Tylenol vs. Advil: An Analysis of Public Opinion
by Raj Shah, University of North Carolina at Chapel Hill
Abstract: The use of painkillers within modern society has become increasingly frequent over the last few decades, and emerging at the forefront of painkiller medications are two drugs almost every individual can identify: Tylenol and Advil. While these medications are fairly common, the underlying mechanisms and ingredients that both Tylenol and Advil incorporate are usually more difficult to recognize. Consequently, the purpose of this report is to publicize these unfamiliar characteristics of each medication and ultimately offer the consumer a basis from which to make a comparison. While the report will not be biased toward either Tylenol or Advil, the information included should be sufficient enough to expand the consumer's knowledge of the two drugs and thus allow them to make a more educated decision, whether it be a preference for one medication over the other, or a decreased usage overall.
Full Article: The concept of pain relief has been a pinnacle within the realm of medicine for thousands of years; the field has steadily progressed from what was first the simple application of ice and implementation of slow, steady breathing to the development of medication to target specific types of pain and discomfort. As society continues to evolve, there are two medications that have undoubtedly emerged at the forefront of pain relief: Tylenol (Acetaminophen) and Advil (Ibuprofen). These two medications can be found in the majority of households and are probably two of the most common medications taken on an everyday basis. This fact, in combination with the data received throughout my progression as an intern for RateADrug, has led me to dedicate this analysis solely to these two medications. An examination of "Advil vs. Tylenol" seemed to be the most relevant discussion and consequently, is likely to have the greatest impact on RateADrug.com users as a whole. However, the purpose of this report is not to sway the consumer into using one drug or the other; rather, its purpose is to be informative and examine the feedback, both positive and negative, that has been collected via surveys. After viewing survey data for Advil and Tylenol, there were three main areas of discussion that became obvious, and they are: the most common side effect(s) for both medications, the main ingredient within each drug and its implications, and the preferred use for each individual medication.
While the majority of respondents were satisfied with both Tylenol and Advil, there were a significant number of survey takers who listed drawbacks for each medication and the resulting personal consequences. A relatively common response for both medications was that they were "ineffective", at least when taken in a recommended dosage. The Tylenol website describes how the medicine actually works, stating that Tylenol is thought to relieve "mild to moderate pain" by reducing the body’s overall threshold to pain and discomfort. The main ingredient in Tylenol, which will be discussed later in this report, supposedly acts to reduce the body’s sensitivity to pain and reduce heat (Monson). For those individuals who find Tylenol ineffective, it is more than likely an individualistic effect rather than a holistic one, where that individual’s body may have a lower tolerance for pain than others. For such individuals, it is probably best to simply try different medications and see what works for them. When looking to the official website for Advil, it seems that the mechanism for reducing pain is fairly similar to that of Tylenol, where specific chemicals are targeted to ultimately reduce the body’s sensitivity to pain. Once again, the "ineffective" side effect is specific to the person taking the medication, and as a result, there is no real solution to this issue. Aside from reduced or zero effectiveness, survey takers did not report an experienced side effect from Tylenol. Advil, however, had one significant side effect that roughly ¼ of users attested to: stomach aches. What was interesting to note, however, was the fact that many survey takers who stated that they had experienced stomach pains also commented on "the dosage needed to be effective", where they felt they had to take more than the recommended amount to experience pain relief. The solution to this issue lies in the problem: overdose of medication. The Advil website indicates that stomach pains and/or ulcers can in fact result from taking more than the recommended amount, and so it is likely that those individuals experiencing such stomach pains may have taken too much. Another likely cause for stomach pain is the fact that some individuals choose to take Advil on an empty stomach; this is also not advised and can result in stomach pain (Slotnick). As far as side effects are concerned, it seems that both Tylenol and Advil are fairly user friendly; as long as the directions on the box are followed for each medication, side effects should be minimal. As with all medications, however, the effectiveness will ultimately depend on the individual at hand.
