Tylenol vs Advil vs Aleve: which pain reliever should you use?
Tylenol, Advil and Aleve are the most common over-the-counter pain and fever relievers. The key split: Tylenol (acetaminophen) is not an anti-inflammatory, while Advil (ibuprofen) and Aleve (naproxen) are NSAIDs that also calm swelling. Among the NSAIDs, the practical difference is how long each dose lasts.
There's no single winner — it depends on the job and your health risks. For plain fever or a headache, all three work. Choose Tylenol (acetaminophen) to avoid the stomach, kidney and heart cautions that come with NSAIDs (and it's generally preferred in pregnancy); choose an NSAID — Advil (ibuprofen) for short, flexible dosing or Aleve (naproxen) for longer-lasting relief — when inflammation or swelling is part of the problem.
| Tylenol acetaminophen | Advil ibuprofen | Aleve naproxen | |
|---|---|---|---|
| Active ingredient | Acetaminophen | Ibuprofen | Naproxen Sodium |
| Our rating | 70/100 | 72/100 | Not yet rated |
| Pharmacy pays | $0.03 /mL | $0.04 /mL | $0.06 /mL |
| Drug type | Acetaminophen (not an NSAID) | NSAID | NSAID |
| Reduces inflammation? | No | Yes | Yes |
| How long a dose lasts | 4–6 hours | 4–6 hours | 8–12 hours |
| Main risk | Liver harm if you exceed the daily limit | Stomach, kidney and heart cautions | Stomach, kidney and heart cautions |
| Good to know | Easiest on the stomach and usually the first choice in pregnancy; relieves pain and fever but not swelling. | Fast and flexible for short-term aches with inflammation; take with food to ease the stomach. | Longer-lasting, so fewer doses a day; same NSAID cautions as ibuprofen. |
Ratings are our independent FDA recall-safety score. General information, not medical advice.
Which should you choose?
Tylenol (acetaminophen)
Easiest on the stomach and usually the first choice in pregnancy; relieves pain and fever but not swelling.
Advil (ibuprofen)
Fast and flexible for short-term aches with inflammation; take with food to ease the stomach.
Aleve (naproxen)
Longer-lasting, so fewer doses a day; same NSAID cautions as ibuprofen.
Match the medicine to the situation. Pain with swelling (sprains, arthritis) responds better to an NSAID; per MedlinePlus, NSAIDs “reduce swelling,” whereas acetaminophen “does not relieve inflammation.” Pick Tylenol if you need to steer clear of NSAID stomach/kidney/heart risks, or are pregnant or breastfeeding (the NHS calls paracetamol the usual first choice then). Among NSAIDs, Advil acts fast and is easy to dose around the day; Aleve lasts longer so you take it less often. Respect daily limits — too much acetaminophen can harm the liver, and NSAIDs shouldn't be taken longer than directed. Ask a pharmacist if you have a stomach ulcer, kidney/heart/liver condition, take blood thinners, or are pregnant. General information, not medical advice.
Frequently asked questions
Which is the strongest pain reliever — Tylenol, Advil or Aleve?
None is universally strongest. For pain involving inflammation (sprains, arthritis), the NSAIDs Advil and Aleve tend to work better; for plain fever or headache the three are comparable. The best one is the one that controls your pain with risks that fit your health.
Which is easiest on the stomach?
Tylenol (acetaminophen). Because it isn't an NSAID, it doesn't carry the same risk of stomach irritation or ulcers — its main concern is the liver if you take too much. NSAIDs (Advil, Aleve) are better taken with food.
Which lasts the longest?
Aleve (naproxen) — typically 8–12 hours per dose, versus about 4–6 hours for Advil (ibuprofen) and Tylenol, so you take it less often.
Can you take them together?
Acetaminophen can be combined or alternated with an NSAID when one alone isn't enough (the NHS notes adults can take paracetamol with ibuprofen), but you should not take two different NSAIDs (e.g., Advil + Aleve) together. Check with a pharmacist.