Aleve vs Tylenol

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For patients dealing with pain, inflammation, or fever, certain drugs that inhibit the production of chemicals in the body that cause these symptoms can help in alleviating discomfort and managing symptoms. Aleve and Tylenol are two such drugs that are commonly used for pain relief. They each work differently in the body, but both have effects in easing pain and reducing fever. Aleve, also known as Naproxen, is a nonsteroidal anti-inflammatory drug (NSAID), effectively reducing inflammation and providing longer-lasting pain relief. Tylenol, on the other hand, also known as Acetaminophen, is not an anti-inflammatory drug, but it is effective in reducing fever and providing immediate pain relief. It's worth noting that while Aleve can be taken less frequently due to its long-lasting effects, Tylenol can be safer for those with certain health conditions, such as heart disease, as it carries less risk of causing stomach and heart problems.

What is Aleve?

Naproxen (the generic name for Aleve) is a nonsteroidal anti-inflammatory drug (NSAID), which signified a significant breakthrough in the class of drugs used to manage pain and inflammation. Naproxen was first approved by the FDA in 1976. Aleve works by reducing hormones that cause inflammation and pain in the body, providing relief for many types of discomfort including arthritis, bursitis, gout attacks and more. It has a selective effect on cyclooxygenase-2 with only minor influence on cyclooxygenase-1, thus resulting in fewer gastrointestinal side effects than other NSAIDs that have stronger effects on these two enzymes.

On the other hand, Acetaminophen (the active ingredient in Tylenol) is not classified as an NSAID but still provides effective relief from mild to moderate pain such as headaches or toothaches and reduces fever effectively. Unlike NSAIDs like naproxen, acetaminophen doesn't reduce swelling or inflammation; instead it alters how our bodies perceive pain.

What conditions is Aleve approved to treat?

Aleve (naproxen) is FDA approved for the treatment of various types of pain and inflammation:

  • Arthritis-related conditions such as rheumatoid arthritis, osteoarthritis, and ankylosing spondylitis
  • Mild to moderate pain due to muscle aches or sprains
  • Menstrual cramps
  • Headaches, including migraines
  • Fever reduction

On the other hand, Tylenol (acetaminophen) is also used to relieve mild-to-moderate pain from headaches, reduce fever and relieve minor aches and pains due to the common cold or flu. However, unlike Aleve it does not have anti-inflammatory properties.

How does Aleve help with these illnesses?

Aleve, generically known as naproxen, works to alleviate pain and reduce inflammation by inhibiting the production of prostaglandins, bodily chemicals that cause inflammation, fever and pain. It does this by blocking enzymes called COX-1 and COX-2 that are involved in prostaglandin production. By preventing their formation, Aleve can mitigate symptoms like swelling and fever associated with various conditions such as arthritis.

On the other hand, Tylenol or acetaminophen primarily acts within the central nervous system. It is believed to inhibit a specific variant of the cyclooxygenase enzyme found predominantly within the brain. This reduces pain signals at their source within the nervous system itself. Additionally, it has minimal anti-inflammatory action compared to Aleve making it less effective for inflammatory issues but more suitable for general pain relief and fevers.

What is Tylenol?

Tylenol, a brand name for acetaminophen (also known as paracetamol in many parts of the world), is an analgesic and antipyretic, meaning it reduces pain and fever. Tylenol is thought to work by reducing the production of prostaglandins in the brain, which helps to lower fever and reduce pain. Unlike Aleve, a non-steroidal anti-inflammatory drug (NSAID), Tylenol does not reduce inflammation. This key difference in mechanism means that Tylenol might be a better choice for those who cannot take NSAIDs due to stomach issues or heart disease. Tylenol was first made available in 1955 and is now one of the most commonly used medications in the United States. It's available over-the-counter in tablet, chewable tablet, liquid and suppository forms. The side effect profile of Tylenol differs from that of NSAIDs like Aleve; it does not cause stomach upset or heart-related problems, but overuse can lead to liver damage. Therefore, it is crucial to follow the recommended dosage instructions when taking Tylenol.

What conditions is Tylenol approved to treat?

Tylenol, also known as acetaminophen, has been approved for the treatment of various pain-related conditions and fever, such as:

  • Headaches and migraines
  • Muscle aches and back pain
  • Toothaches and menstrual cramps
  • Arthritis
  • Reduction of fever

Although it's not an anti-inflammatory drug like Aleve, Tylenol is often the first choice of many healthcare professionals for pain relief due to its safety profile when used at recommended doses.

How does Tylenol help with these illnesses?

