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Over-the-counter (OTC) medication is often the first line of defense against headaches, joint discomfort, and other minor ailments. Tylenol (acetaminophen) and nonsteroidal anti-inflammatory drugs (NSAIDs) are OTC medicines used to treat mild to moderate aches and pains.
NSAIDs not only lessen or eliminate the feeling of pain, but they also reduce inflammation as well. Many individuals are unclear whether or not Tylenol, the brand name for acetaminophen, is an NSAID. Tylenol is an analgesic (pain reliever) but not an anti-inflammatory, so Tylenol is not considered an NSAID.
Learn more about the differences between Tylenol and NSAIDs, their side effects, and which is better for the different types of pain you may experience.
What’s the difference between acetaminophen and NSAIDs?
Technically, acetaminophen blocks the brain from sending pain signals to affected areas of the body. It is also a fever reducer. In addition to being the active ingredient in Tylenol, acetaminophen is in numerous brand-name products such as NyQuil Cold and Flu, DayQuil, Alka-Seltzer Plus, and Excedrin.
Tylenol may be useful for mild to moderate pain relief associated with headaches, menstrual cramps, toothaches, and so forth. An NSAID, like ibuprofen, may be more suitable if there is inflammation or swelling associated with the pain. Some arthritis pain, joint pain, muscle aches, back pain, and sprains may benefit from the anti-inflammatory properties of an NSAID.
How to choose the right over-the-counter pain reliever
When choosing an OTC pain reliever, it is helpful to know the generic name of the medicine and if it is an NSAID. Several factors will help you determine which pain reliever is the best choice for you. These include:
- Your doctor’s medical advice or a self-assessment of your specific ailment
- Your age, weight, medical condition, etc.
- If you are taking other medications and whether they could cause a negative drug-drug interaction
- The medication’s possible side effects
The chart below outlines the various brand-name OTC drugs, their generic names, and whether they are NSAIDs. The general dosage recommendations for adults are also listed. Many of these medications are available in alternative doses and extra-strength. Prescription drugs, like Tylenol #3, are available for pain management for severe and chronic pain.
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| Brand name | Generic name | NSAID? | General adult dose information |
| Tylenol | acetaminophen | No | 325 mg per tablet 2 tablets every 4-6 hours Not to exceed 3000 mg per day |
| Advil, Motrin | ibuprofen | Yes | 200 mg per tablet 1 tablet every 4-6 hours Not to exceed 6 tablets per day |
| Aleve | naproxen | Yes | 220 mg per tablet 1 tablet every 8-12 hours Not to exceed 2 tablets in an 8-12 hour period or 3 tablets per day |
| Bufferin | aspirin/antacid | Yes | 325 mg per tablet 2 tablets every 4 hours Not to exceed 12 tablets every 24 hours |
| Bayer | aspirin | Yes | 325 mg per tablet 1-2 tablets every 4 hours Not to exceed 12 tablets in 24 hours |
| Anacin | aspirin/caffeine | Yes | 400 mg aspirin and 32 mg caffeine per tablet 2 tablets every 6 hours Not to exceed 8 tablets per day |
Most of the OTC drugs above should not be taken on an empty stomach. Drinking a full glass of water with each dose is recommended. Furthermore, most of these OTC drugs warn against using any OTC pain medicine for more than 10 consecutive days. Be sure to read the medication guide as dosage instructions may vary.
Pros and cons of acetaminophen vs. NSAID
You should always weigh the health benefits and risks associated with each type of drug before taking it. Consider your health condition and the other medications you’re currently taking. The side effects and drug-drug interactions are important factors in determining which is better: acetaminophen or NSAIDs.
For example, your doctor or pharmacist may recommend acetaminophen instead of ibuprofen if you are prone to stomach ulcers. If you are at risk of a heart attack, taking aspirin could be the right choice for you. However, if you’re already taking a blood thinner, then taking aspirin could be dangerous. Another drug, Anacin, contains caffeine, which may or may not be helpful to one’s condition.
