t a nonsteroidal anti-inflammatory drug (NSAID). Ibuprofen, however, is an NSAID — a class of medication that also includes aspirin (Ecotrin) and naproxen (Aleve, Naprosyn).
Acetaminophen is broken down almost completely by the liver, so the kidneys hardly do any work. But if you take too much acetaminophen, or drink alcohol while taking it, the added stress on your liver could result in liver damage.
Ibuprofen blocks the production of prostaglandins. Prostaglandins cause inflammation, so blocking them helps reduce swelling. But they also protect the stomach, so blocking them can cause irritation of the stomach, intestines, and esophagus, as well. This is why long-term use of ibuprofen can cause stomach inflammation (gastritis) and bleeding. Acetaminophen, on the other hand, is safe for the stomach.
Unlike acetaminophen, ibuprofen is mostly broken down by the kidneys, so it’s safe for the liver. But the anti-inflammatory properties that can irritate your stomach also affect blood vessels entering the kidneys. This is why taking too much ibuprofen can damage your kidneys.
Still, if you’re using these medications in safe amounts, there’s minimal concern for harmful side effects.
How much acetaminophen can I take?
The dosing recommendation for acetaminophen depends on the strength of the medication. For the 325 mg pills, adults and children over 12 years of age can take up to 2 pills every 4 to 6 hours as needed. For the 500 mg pills (extra-strength tablets), you can take up to 2 pills every 6 hours. For children, the dosage is based on weight. Your healthcare provider can help determine the right dose for your child.
You should also be aware that acetaminophen may also be included in other medications, such as OTC cough and cold products. The dose of acetaminophen in these medications may vary, so it’s important to read the package.
The highest dose of acetaminophen you should ever take is 4 grams (4,000 mg) per day for adults and children 12 and over. But a lower daily dose may be better. The manufacturer recommends no more than 3 grams (3,000 mg) daily. This may be a better choice, especially if you have low body weight, drink more than 3 alcoholic drinks a day, or have a fever. A lower dose is also better if you’re taking acetaminophen every day for more than a week at a time.
How much ibuprofen can I take?
Ibuprofen is available over the counter (OTC) as 200 mg tablets. A children’s version is also available as 100 mg chewable tablets or 100 mg per 5 mL liquid.
To treat mild to moderate pain, taking 200 mg to 400 mg (1 to 2 tablets) of ibuprofen every 6 to 8 hours as needed will work for adults and children ages 12 years and older. The maximum dose of ibuprofen you should take on your own is 1,200 mg (6 adult tablets) per day. You shouldn’t take more than that without a healthcare provider’s recommendation. Keep in mind that dosing for children is based on weight, and the maximum daily dose may be lower.
You can take acetaminophen and ibuprofen at the same time. You can also alternate between them, which may be more helpful for controlling fevers in children. Be sure to take only the minimal amount of ibuprofen or acetaminophen you need to relieve your pain. Always ask your healthcare provider or pharmacist if you aren’t sure of the right dose for your situation.
What about taking Advil or Tylenol with Aleve (naproxen)?
As mentioned, naproxen is another NSAID commonly used for pain and inflammation. It can also be taken with acetaminophen for added pain relief. Naproxen is available OTC as 220 mg tablets. The dose for adults and children over 12 years old is 220 mg (1 tablet) every 8 to 12 hours, as needed. You shouldn’t take more than 660 mg (3 tablets) in a 24-hour period.
Keep in mind that naproxen should only be taken with acetaminophen. You should not take naproxen and ibuprofen at the same time. They are both NSAIDs, and the combination could put you at risk for side effects, including kidney damage, stomach ulcers, or bleeding.
The bottom line
Acetaminophen and ibuprofen are two commonly used OTC medications used for pain. When one alone doesn’t do the trick, they can be safely used together for added pain relief for most people. It’s generally safe to take them together because they work differently in the body and are cleared by different organs.
Always follow the recommended dosing for both medications. If your pain still isn’t relieved by taking acetaminophen and ibuprofen, talk to your healthcare provider. They can help you find another option that’s safe for you.
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