Can You Take Acetaminophen (Tylenol) With Naproxen (Aleve)?
Short answer
No known interactionYes. Acetaminophen (Tylenol) and naproxen (Aleve) have no known interaction, and they are often used together for arthritis, back pain, dental pain and injuries. Naproxen lasts much longer than most pain relievers, so acetaminophen can be added in between for extra relief. Be careful with the “PM” versions: Tylenol PM and Aleve PM both contain the sleep aid diphenhydramine, so taking both doubles it.
How the two work differently
Naproxen is an NSAID. It reduces pain, swelling and fever by blocking prostaglandins, and one dose lasts about 8 to 12 hours, which is why Aleve is taken less often than ibuprofen. Acetaminophen relieves pain and fever through a different pathway and does not reduce swelling.
Because they work and are processed differently, combining them does not increase either drug’s side effects. Naproxen’s risks center on the stomach, kidneys, heart and bleeding. Acetaminophen’s main risk is liver damage if you take more than the label allows.
A practical way to combine them
A common approach for ongoing pain is to take naproxen on its regular schedule and use acetaminophen for extra relief when needed, keeping each within its own label limits. Naproxen works best for pain with swelling, such as a sprain or arthritis flare. Acetaminophen fills gaps without adding to naproxen’s stomach and kidney load.
Write down the time of each dose. Naproxen’s long action makes it easy to forget when the last dose was, and acetaminophen’s daily maximum includes every product you take that contains it.
Watch out for the PM versions
Tylenol PM and Aleve PM each pair their pain reliever with diphenhydramine (the active ingredient in Benadryl). If you take both PM products, you get a double dose of diphenhydramine, which can cause heavy drowsiness, confusion, constipation and trouble urinating, especially in older adults.
If you want help sleeping, use only one PM product. Also check cold, flu and sinus products: many contain acetaminophen, and some contain an NSAID.
Who should ask a doctor first
- Anyone with a history of stomach ulcers or bleeding, or who takes a blood thinner, aspirin or a steroid such as prednisone
- People with kidney disease, heart disease, heart failure or high blood pressure
- People with liver disease, or who have 3 or more alcoholic drinks a day
- Anyone who is pregnant, especially from 20 weeks onward, when NSAIDs are generally avoided
- Adults 60 and older, who have a higher risk of stomach bleeding with NSAIDs
Over-the-counter labels say not to use naproxen for pain for more than 10 days, or for fever for more than 3 days, unless a doctor tells you to.
What the FDA labels say
We reviewed the warnings, precautions and drug interaction sections of the current FDA labels for Acetaminophen and Naproxen. Neither label lists the other medicine, or its drug class, as an interaction.
Frequently asked questions
Can I take Tylenol and Aleve at the same time?
Yes. They do not interact, so you can take them together. Follow each label for how often to take it and the daily maximum.
Is it better to take naproxen or ibuprofen with Tylenol?
Either NSAID can be paired with acetaminophen. Naproxen lasts longer, so it needs fewer doses a day. Ibuprofen wears off sooner, which some people prefer for short-term pain. Do not take naproxen and ibuprofen together.
Can I take Aleve PM and Tylenol?
Plain Tylenol with Aleve PM is fine because only Aleve PM contains the sleep aid. Avoid taking Aleve PM with Tylenol PM, since both contain diphenhydramine.
Taking anything else?
Add all your medicines, supplements and alcohol to check every combination at once.
Sources
This page is for general education and is based on FDA labeling. It is not medical advice and does not replace a conversation with your doctor or pharmacist, who know your health history, doses and other medicines. If you think you have taken too much of a medicine, call Poison Control at 1-800-222-1222 or 911.