Tylenol, known generically as acetaminophen, is an analgesic that works primarily in the nervous system, inhibiting the synthesis of chemical messengers called prostaglandins which help transmit pain signals to the brain. This makes Tylenol highly effective in relieving pain and reducing fever. Unlike Aleve, which belongs to the nonsteroidal anti-inflammatory drugs (NSAIDs) class and may cause stomach upset or heart problems, Tylenol is not associated with these risks. Moreover, it is less likely to interact with other medications. However, it does not have the same anti-inflammatory effect as Aleve, therefore it may not be as effective in relieving pain from inflammation-related conditions. It's often the go-to option for patients who cannot take NSAIDs like Aleve, or for those who are looking for a safer, gentler option for pain relief.

How effective are both Aleve and Tylenol?

Both naproxen (Aleve) and acetaminophen (Tylenol) have established histories of success in managing pain and reducing fever, with their initial FDA approvals occurring just a few years apart. They act on different mechanisms within the body, which may be considered under varying conditions. A 2004 study directly compared the effectiveness of naproxen and acetaminophen in alleviating postoperative dental pain; both drugs demonstrated similar efficacy in managing symptoms as well as comparable safety profiles.

A review from 1991 showed that acetaminophen is effective at relieving mild to moderate pain, especially when it's due to inflammation such as headaches or arthritis. Its side effect profile is more favorable than many other over-the-counter analgesics, making it a commonly prescribed drug worldwide for various types of discomfort. Moreover, unlike NSAIDs like Aleve, Tylenol does not increase the risk of stomach ulcers or interfere with blood clotting.

On the other hand, a meta-analysis conducted in 2015 revealed that while Aleve seems to have comparable efficacy to Tylenol for general pain relief and reduction of fever, it has an edge when dealing with inflammatory conditions thanks its anti-inflammatory properties. However, Naproxen is typically considered only after using safer first-line treatments like Acetaminophan because long-term usage can lead to gastrointestinal complications such as stomach ulcers or bleeding.

abstract image of a researcher studying a bottle of drug.

At what dose is Aleve typically prescribed?

Oral dosages of Aleve, also known as naproxen, typically range from 220-440 mg every 8 to 12 hours as needed. For Tylenol (acetaminophen), the standard adult dose is usually 325-650 mg every four to six hours or 1000mg every six to eight hours. However, it's important not to exceed a maximum of 3000mg in one day unless directed by a healthcare provider. Children's doses for both medications are determined based on their weight and should be given under guidance from a healthcare professional. It’s crucial not to increase the dosage if there is no response without consulting with your doctor first.

At what dose is Tylenol typically prescribed?

Tylenol treatment is usually initiated with a dosage of 325–500 mg every 4-6 hours as needed for pain or fever. The dose can then be increased, but should not exceed the maximum daily limit of 3000 mg for adults to avoid liver damage. For children and adolescents, the recommended dosage varies depending on their weight and age; therefore, it's essential to consult with a healthcare provider before administering Tylenol. If there's no response to the initial dosage after a short period, you may consider increasing the dose within safe limits or switching to another medication under medical supervision.

What are the most common side effects for Aleve?

Common side effects of Aleve (naproxen) could include:

  • Upset stomach, heartburn

  • Nausea, vomiting

  • Headache, dizziness or drowsiness

  • Rash

  • Ringing in the ears. On the other hand, Tylenol (acetaminophen) may cause:

  • Mild skin itching or rash

  • Headache -Nausea, stomach pain, -Loss of appetite, -Dark urine, -Jaundice (yellowing of the skin or eyes)

Remember that these lists are not exhaustive and if you experience any unusual symptoms while taking either medication, it would be prudent to consult your healthcare provider for further advice.

abstract image of a patient experiencing side effect

Are there any potential serious side effects for Aleve?

In rare cases, Aleve (naproxen) can potentially cause serious side effects, which include:

  • Signs of a severe allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue or throat
  • Symptoms of heart attack or stroke: chest pain spreading to your jaw or shoulder, sudden numbness or weakness on one side of the body, slurred speech
  • Liver problems: nausea and vomiting coupled with loss of appetite and tiredness that may escalate into dark urine and yellowing skin/eyes (jaundice)
  • Kidney issues indicated by changes in quantity/coloration of urine output
  • Anemia symptoms including fatigue and paleness.

If you experience any such symptoms after taking Aleve it's important to seek immediate medical attention. Tylenol (acetaminophen), while generally safe for most people at recommended doses can also have potential adverse effects like:

  • Allergic reactions often manifesting as rash/itching/swelling especially in the face/tongue/throat region
  • Severe dizziness
  • Difficulty in breathing

Again if these occur stop using Tylenol immediately and consult a healthcare professional.

What are the most common side effects for Tylenol?

Common side effects of Tylenol (acetaminophen) may include:

  • Mild headache
  • Mild skin rash
  • Nausea, stomach pain, loss of appetite
  • Trouble sleeping (insomnia)
  • Itching or rash
  • Increased sweating and feeling anxious or nervous
  • Ringing in the ears or change in hearing.

