Is It Safe To Take Tylenol (Acetaminophen) With Advil or Motrin (Ibuprofen)?

The simple answer? Yes, you can safely take acetaminophen and ibuprofen together.

This may surprise you, though: Taking these two medications together works better to relieve pain than taking them separately. Several large research studies have shown that ibuprofen (Advil, Motrin) and acetaminophen (Tylenol) together work well to relieve pain with few side effects. In fact, even for extreme dental pain, these medications combined work better than many opioid pain medications (like Vicodin or Norco).

Here’s why it’s generally safe to take acetaminophen and ibuprofen together and how much of each you can take.

Why is the combination safe?

Acetaminophen and ibuprofen work differently and they’re cleared from the body by different organs. Acetaminophen can put some stress on the liver, and ibuprofen may put some stress on the stomach and kidneys, but if you’re using these drugs in safe amounts, there is minimal concern here.

Acetaminophen is broken down almost completely by the liver, so the kidneys hardly do any work. However, if you take too much acetaminophen or you take it with alcohol, you could run into acute liver damage because of all the stress you’re putting on your liver.

In the stomach, ibuprofen blocks the actions of two chemicals that activate inflammation: prostaglandin and prostacyclin. But blocking these two chemicals can also result in irritation of the stomach and esophagus. This is why long-term use of ibuprofen can cause stomach inflammation (gastritis) and gastrointestinal bleeding. (Acetaminophen, on the other hand, is safe on the stomach.)

Unlike acetaminophen, ibuprofen is mostly broken down by the kidneys, so it’s very safe on the liver. However, the anti-inflammatory properties that can irritate your stomach also dilate blood vessels entering the kidneys. Take too much ibuprofen and you can get acute kidney injury. 

How much acetaminophen can I take?

The dosing recommendation for acetaminophen depends on the strength of the pill. For the 325 mg pills, you can take up to 2 pills every 6 hours. For the 500 mg pills (extra-strength tablets), you can take up to 2 pills every 8 hours (or twice a day).

The highest dose of acetaminophen you should ever take (not that you should try), is 4 grams per day. That would be 8 extra-strength Tylenol tablets (500 mg each) or 12 regular-strength tablets (325 mg each). Don’t take more than that.

How much ibuprofen can I take?

To treat mild to moderate pain, 200 mg to 400 mg of ibuprofen every 6 to 8 hours will work. The maximum dose of ibuprofen you should ever take is 2400 mg per day, which is 12 over-the-counter tablets.

Be sure take only the minimal amount of ibuprofen or acetaminophen you need to relieve your pain. Always ask your doctor or pharmacist if you aren’t sure of the right dose for your situation.

Dr O.

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