Walk into any pharmacy and you will find an aisle devoted to pain relief. There are so many brands and generic options that it could give you a headache just trying to figure out which of the many products is right for your kind of pain. Is aspirin harder on the stomach than ibuprofen? What about Aleve? Is it stronger than Advil? It’s hardly any wonder that this reader is suffering from pain reliever confusion. She wants to know how to decide between aspirin | Advil | Aleve | Excedrin.
How to Pick a Pain Reliever:
Q. Could you please explain the differences between popular OTC pain relievers? How is Advil different from Aleve, and how are these NSAIDs different from aspirin? What makes Excedrin different? I haven’t needed pain relievers before, but now I do.
A. Nonsteroidal anti-inflammatory drugs (NSAIDs) include both prescription medicines (celecoxib, diclofenac, meloxicam) and the OTC drugs ibuprofen and naproxen.
Aspirin is also considered an NSAID, though it has heart benefits rather than the risks posed by other NSAIDs. Most non-aspirin NSAIDs increase blood pressure and also have the potential to trigger heart attacks and strokes.
Advil vs. Aleve?
Advil is the brand name for ibuprofen and Aleve is the brand name for naproxen. They are similar in terms of their pain-relieving activity and their side effect profile.
The dosing schedule is slightly different between these two NSAIDs.
The manufacturer of Advil provides the following dosing information for 200 mg pills:
“12 years of age and older:
“• 1 tablet/caplet/gel caplet every 4 to 6 hours while symptoms persist.
“• If pain or fever does not respond to 1 tablet/caplet/gel caplet, 2 may be used.
“• Do not exceed 6 tablets/caplets/gel caplets in 24 hours unless directed by a doctor.”
The manufacturer of Aleve offers this dosing information:
“Adults and Children 12 Years and Older:
“Take 1 caplet every 8 to 12 hours while symptoms last. For the first dose you may take 2 caplets within the first hour. Do not exceed 2 caplets in any 8- to 12-hour period. Do not exceed 3 caplets in a 24-hour period.”
Each Extra Strength Excedrin pill contains aspirin (250 mg) and acetaminophen (250 mg). Acetaminophen is the ingredient in Tylenol. In addition to aspirin and acetaminophen, Extra Strength Excedrin contains 65 mg of caffeine.
The manufacturer of Excedrin offers the following dosing directions:
“Adults and children 12 years and over: Take 2 tablets every 6 hours; not more than 8 tablets in 24 hours”
A Word of Caution About Caffeine:
Taking two Excedrin pills as directed would mean that you are getting 130 mg of caffeine. That’s a pretty good jolt, about as much as you would get from a large cup of coffee.
If you were to take Extra Strength Excedrin in the evening, sleeping might be a problem. And if you were to take the maximum dose (8 tablets in 24 hours) that would be the equivalent of 520 mg of caffeine. Some people might find that excessive.
What’s Your Solution to Pain Reliever Confusion?
What works for you? Is aspirin adequate or do you experience side effects? What about Advil or Aleve? Are they equivalent or does one work better? And what about Excedrin? As far as we can tell, Extra Strength Excedrin and Excedrin Migraine are identical as far as their ingredients are concerned. Share your own experience with aspirin | Advil | Aleve | Excedrin in the comment section below.