Can You Take Aleve and Tylenol Together?

Taking Tylenol (acetaminophen) together with anti-inflammatory drugs like Aleve (naproxen) or Advil (ibuprofen) is generally considered safe, as long as you don't exceed recommended dosages. 

Acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs) have different compositions and actions. They are also eliminated from the body in different ways, which means taking them together won't put too much stress on the liver or kidneys in most cases.

This article discusses the simultaneous use of Tylenol and anti-inflammatories for pain relief. It also provides information about how you can take Aleve and Tylenol together safely.

Doctor giving patient pills
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Combining Tylenol With Aleve

It is generally considered safe to take Tylenol together with Aleve or another NSAID. These two medications belong to different drug classes, which means they work in different ways inside your body. They are also metabolized differently.

Tylenol is eliminated through the liver, while NSAIDs like Aleve are eliminated by the kidneys. For this reason, taking them together won't overwork either one of these organs. Consider alternating Tylenol with another NSAID, too, to limit the risks that occur with either type of medication.

Some experts warn that certain side effects (digestive, for example) may be worse when you take both drugs together. But you may want to take Aleve and Tylenol together if just one is not providing you the relief you need. Be sure to adhere to recommended dosages when you combine these medications, and discuss their use with your healthcare provider.

On the other hand, if you have underlying kidney impairment or liver disease (like hepatitis B or C), you will need to work with your healthcare provider to either tailor your usage or find alternatives that won't contribute to organ damage.

How Tylenol Works

Tylenol works on prostaglandins (hormone-like substances) in the brain and spinal cord to reduce pain and inflammation. This also makes Tylenol a good choice for relieving fever.

Researchers, however, continue to study the exact mechanisms of Tylenol in the body. Other NSAID pain relievers act on cyclooxygenase (COX) compounds that the body needs to make prostaglandins; Tylenol has shown some comparatively weak ability to act as a COX inhibitor, too, but studies haven't demonstrated clear evidence for this.

Tylenol is primarily broken down in the liver and is known for liver-related risks and complications.

How Aleve Works

Aleve is an NSAID, and it blocks the COX enzymes (called COX-1 and COX-2) that the body uses to make prostaglandins. This, in turn, acts on inflammation by limiting the body's ability to produce prostaglandins.

Aleve and other NSAID drugs can cause kidney damage and, in some cases, chronic disease. It also is implicated in rare cases of liver damage.

How Tylenol and NSAIDs Differ

There are key differences between Tylenol (acetaminophen), Advil (ibuprofen), and Aleve (naproxen).

Tylenol
  • Active drug: acetaminophen

  • Pain reliever (analgesic) and fever reducer (antipyretic)

  • Used for headaches, fever, muscle aches, backache, toothache, colds

Anti-Inflammatories
  • Active drug: ibuprofen, naproxen sodium, or aspirin

  • Reduces pain, fever, and inflammation

  • Used for conditions such as arthritis, bursitis, and tendinitis

Some differences between the two drugs are related to how they work, with Tylenol having lesser action as a COX inhibitor than Aleve does.

Tylenol and NSAID Side Effects

The utility of Tylenol and anti-inflammatories is largely defined by their side effects.

The side effects of Tylenol are typically minor and may include stomach upset, nausea, loss of appetite, and headache. On occasion, itchiness and rash can also develop.

One of the major challenges of NSAIDs is their effect on prostaglandin. As prostaglandin levels decrease so, too, does the protective benefit to the stomach. This is why NSAIDs can cause heartburn, stomach pain, and peptic ulcers.

Long-term or excessive use can affect blood pressure and clotting and increase the risk of:

Because Tylenol has less effect on prostaglandin, its gastrointestinal side effects are far less severe. It is not associated with peptic ulcer risk or cardiovascular risk.

It can, however, cause serious liver damage if used in excess (more than 3,000 milligrams per day, or six Tylenol Extra Strength caplets) or taken with alcohol.

While NSAIDs can also hurt the liver if used in excess, the risk is far smaller. The same applies to the kidneys but usually only when there is an underlying kidney disorder.

As a rule, you wouldn't double up on NSAIDs because of the increased risk of gastrointestinal and cardiovascular side effects. Similarly, you wouldn't want to make a habit of doubling your Tylenol dose because of the risk of liver toxicity.

But combining normal doses of the two medications (like taking Aleve and Tylenol together) may provide pain relief when either medication alone is not enough. Be sure to use the correct doses when doing so.

Dosage

These are the typical adult dosages for Aleve when used for inflammation and pain relief:

  • 250 to 500 mg every 12 hours, or
  • 250 mg every six to eight hours

Maximum doses of Aleve per day can vary based on circumstances, including:

  • 1,000 mg for chronic conditions
  • 1,250 mg for use with an acute (sudden) episode
  • 1,500 mg during a disease flareup

Tylenol may be a better option if looking for a drug with shorter action. Dosages include:

  • 400 mg every four to six hours, or
  • 600 to 800 mg every six to eight hours

The maximum dose of Tylenol for an acute episode is 3,200 mg per day, and lower (2,400 mg per day) for chronic pain.

NSAIDs like Aleve and Tylenol are preferred by most people because of their short-to-moderate effects. It's advised to use the lowest possible dose that works for the shortest amount of time.

Summary

It is generally considered safe to take a normal dose of Tylenol together with a normal dose of an NSAID like Aleve or Advil, as long as you're otherwise healthy. These medications belong to different drug classes and work differently in the body.

You may want to take both medications together if either one doesn't provide the relief you need on its own.

Stick to the recommended dosages and talk to your healthcare provider first if you have a kidney or liver condition.

12 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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By Carol Eustice
Carol Eustice is a writer covering arthritis and chronic illness, who herself has been diagnosed with both rheumatoid arthritis and osteoarthritis.