Compare the pros and cons of these types of pain relievers below and ask a healthcare professional for advice if you’re unsure which is best for you.
Advantages of acetaminophen
Acetaminophen is less likely than a nonsteroidal anti-inflammatory to cause stomach upset. Individuals with sensitive stomachs, stomach ulcers, or acid reflux may benefit from taking Tylenol versus an NSAID.
Additionally, acetaminophen is not a blood thinner. Acetaminophen could be a safer option than aspirin for people with bleeding disorders or those already taking blood thinners.
Side effects of acetaminophen
Some individuals reported side effects of acetaminophen, including:
- Sweating more than usual
- Nausea
- Bruising
- Faint or lightheadedness
- Trouble urinating
- Dark stool
- Jaundice (yellowing of skin and eyes)
Ask your doctor if you can use Tylenol and products containing acetaminophen when pregnant or breastfeeding because some of the drug may be passed to the baby.
You should not take Tylenol if you have liver disease or cirrhosis of the liver. Acetaminophen can further damage your liver and affect your ability to urinate properly. Additionally, combining alcohol with acetaminophen can cause liver damage or failure.
Acetaminophen’s primary drug-drug interaction is with itself. Too much acetaminophen can cause Tylenol poisoning. Some side effects include vomiting, loss of appetite, extreme fatigue, and stomach pain. Be careful when mixing medicine that contains acetaminophen, such as Tylenol with DayQuil or NyQuil, Alka-Seltzer, and Excedrin.
Allergic reactions to acetaminophen can occur. Stop taking the medication and seek medical attention if you have difficulty breathing or develop hives or blisters. An overdose of Tylenol can be toxic, so do not take more than the recommended amount.
Advantages of NSAIDs
A nonsteroidal anti-inflammatory drug has the added benefit of reducing inflammation. If you have swelling, an NSAID may be more appropriate to treat your ailment.
NSAIDs can also be safer, less addictive alternatives to prescription-strength painkillers, like OxyContin, Percocet, and Vicodin. Your doctor may recommend NSAIDs for recovery after a minor injury or during physical therapy.
Naproxen was even ranked the most effective NSAID for knee osteoarthritis in 2018 by the American Academy of Orthopedic Surgeons. And, depending on your health condition, a doctor may recommend low-dose aspirin therapy to prevent blood clots and decrease your risk of heart attack or stroke.
However, long-term use of NSAIDs is not often recommended. It can cause serious side effects, which you can learn more about below.
Side effects of NSAIDs
Nonsteroidal anti-inflammatory drugs can cause side effects including but not limited to:
- Lightheadedness or dizziness
- Gas and bloating
- Nausea
- Diarrhea or constipation
- Stomach pain and heartburn
Stomach pain and heartburn associated with NSAIDs like ibuprofen tend to be more severe than when using Tylenol. Ulcers may even occur. An increased risk for gastrointestinal bleeding is also a potential side effect of NSAIDs, especially when using aspirin.
Those with medical conditions such as kidney disease or liver disease should avoid using NSAIDs. Additionally, combining alcohol with NSAIDs can increase your risk of gastrointestinal bleeding.
NSAIDs may also raise one’s blood pressure. Talk to your doctor before taking OTC anti-inflammatory drugs if you have high blood pressure or if you are at risk for or have had a heart attack or stroke. Aspirin is the only NSAID that lowers the risk of heart attack, stroke, and blood clots.
In addition, NSAIDs may cause adverse effects during pregnancy, such as an increased risk of miscarriage, according to the U.S. National Library of Medicine. There are many risks involved when taking medicine during pregnancy, so be sure to consult your physician before taking pain medicine while pregnant.
You may be experiencing an allergic reaction to an NSAID if you have difficulty breathing, wheezing, tightness of chest, or skin rash. Immediately stop taking the drug and seek professional medical assistance.
