Advil vs. Tylenol: How They Work and Which to Use

In today’s fast-paced world, one would be hard-pressed to find a household that did not own some form of over-the-counter (OTC) pain medicine. Whether it be to relieve sore muscles after working out, a pounding headache from staring at screens all day, or even a fever you can’t quite seem to shake, pain relievers like ibuprofen and acetaminophen are almost always within arm’s reach. While these medications serve as an efficient means to relieve pain, it is important to know just how they work so that the next time you sprain your ankle, you know exactly which one will help the most.

First, it is important to understand exactly how pain works within the body. The feeling of pain, essentially, is a way for our body to let us know there has been tissue damage, or that damage will occur if you continue to, for example, keep working out a strained muscle. Within our tissues, we have nerve endings called nociceptors that alert our brain to an injury. When damage occurs to the tissues, lipids called prostaglandins are released to the area and cause inflammation to the tissues in order to heal them. Prostaglandins also play a role in homeostatic functions as well, such as inducing a fever in response to a cold or flu. However, nociceptors are extremely sensitive to prostaglandins and thus, in combination with inflammation, can lead to the feelings and sensations of pain.  

In response to the throbbing muscles on a bruised leg or the overwhelming heat of a fever, an OTC pain reliever can be fairly effective at relieving the pain. Two of the most common OTC painkillers are ibuprofen and acetaminophen, more commonly known by their brand names Advil and Tylenol, respectively.  Millions of people all across the globe take Advil or Tylenol pretty regularly to relieve mild to moderate pain, but just how do they work? 

While Advil and Tylenol are both considered to be analgesics (pain-relieving medications), they fall into separate categories. Advil, also known as ibuprofen, is categorized as a non-steroidal anti-inflammatory drug or NSAID.  As an NSAID, ibuprofen functions by inhibiting an enzyme called cyclooxygenase which is responsible for producing prostaglandins.  By inhibiting cyclooxygenase, ibuprofen effectively stops the production of prostaglandins, thereby allowing inflammation and pain to subside. Tylenol, or acetaminophen, works a little differently as it does not inhibit cyclooxygenase to the extent that ibuprofen does and, while it is still an analgesic, it is not categorized as an NSAID. To this day, the exact science behind how acetaminophen works is slightly unclear. However, it is widely believed that acetaminophen works within the brain and central nervous system to alter the perception of pain and lower the sensation of it as well, as opposed to ibuprofen that works directly in the tissues to stop or slow pain signals.  

Understanding the differences between ibuprofen and acetaminophen is crucial in determining which pain reliever will be most helpful for you and when.  When experiencing the common cold or a fever, both ibuprofen and acetaminophen can be helpful in relieving symptoms like headaches or lowering body temperatures. However, when it comes to injured and strained muscles, ibuprofen is likely to be more effective thanks to its anti-inflammatory properties that can help to reduce swelling and ease the pain.  

Additionally, another aspect to consider when choosing an OTC pain medication is the potential side effects or extraneous health issues that may arise. Generally, those with a history of liver problems should stay away from acetaminophen as it has been known to cause liver damage. Ibuprofen, on the other hand, can cause health issues in people who have heart disease, high blood pressure, and those who have blood clotting disorders. Ibuprofen should also be avoided by pregnant women and people who have problems with their kidneys.

As both ibuprofen and acetaminophen have their own pros and cons, choosing between the two ultimately boils down to personal preference and specific doctor recommendations.     

References:

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Illinois, University of. “Is Tylenol Anti-Inflammatory?” Healthline, Healthline Media, 25 July 2016, www.healthline.com/health/pain-relief/is-tylenol-anti-inflammatory.

McNicol, Ewan. “Ask The Professor - How Does Acetaminophen Relieve Pain? .” Tufts Journal, 2008, tuftsjournal.tufts.edu/2008/04/professor/01/.

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Ricciotti, Emanuela, and Garret A FitzGerald. “Prostaglandins and inflammation.” Arteriosclerosis, thrombosis, and vascular biology vol. 31,5 (2011): 986-1000. doi:10.1161/ATVBAHA.110.207449