However, it is important to note that most people who take Tylenol do not experience all these side effects. Consulting with a healthcare provider can help ensure you're using this medication safely.

Are there any potential serious side effects for Tylenol?

While Tylenol is generally considered safe for use, it's important to be aware of potential side effects that may indicate serious health issues. These can include:

  • Signs of a severe allergic reaction, such as hives; difficulty breathing; swelling in your face, lips, tongue or throat
  • Skin redness or rash that spreads and causes blistering and peeling (even with no fever), which could be signs of certain severe skin reactions
  • Changes in behavior with nausea and stomach pain
  • Liver problems: upper stomach pain, loss of appetite, dark urine or jaundice (yellowing of the skin or eyes)
  • Low platelet count leading to unusual bleeding or bruising
  • Severe headache

If you experience any of these symptoms while using Tylenol, stop taking the medication immediately and seek emergency medical attention.

Contraindications for Aleve and Tylenol?

Both Aleve and Tylenol, like all pain relievers, may increase your risk of certain side effects if used improperly. If you experience any unusual symptoms or discomfort after taking these medications, seek immediate medical attention.

Neither Aleve nor Tylenol should be taken in conjunction with certain other drugs without consulting a healthcare professional. Specifically, mixing NSAIDs such as Aleve with blood thinners can increase the risk of bleeding, while combining acetaminophen (Tylenol) with alcohol or other liver-damaging substances can lead to severe liver damage.

Always inform your healthcare provider about any medications you are currently taking; this includes prescription drugs, over-the-counter medicines, vitamins and herbal supplements. This allows them to ensure that there won't be any dangerous interactions between Aleve or Tylenol and what is already in your system.

How much do Aleve and Tylenol cost?

For the brand name versions of these drugs:

  • The price for 100 tablets of Aleve (naproxen sodium, 220 mg each) averages around $10, which works out to about $0.20/day if you're taking a typical over-the-counter dose.
  • The price for 100 caplets of Tylenol Extra Strength (acetaminophen, 500 mg each) is approximately $10 as well, working out to roughly $0.40/day at the maximum recommended daily dose.

Thus, if you are in need of long-term pain management and considering costs only, Aleve may be more cost-effective than Tylenol on a per-day treatment basis. However, please note that cost should not be your primary consideration in determining which drug is right for you - side effects and possible interactions with other medications are also important factors.

For generic versions of these drugs – naproxen sodium and acetaminophen – prices can vary but tend to be even lower:

  • Generic naproxen sodium is available in packs from 50 up to several hundred tablets with approximate costs ranging between less than ten cents per day up to about twenty cents depending on dosage.
  • Acetaminophen generics come in similar quantities with costs typically under ten cents per day at common over-the-counter dosages.

Popularity of Aleve and Tylenol

Naproxen, in generic form as well as brand names such as Aleve, was estimated to have been prescribed to about 6.1 million people in the US in 2020. Naproxen accounted for just over 10% of nonsteroidal anti-inflammatory drug (NSAID) prescriptions in the US. However, it appears to be one of the most common "long-acting" NSAIDs due to its twice-daily dosing schedule. The use of naproxen has been generally increasing since its over-the-counter status approval.

Acetaminophen, including brand versions like Tylenol, is an over-the-counter medication and hence difficult to track prescription numbers accurately; however, it's widely recognized as one of America’s leading analgesic drugs consumed by millions every year. It accounts for a significant percentage of overall OTC pain reliever sales and usage across various age groups. Unlike NSAIDs like naproxen, acetaminophen does not reduce inflammation but is often favored for its safer profile on gastrointestinal side effects and cardiovascular risks.


Both Aleve (naproxen) and Tylenol (acetaminophen) have a long track record of efficacy in managing pain and reducing fever. Their effectiveness is well-documented in numerous clinical studies, which show that they offer more relief than placebo treatments. However, the two drugs work differently; naproxen both reduces inflammation and relieves pain, while acetaminophen only relieves pain.

Aleve is often used for conditions associated with inflammation such as arthritis or tendinitis, whereas Tylenol may be preferred for non-inflammatory conditions like headache or fever. In some cases, these medications can be taken together but this should always be done under the guidance of a healthcare professional due to potential risks of side effects.

Both medicines are available over-the-counter at relatively low cost. The onset of action varies between them: While Aleve might take longer to start working compared to Tylenol, it has a longer duration of action and therefore requires fewer doses per day.

In terms of side effects: Both drugs are generally well-tolerated if used correctly; however, they do carry certain health risks if misused or taken in large amounts over time - Aleve can cause stomach ulcers or heart problems while prolonged use of high-dose Tylenol can lead to liver damage. As with any medication regimen changes or new symptoms warrant consultation with a healthcare provider immediately.