Is It Safe to Take Ibuprofen and Acetaminophen Together? Doctors Explain
Whether you’re dealing with an injury, illness, or chronic condition, chances are you’ve reached for a bottle of Advil or Tylenol at some point. Both drugs are extremely helpful when it comes to keeping pain (and a fever) at bay.
These OTC meds are especially useful in the midst of flu season and the COVID-19 pandemic when you may find yourself sick and struggling with symptoms like a fever, body aches, and a sore throat. In general, people with a mild case of cold, flu, or COVID-19 should be able to recover at home.
While you’re resting up and drinking plenty of fluids, you might be wondering which OTC drugs will help you feel better faster. At the top of the list? Ibuprofen and acetaminophen (a.k.a Advil and Tylenol).
Doctors say these meds will keep your fever and pains under control until you recover—but what’s the best way to take them? And is it safe to alternate the two, or even take them together? Here’s what you need to know.
Ibuprofen vs. acetaminophen: What’s the difference?
Ibuprofen (Advil, Motrin IB) is a nonsteroidal anti-inflammatory drug (NSAID) that’s often used in its nonprescription form to reduce fever, swelling, and minor pain from headaches, muscle aches, arthritis, menstrual cramps, and the common cold or flu, according to the U.S. National Library of Medicine. Ibuprofen works by inhibiting your body’s production of substances that can cause pain, fever, and inflammation.
Acetaminophen (Tylenol) is essentially used for the same reasons as ibuprofen—it’s just in a different class of medications called analgesics (pain relievers) and antipyretics (fever reducers). The exact mechanism for how acetaminophen works isn’t entirely understood, but it helps cool down the body while altering the way your body senses pain.
Is it safe to take ibuprofen and acetaminophen at the same time?
If you’re having minor pain or discomfort from a respiratory virus, injury, or chronic condition, it’s best to start by taking just one medication to see if it helps, says Richard Watkins, M.D., an infectious disease physician and a professor of internal medicine at the Northeast Ohio Medical University.
You should always read the label to find out how much you should take. If the recommended dosage of ibuprofen or acetaminophen doesn’t help, you could try alternating the two. This is “an old trick of family doctors and pediatricians to decrease fever, since it allows more drug to be taken within the dosing limits,” says John Sellick, D.O., an infectious disease expert and professor of medicine at the University at Buffalo/SUNY in New York.
It’s totally safe to do this, as long as you carefully follow the dosing instructions on the bottle (or talk to your pharmacist beforehand to ensure you’re cycling properly).
Here’s how it works: “Once you take a dose, you have a rise in the levels [of the particular drug] in your body and then a gradual fall in the levels,” explains Jamie Alan, Pharm. D., Ph.D., associate professor of pharmacology at Michigan State University. “Once the levels start to fall, symptoms of fever may re-emerge. However, the levels of the drug [in your body] have not fallen enough to safely take another dose.”
Taking a different medication—acetaminophen if you took ibuprofen first or vice versa—will help “ward off the symptom using a different mechanism,” Alan says. “By the time you are set to take the first medication again, the levels have fallen to a safe dose, and the cycle continues.”
But again, you have to keep a close eye on your doses here. “You should not exceed the maximum daily dose of either product because of risks of toxicity,” cautions David Cennimo, M.D., an infectious disease expert at Rutgers New Jersey Medical School. “People sometimes forget that acetaminophen can be in other things—like cough/cold medications—so they inadvertently take too much.”
He also notes that if your symptoms aren’t too bad, you don’t have to take medication at all, even if you have a fever. “In my personal practice, I only advocate treating fever if it is causing a deleterious effect or making the person uncomfortable,” he explains.
What about drugs that combine acetaminophen and ibuprofen? Are they safe?
Last year, Advil released a new drug called Advil Dual Action that contains 250 milligrams of acetaminophen and 125 milligrams of ibuprofen. The company says it can help relieve minor aches and pains for up to eight hours.
Before you try it, make sure you’re not already taking a drug (like OTC cold meds) that contains acetaminophen or ibuprofen since taking too much of either drug can be dangerous, says Dr. Alan.
If you have a fever or body aches and cycling through ibuprofen and acetaminophen in appropriate doses isn’t helping, you technically can take both medications at once as long as you “dose the drugs carefully and on the correct schedule so that toxicity will be minimized,” Dr. Sellick says. “Too much acetaminophen is liver toxic; ibuprofen can be kidney toxic.”
Bottom line: Always read the labels on the bottle for dosing instructions. And when in doubt, talk to your prescribing doctor or pharmacist to ensure you’re taking all of your medications safely.
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