Acetaminophen or ibuprofen?
| Acetaminophen (Tylenol, generic) | Ibuprofen (Advil, Motrin, generic) | |
|---|---|---|
| Helps with | Fever, aches, headache | Fever, aches, headache |
| Adult maximum | 4,000 mg a day from all medicines combined[1]. Some labels set a lower limit, for example 6 extra-strength (500 mg) caplets, or 3,000 mg, in 24 hours.[2] | Over the counter: 200 mg every 4 to 6 hours, 400 mg if needed, no more than 1,200 mg (6 capsules of 200 mg) in 24 hours unless a doctor directs.[3] |
| Main risk | Liver damage if you take too much, combine products, or drink 3 or more alcoholic drinks a day.[1][2] | Stomach bleeding; higher risk of heart attack, heart failure, and stroke; kidney problems.[3] |
| Ask first if you | Have liver disease or drink 3 or more alcoholic drinks a day.[1] | Have high blood pressure, heart disease, kidney disease, liver cirrhosis, asthma, past stroke, or ulcers; take a blood thinner, steroid, or diuretic; or are 60 or older.[3] |
| Pregnancy | Usually the preferred fever reducer; see pregnancy. | Avoid at 20 weeks or later unless a doctor directs.[3] |
Do not double up
Hundreds of prescription and nonprescription medicines contain acetaminophen, including many multi-symptom cold and flu products. Check every label, take only one product with acetaminophen at a time, and do not combine a prescription and an OTC acetaminophen product unless a clinician tells you to.[1]
Decongestants and high blood pressure
- Pseudoephedrine can relieve a stuffy nose. Its label says to ask a doctor first if you have heart disease, high blood pressure, thyroid disease, diabetes, or trouble urinating from an enlarged prostate, and not to use it with, or within 2 weeks of stopping, an MAOI antidepressant.[4] Stop and ask a doctor if you feel nervous, dizzy, or cannot sleep.[4]
- Oral phenylephrine, the decongestant in many shelf products, was found by FDA not to be effective as a nasal decongestant. FDA has proposed removing it; until a final decision, products can still be sold. Nasal spray phenylephrine is not affected.[5]
When to stop treating it yourself
- A fever that gets worse or lasts more than 3 days on fever reducers.[2][3]
- Any emergency warning sign, or a fever or cough that improves and then returns. Getting worse.
Fever medicine and going back to work
Fever reducers can hide a fever. CDC's return rule counts 24 hours without a fever only when you have not used fever-reducing medicine.[8] How long flu is contagious.
Children
Children's doses depend on weight and age, and some products are not for young children. Ask the child's pediatrician or a pharmacist before giving any cold or flu medicine.