Ask a PT: Ibuprofen or Tylenol?

Question: I have some sore muscles from my work-out two days ago.  Is it better to take ibuprofen or Tylenol to relieve my pain?

Answer: This is one of the most common questions we answer in the clinic.  Ibuprofen or any other NSAIDS (non-steroidal anti-inflammatories) are a class of medications that work differently than Tylenol or acetaminophen.  If you understand how each medicine works, you will know when it’s helpful to choose one over the other.

Ibuprofen is an anti-inflammatory that also helps reduce pain.  The effects on pain are rather immediate, whereas the anti-inflammatory impact is not felt for an entire week of heavy, regular use of the medicine.  For example, Advil or generic ibuprofen can be taken 3x/day for three meals a day for the typical 180 pound male or female, and after one week, a positive impact should be felt.  The dosing schedule can be continued for 2-3 weeks.  After that time, discontinue taking the medication, as the maximal effect should have already been felt.  There are side effects and reasons why you should not take ibuprofen, including if you are on a blood thinner like Eliquis, Coumadin, or aspirin, as well as if you have a tendency toward stomach trouble like ulcers, as NSAIDS are hard on your digestive system.  Long term use, (but even short term use as well) can lead to difficulties with the heart and the cardiovascular system, with the possibility of dramatic and dangerous changes to blood pressure.  Just because a medicine is available over the counter does not mean it is mild and cannot have adverse effects.

Tylenol or acetaminophen is an excellent pain reliever, but has little impact on inflammation.  It also has a rapid pain-reducing impact like ibuprofen, without the need to take with food, because it is not as hard on the stomach.  However, if you have kidney problems, Tylenol should be taken only after consultation with your physician.  Tylenol is often combined with other prescription pain medications, so ask your pharmacist if you are adding it to another pain control regimen to avoid an inadvertent over-dose.  Also, never take more than 4,000mg of Tylenol per day.

Sometimes taking both ibuprofen and acetaminophen together are utilized for acute pain and inflammation after surgery.  Your surgeon will direct you on how much to take and for how long to allow for both good pain control and to reduce swelling.  If you have any questions on the medications you are taking, you can always discuss or send a portal message to your family physician, or better yet, your pharmacist is an excellent, under-utilized resource to make sure your over the counter medicines are not adversely interacting with your prescription medicines.

As always, this information is provided for educational purposes only.  We cannot and do not know your particular situation, diagnosis, and treatment plan, so we cannot provide medical advice.  Please check with your physician or pharmacist before altering or adding anything to your prescription and non-prescription medicines.