NSAIDs (non-steroidal anti-inflammatory drugs) are commonly used to treat pain, swelling and fever, such as in the brand Advil. Acetaminophen (also called paracetamol) is also used to treat pain and fever, but not swelling. Acetaminophen is the active ingredient in Tylenol, among others. Since the most common uses of these drugs overlaps, many consumers think that they are very similar. They are not as similar as one may think.
NSAIDs are actually a large class of drugs that include aspirin, ibuprofen, and naproxen as over-the-counter medications. There are also far more prescription-only drugs within the NSAID group: celecoxib, meloxicam, and indomethacin, just to name a few. Different drugs may have different effects on an individual, either more effective in relieving symptoms or milder side effects. Click here to seen a more detailed list of NSAID families.
In contrast, acetaminophen is a single substance, though it does go by the name paracetamol outside of the United States. It’s also widely available as an over-the-counter mediation, though stronger doses are only available with prescriptions.
The use of these two drugs is very similar. They are often used to treat pain, especially headaches or muscle pain. The mechanism by which they work, however, is very different. NSAIDs affect the hormones – specifically a type of hormone called prostaglandins – that cause pain and swelling. Acetaminophen, however, blocks neurotransmitters responsible for the sensation of pain, but doesn’t address the underlying problem, though it does have an effect on prostaglandins as well. Specific NSAID have other uses, but you can see their most common uses here: What are NSAIDs use for?
Both drugs are able to reduce fever, and their mechanism for doing it are very similar. Both NSAIDs and acetaminophen affect a chemical called cyclooxygenase (COX). With these drugs’ effects on COX, they are able to reduce fever.
One thing that acetaminophen can’t do, however, is significantly reduce swelling. In the event of injury, arthritis, or any other pain caused by large amounts of swelling, acetaminophen isn’t likely to be as effective. It will relieve immediate pain, but not address the cause of that pain, making it far more likely for it to return.
Also, since acetaminophen is processed by the liver, it’s dangerous to mix it with other substances that also put a strain on the liver. This could lead to liver damage. In fact, acetaminophen is the leading cause of liver failure in the United States and the United Kingdom. This makes it a very poor choice of hangover medication as both alcohol and acetaminophen put a strain on the liver.
NSAIDs aren’t always the best choice, however. All NSAIDs have well-known effects on the stomach and intestines. They can also have a negative effect on the heart and blood pressure. They can also thin the blood to make clotting more difficult. Acetaminophen has a milder set of side effects, especially on the heart and digestive system.
It’s also not recommended to give NSAIDs to young children or nursing mothers. They can cause organ damage in young children, such as kidney damage, and they can seriously harm an unborn child. In these cases, acetaminophen may be the best choice, as prescribed by a doctor. In certain specific cases, an NSAID will be given to a young child, but this is only under very careful supervision by a medical professional.
Here is a more detailed look at the side effects of NSAIDs.
Each of these medicines has its place, certain times when it is effective and times when it isn’t the best choice. It’s always a good idea to consult a doctor or a pharmacist about any unfamiliar medications before taking it. It’s equally important to know exactly what a medicine is used for, and where it can do more harm than good.
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