Advil and Aleve: What's the Difference?

2 common over-the-counter NSAIDs

woman taking medication
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Maybe you have a headache or your arthritis is acting up. You open your cupboard and see both Advil and Aleve. What's the difference between them and which one should you take?

Advil and Aleve are both nonsteroidal anti-inflammatory drugs (NSAIDs) used to relieve pain and reduce fever. Though they are different drugs, they fall within the same drug class. Here, we explore similarities and differences between the two.

Similarities Between Advil and Aleve

Advil and Aleve are sold over-the-counter in pharmacies, which means they don't require a prescription. They temporarily relieve minor aches and pains that occur with a headache, toothache, backache, menstrual cramps, sprains, the common cold, muscular aches, and minor arthritis pain.

Advil and Aleve both have the same action: they inhibit cyclooxygenases, COX-1 and COX-2, which are enzymes that are involved in the inflammatory process and other processes in the body. The main target to relieve pain and inflammation is inhibiting COX-2, but both of these drugs also inhibit COX-1, which isn't desirable.

Because COX-1 maintains the normal lining of the stomach, inhibiting it can produce gastrointestinal symptoms like ulcers and upset stomach. COX-1 is also involved with kidney and platelet function, so there can be side effects with prolonged bleeding times and kidney function.

Differences Between Advil and Aleve

There are several differences between the two NSAIDs, including:

  • Active ingredients. The active ingredient in Advil is ibuprofen. Each Advil tablet contains 200mg of ibuprofen. Aleve tablets contain 220mg of naproxen sodium.
  • Dosing. Each drug has different lasting effects and dosing instructions.
    • For Advil: Adults and children 12 years old and over should take one tablet every four to six hours while symptoms persist. If one is not effective, two tablets can be taken together, but you should not exceed six tablets in 24 hours unless directed by a doctor.
    • For Aleve: Take one Aleve every eight to 12 hours while symptoms last. For the first dose, you can take two Aleve within the first hour. You should not exceed two Aleve in any eight to 12-hour period and should not exceed three Aleve in any 24-hour period. Essentially, the effects of Advil last for four to eight hours while Aleve lasts for eight to 12 hours.
  • Side effects. Advil (ibuprofen) has the lowest incidence of digestive reactions of the non-selective NSAIDs, including Aleve (Naproxen). It is favored for people who have ulcers or acid reflux disease. Aleve is more likely to cause pseudoporphyria, a type of photosensitivity. The FDA warned about increased heart attack and stroke risk with all NSAIDs, including Aleve and Advil, in 2015. Further research may or may not show a difference in the risk of heart attack and stroke between the two NSAIDs.

Can You Take Advil and Aleve Together?

Taking Advil and Aleve together is not recommended. The risk of side effects and adverse events increases if both are taken together. You should stick to taking one or the other, and only as directed, using the lowest effective dose.

Sources:

Advil. Advil Story.

Aleve. Frequently Asked Questions.

U.S. Food & Drug Administration (FDA). Medication Guide for Non-Steroidal Anti-inflammatory Drugs (NSAIDs).

U.S. Food & Drug Administration (FDA). FDA Strengthens Warning of Heart Attack and Stroke Risk for Non-Steroidal Anti-Inflammatory Drugs (July 9, 2015).

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