What's the Difference Between Tylenol, Advil and Aleve?

Ever wonder which over-the-counter medicine to give a child experiencing muscle aches or pain from a mild injury? Tylenol, Advil, and Aleve are common pain relievers on drugstore shelves. While all three medications can help alleviate a child's discomfort, the active ingredient in each drug is different. In Tylenol, it's acetaminophen; in Advil and Motrin, it's ibuprofen; and in Aleve, it is naproxen.

Dr. Shevaun Doyle, a pediatric orthopedic surgeon at HSS, provides some general information and guidelines about acetaminophen, ibuprofen, and naproxen:

Acetaminophen (Tylenol)

• Provides pain relief.
• May be given to infants.
• Available as a pill, chewable tablet, liquid, and suppository.
• May not be used in children with liver abnormalities or medications affecting liver function.
• In children scheduled for surgery, it may be used right up until surgery.

Ibuprofen (Advil and Motrin)

• Provides pain relief.
• Works as an anti-inflammatory to reduce swelling.
• Longer-acting than Tylenol.
• Available as a pill, chewable tablet, and liquid.
• Needs to be taken with food or milk.
• Should not be taken if a child is vomiting, dehydrated, or not eating much.
• May not be used in children with gastrointestinal or kidney abnormalities or with medications affecting kidney function.
• May not be used 72 hours prior to surgery.
• May not be used in patients under six months old.

Naproxen (Aleve)

• Provides pain relief.
• Works as an anti-inflammatory.
• Longer-acting than acetaminophen and ibuprofen.
• Available over the counter in pill form and by prescription in liquid form.
• May not be used in children with gastrointestinal or kidney abnormalities or with medications affecting kidney function.
• Needs to be taken with food or milk.
• May not be used 72 hours prior to surgery.
• May not be used in patients under two years old.

Proper Dosage is Key

No matter which medication is used, Dr. Doyle advises parents to pay careful attention to dosing. For the liquid form, parents should use the dropper or dosing cup that comes with the product. Kitchen spoons should never be used since they're not uniform in size.

A study commissioned by the National Institutes of Health found that many parents had trouble measuring the proper dose and inadvertently gave their children too much medicine. The research supports the use of oral syringes rather than dosing cups, especially when small amounts of medication are given.

"Some parents mistakenly believe that because a medicine is sold over the counter, it's safer. That's not the case. An overdose can be very serious," Dr. Doyle said. In addition, she notes that the active ingredients in Tylenol and Advil are also found in other medications, such as cough and cold medicines. Parents are advised to read the list of ingredients in all medications a child is receiving to prevent double dosing.

Dr. Doyle also recommends that parents set up a schedule. "It's a good idea to write down the time a medication is given so it's easier to keep track of how much a child is receiving," she says. "If a parent has any questions about which over-the-counter medication to use or the proper dose, it's best to call the child's doctor."

Reviewed and updated May 9, 2022