Independent side-by-side comparison.
Neither is universally "better" — they're different types of drug: Aleve (naproxen) is an anti-inflammatory NSAID that's better for swelling-related pain, while Tylenol (acetaminophen) is a gentler-on-the-stomach pain/fever reliever, so the right pick depends on your pain type and your stomach, heart, kidney, and liver health.
They are different drug classes, not interchangeable brands of the same thing. Per MedlinePlus, naproxen (Aleve) is an NSAID that works "by stopping the body's production of a substance that causes pain, fever, and inflammation," so it reduces swelling; acetaminophen (Tylenol) is an analgesic/antipyretic that works "by changing the way the body senses pain and by cooling the body" and is not generally used to reduce inflammation. Their risks differ accordingly: NSAIDs carry stomach-ulcer/bleeding and heart-attack/stroke risks (MedlinePlus notes naproxen "may cause ulcers, bleeding, or holes" in the stomach or intestine and a "higher risk of having a heart attack or a stroke"), while acetaminophen's main danger is liver damage from taking too much (MedlinePlus: "do not take more than 4000 mg of acetaminophen per day from all sources").
Consider Aleve (naproxen) when pain involves inflammation or swelling — NHS notes naproxen is "better for some types, such as period pain or back pain," and MedlinePlus lists it to relieve pain from arthritis, muscle aches, menstrual periods, and backaches. But avoid or check with a pharmacist or doctor first if you have stomach ulcers, heart disease, or kidney disease, or take blood thinners, given the bleeding, heart, and kidney risks NSAIDs carry.
Consider Tylenol (acetaminophen) for everyday aches, headaches, and fever, and especially if you're prone to stomach problems — NHS advises you can "take paracetamol instead of naproxen as it's gentler on your stomach," and MedlinePlus notes acetaminophen "does not cause as many stomach problems as other pain medicines do." If you have heart, kidney, or bleeding concerns, MedlinePlus says to talk to your provider or pharmacist before using an NSAID, which may make acetaminophen a reasonable alternative. Don't exceed the daily limit and avoid combining it with heavy alcohol use, because of liver-damage risk.
There's no single winner — they're different drugs for overlapping but distinct jobs. Pick by your situation: Aleve (an NSAID) for inflammatory pain like back or period pain if your stomach, heart, and kidneys can tolerate it; Tylenol if you need something easier on the stomach or are advised to avoid NSAIDs. NHS says paracetamol "is usually the best treatment for most types of pain," with naproxen better for certain inflammatory pains. Follow the label, don't exceed dosing, and ask a pharmacist or doctor if you have heart, kidney, stomach, or liver conditions or take other medicines.
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Ratings are based on FDA regulatory (recall-safety) data. This comparison is for general reference only — not medical advice. Always consult a licensed professional before choosing or switching a medication.