Advil and Aleve are two over-the-counter (OTC) medications that belong to a class of drugs called nonsteroidal anti-inflammatory drugs (NSAIDs).
People may take these drugs to help reduce inflammation and pain or to help control a fever.
This article provides information on how Advil and Aleve work and outlines the similarities and differences between them. It also explains how to take each drug safely.
What are they?
Although Advil and Aleve can both reduce inflammation and pain, the intended uses and dosages differ.
Advil is the brand name of the drug ibuprofen, and Aleve is the brand name of the drug naproxen. Ibuprofen and naproxen are NSAIDs.
Doctors and pharmacists recommend NSAIDs to help reduce inflammation, pain, and fever.
People can use Advil and Aleve for the following:
- muscle pain
- menstrual pain
- headaches
- migraine episodes
- arthritis and arthrosis
- gout
What are the similarities and differences between them?
The sections below will outline some of the similarities and differences between Advil and Aleve.
Similarities
Drugs within the NSAID family can belong to different categories depending on their chemical structure. Advil and Aleve have similar chemical structures. They are propionic acids.
Another NSAID grouping corresponds to the selectivity of the drug for the cyclooxygenase, or COX, enzyme. This enzyme plays a role in the inflammatory process. Advil and Aleve are both non-selective NSAIDs, meaning that they can bind to both the COX-1 and COX-2 enzymes.
Differences
Advil and Aleve differ somewhat in terms of their intended use. The two drugs also differ in terms of their duration of action and their recommended dosages.
Learn more about these differences in the sections below.
Indications
Although ibuprofen and naproxen are both NSAIDs, the Food and Drug Administration (FDA) have approved each drug for different indications.
The following table lists these indications.
| Ibuprofen | Naproxen | |
| FDA-approved indications | fever mild-to-moderate pain painful menstruation inflammatory diseases arthrosis rheumatoid disorders closure of patent ductus arteriosus in premature infants | painful menstruation rheumatoid arthritis pain juvenile idiopathic arthritis arthrosis tendinitis acute gout bursitis ankylosing spondylitis |
Duration of action
A major difference between Advil and Aleve is their duration of action.
Advil has a shorter duration of action, with people typically needing to take repeat doses every 4–8 hours, if necessary.
Aleve has a longer duration of action, with people typically needing to take the medication twice per day, if necessary. People should not exceed three tablets in a 24-hour period.
The reason for this difference in duration of action is the half-life of each medication. The half-life of a drug corresponds to the time it takes for the body to remove half of the amount of the absorbed medication.
In adults, Advil has a half-life of 1.5 to 2 hours, whereas Aleve has a half-life of 12–17 hours.
Dosages
The dosages of Advil and Aleve are also different. The effective dose of ibuprofen starts at 200–400 milligrams (mg), while the effective dose of naproxen starts at 220–440 mg.
The daily dosage limit of ibuprofen for OTC use is 1,200 mg per day, while the daily limit of naproxen depends on what a person is using it for.
If necessary, doctors may recommend a higher dosage of either drug.
What do they do?
Advil and Aleve work by inhibiting the COX enzyme that produces prostaglandins. Prostaglandins are chemicals that the body makes to help heal injury or illness. However, they also cause inflammation and fever.
The body produces two COX enzymes: COX-1 and COX-2. Both play a role in the body’s inflammatory response. COX-2 also plays a role in maintaining the lining of the stomach and promoting blood clotting.
Advil and Aleve block COX-1 and COX-2, which explains their therapeutic action against inflammation and pain. It also explains some of the possible side effects of these drugs, which may include:
- digestive issues
- cardiovascular diseases
- kidney diseases
People with a history of medical conditions involving the digestive system, heart, or kidneys should speak to a doctor before taking Advil or Aleve. These NSAIDs may aggravate such conditions.
Can I take them together?
People should avoid taking Advil and Aleve together.
Since both drugs act on the COX-1 and COX-2 enzymes, there is no benefit in combining them. If necessary, people can combine an NSAID with acetaminophen, since these drugs have different mechanisms of action to treat pain and fever.
Combining Advil and Aleve can put people at risk of additional side effects without improving the efficacy of either drug. Side effects of taking high amounts of NSAIDs or a combination of NSAIDs include:
- decreased kidney function
- stomach and intestinal bleeding
- decreased blood clotting ability and increased bleeding time
How to take them safely
Before a person takes an OTC NSAID, they need to determine whether or not the drug is safe for them to take.
People with underlying medical conditions may need to speak with a doctor before taking Advil or Aleve.
NSAIDs are not suitable for the following groups:
- people in their third trimester of pregnancy
- people who are sensitive to NSAIDs or salicylates
- people who have previously experienced an allergic reaction after taking an NSAID
- people who have undergone coronary artery bypass graft surgery
People who are able to take NSAIDs need to ensure that they take a safe dosage. Most adults can take up to 1,200 mg of ibuprofen every 24 hours. People can take up to 600 mg of Aleve every 24 hours. However, a person should never combine these drugs.
To reduce the impact of digestive side effects, doctors and pharmacists recommend taking NSAIDs with food.
When to see a doctor
A person should see a doctor if they experience side effects while taking an NSAID or if they take more than the recommended dosage.
Children may experience symptoms of overdose depending on how much Advil or Aleve they have taken. Experts suggest that children who take more than 400 mg of ibuprofen per kilogram of body weight may develop life threatening toxicity.
However, they have not yet established a specific toxic amount for symptomatic overdose in adults.
Since both Advil and Aleve are propionic acid NSAIDs, their toxic effects may be similar. For example, they may both induce seizures and cause metabolic acidosis. This is the medical term for a toxic buildup of acid within the blood.
Most people do not experience side effects from taking too much ibuprofen. If symptoms do occur, they usually occur within about 4 hours of overdosing.
Ibuprofen toxicity may cause the following symptoms:
- headaches
- nausea
- vomiting
- abdominal pain
- bright red or dark blood in the feces
- a rapid heartbeat
- rapid breathing
- shortness of breath
- chest pain or pressure
- swelling in the legs or ankles
- tiredness
- weakness
- confusion
- coma
Summary
Advil and Aleve are both NSAIDs that are effective in treating inflammation and pain. Both drugs can also help lower body temperature and reduce a fever.
People should not take Advil and Aleve together, as both drugs target the COX enzymes. Therefore, taking the two drugs together does not confer any extra benefit and only increases the risk of side effects.
NSAIDs are not suitable during the third trimester of pregnancy or for people with certain underlying health conditions.
If in doubt, a person should talk to their doctor or pharmacist to determine whether or not it is safe for them to take an NSAID.
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