While side effects were a popular factor for consumers to discuss, what was observed at a greater frequency (particularly with regards to Tylenol) was commentary concerning the main ingredient within each medication. More than half of all surveys directed toward Tylenol had a concern with its main ingredient, Acetaminophen, and the "adverse effects" it could have on the liver. Acetaminophen is basically a chemical that, while directing certain enzymatic processes within the human body, is metabolized by the liver. The potential problem arises from the fact that if the liver is presented with too much of this drug, even by a slight amount, it begins to produce a metabolic byproduct that can attack and damage liver cells (Highleyman). The obvious solution, of course, is to limit one’s intake of acetaminophen, but this is easier said than done. The FDA (Food and Drug Administration) states, "too much acetaminophen -- even a little too much taken by accident -- can lead to liver injury", and this concept of "too much" really depends on the individual consumer and how much of this drug their body can handle (Acetaminophen and Liver Injury). As a general precaution, however, it is stated that one should take no more than what is directed on the container. In addition, a close eye should be kept on the intake of ALL acetaminophen-containing products; many times individuals will complement Tylenol with another type of medication and not realize that both medications contain traces of acetaminophen. It is vital to realize that the build up of acetaminophen is not limited to Tylenol, and that taking the correct amount of two different acetaminophen-containing medications can also lead to a potential overdose. The gravity of this issue was highlighted by an FDA Joint Meeting that occurred at the end of June. The meeting’s sole purpose was to discuss possible liver injury as a result of acetaminophen intake, with the possible outcome of banning over-the-counter acetaminophen products altogether. Of course, the blame cannot be placed upon the product makers, as it is ultimately the consumer’s choice to take the medication in a safe amount. That being said, the FDA has made a list of steps that individuals should consider when taking acetaminophen-containing products:
While the concern regarding Tylenol and liver injury was high amidst survey takers, it seemed that there was not a similar type of unease regarding Advil. The main ingredient in Advil is ibuprofen, and while the exact mechanism of how ibuprofen works is not known, it is said that it works to prevent the production of prostaglandins, which cause inflammation (Slotnick). The reason behind why consumers are generally less concerned with the effects of Advil’s main ingredient could be attributed to multiple factors, but it is likely that a major contributor is the fact that there is simply not as much publicity. The media has definitely showcased acetaminophen and pointed out how it can damage the liver, but a similar type of portrayal for ibuprofen has not been observed (at least not to the same extent). This could be due to the fact that there are many cases of liver injury by acetaminophen that are constantly being reported, which in turn could simply be due to the fact that more people choose to take acetaminophen. That being said, ibuprofen does have its side effects, and if taken more than needed, can cause just as much damage as acetaminophen. The FDA has warned, "Ibuprofen increases the risk of serious gastrointestinal bleeding and cardiovascular events such as heart attack and stroke". In addition, an overdose of ibuprofen can cause severe stomach pains and, according to the National Institute of Health (NIH), may even contribute to kidney disease (Slotnick). Thus, both acetaminophen and ibuprofen have the potential to harm an individual, regardless of whether the side effects of one of the drugs are more publicized than the side effects of the other. Consequently, when taken in a safe amount, the likelihood of damage caused by either acetaminophen or ibuprofen is minimal.
A final area of analysis regarding "Tylenol vs. Advil" emerges when looking to the uses of each respective medication. Survey data indicates that individuals with headaches and similar types of head pain tend to use Tylenol, while individuals with pain that is more muscle related prefer the use of Advil. It appears that minimal research has been done to test whether each medicine is actually better equipped for certain types of pain, but if there is in fact some discrepancy, it can only be attributed to the main ingredient within each medication. If we look to the main ingredients, namely ibuprofen and acetaminophen, it seems that the trend observed in survey data is somewhat accurate. Both acetaminophen and ibuprofen, as described earlier, act to reduce sensitivity to pain, yet they use different mechanisms to do so. Ibuprofen acts mainly as an "anti-inflammatory agent", and inflammation is usually the type of pain individuals experience from muscular injuries or strains. Inflammation is generally characterized by "redness, swelling, and joint pain", resulting from an increased blood flow to the area of pain (Inflammation). Thus, ibuprofen ultimately aims to prevent such inflammatory symptoms and by doing so, alleviate pain. Acetaminophen, on the other hand, is not known as a "anti-inflammatory agent", and is thus limited in its anti-inflammatory uses. WebMD describes how "acetaminophen does not reduce swelling and inflammation like ibuprofen does", and also points out that acetaminophen is more commonly used to relieve headaches and reduce fevers (Acetaminophen). This results in a parallel between what was observed in survey data and how both Tylenol and Advil can be used, as each medication may in fact be better suited for certain types of pain. By looking solely at the main ingredients in Tylenol and Advil, it might well hold true that Tylenol is a better choice to treat headaches and migraines, while Advil is the better option for muscle pain. Thus, the public’s choice in this case looks to be accurate, though nothing can be said for certain without experimentation and evidence.
An analysis of both Tylenol and Advil may at first appear intimidating, as there are definitely serious side effects for both medications. As a consumer, however, it is important to note that such side effects are rare and usually only occur when the medication is taken improperly. Both medications ultimately offer benefits of pain relief that the majority of consumers can attest to, and as a whole, it seems that the public is generally satisfied with each medication. Tylenol (on a scale of 1-10) received a mean satisfaction score of 6.3, while Advil received a mean satisfaction score of 7.31. All comparisons aside, there is one concept that the public should definitely consider: roughly 2/3 of all surveyed consumers take either Tylenol or Advil on a regular basis. This report has illustrated the fact that too much of either medication is detrimental, and the fact that so many survey takers rely so heavily on these over-the-counter pain relievers may eventually become a problem. While both Tylenol and Advil are exceptional drugs, perhaps consumers should think twice before turning to them for every single episode of pain or discomfort. The realm of pain relief has indeed evolved considerably, yet as with all improvements and progressions, it is important not to forget the basis from which such evolution occurred. After all, when was the last time you considered "side effects" and "overdosing" when icing a wound or applying a wet cloth to your forehead?
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