Advil (ibuprofen) and aspirin are common medications used to relieve pain, fever, and swelling. While they share some similarities, their differences allow for a few unique uses.

Aspirin can be prescribed for certain heart conditions and the prevention of blood clots.

At higher doses, Advil can be prescribed for moderate pain due to conditions like rheumatoid arthritis (RA) or osteoarthritis (OA).

With so many pain medications available, it can be overwhelming to decide which one to use for pain relief. Advil (ibuprofen) and aspirin are two common over-the-counter (OTC) pain relievers to choose from at the pharmacy. But how do you decide which is better for you?

Before making a decision, you may pick up the box and read the medication’s label information, looking for uses and side effects. Sometimes, the information can look similar between different medications. Not only does this make it harder to pick one, but it can become confusing. This can be the case with Advil and aspirin.

Below, we’ll take a look at the similarities and differences between Advil and aspirin.

How do aspirin and Advil work?

The active ingredient in aspirin is salicylic acid. This medication can relieve fever, pain, and inflammation (swelling). It can also prevent platelets (a type of blood cell) from clumping together and forming blood clots.

The active ingredient in Advil is ibuprofen. This medication is also sold under the brand name Motrin. Ibuprofen also works to relieve fever, pain, and inflammation. But unlike aspirin, Advil doesn’t affect platelets as much.

Both medications work similarly in the body. They affect a process called the cyclooxygenase (COX) pathway. This pathway plays a significant role in fevers, pain, and swelling. But there are slight differences in how the two medications affect this process, as we’ll detail below.

Are aspirin and Advil both NSAIDs?

Yes. Aspirin and Advil both belong to a group of medications known as non-steroidal anti-inflammatory drugs (NSAIDs). All medications in this class affect the COX pathway and can help with pain and inflammation.

What makes aspirin and Advil different?

The main difference between aspirin and Advil is how they affect the COX pathway. There are two main enzymes (proteins) involved in this process: COX-1 and COX-2. COX-1 helps maintain the health of the blood vessels, kidneys, and digestive tract. COX-2 is involved in creating pain and inflammation.

Aspirin strongly blocks COX-1. It has a lesser effect on COX-2. Advil equally blocks both COX-1 and COX-2. It’s known as a non-selective NSAID because it blocks both.

Aspirin also affects a substance called thromboxane A2 (TxA2). TxA2 helps tell our platelets when it’s time to form a clot. Aspirin stops TxA2 from delivering this message to platelets. This allows aspirin to help prevent blood clots. Advil has a much weaker effect on TxA2, and the effect wears off quickly.

These differences allow each medication to be used for unique conditions.

Is Advil a blood thinner like aspirin?

No, Advil is not a blood thinner (anticoagulant). Because its effects on TxA2 are weaker than aspirin, it’s not useful for treating or preventing blood clots. But because it does have some effect on TxA2, it can raise the risk of bleeding. This is why you shouldn’t take Advil if you take blood thinners.

Are aspirin and Advil used for the same things?

Aspirin and Advil share similar uses. But because of how they work, they’re also used for a few different things. As mentioned above, both medications can relieve fever, pain, and swelling.

Other aspirin uses

Aspirin is sometimes also used to relieve symptoms of:

  •     Rheumatic fever
  •     Kawasaki disease
  •     Arthritis
  •     Lupus
  •     Prevention of blood clots

People with certain heart conditions may also be given aspirin for the prevention of heart issues. It can also be used to help prevent repeat strokes in people who have had strokes in the past. This is typically given in the form of daily low-dose aspirin.

Other Advil uses

Ibuprofen is sometimes given at higher doses as a prescription (400 mg tablets and stronger). Advil is only the brand name for the OTC strength of ibuprofen. Prescription-strength ibuprofen can help treat moderate pain due to certain health conditions, such as rheumatoid arthritis (RA) and osteoarthritis (OA). Both OTC and prescription-strength ibuprofen are also effective for relieving mild to moderate menstrual cramps.

Which is a better pain reliever, aspirin or Advil?

Depending on your health history, aspirin or Advil could be the better option. All NSAIDs are similarly effective in relieving mild pain. But while they both work well for minor pain, Advil works better for moderate pain.

Before choosing the right medication for you, your healthcare provider will consider the side effects and any other medications you may currently be taking. This is to help prevent any complications or serious side effects.

If you’re at your local pharmacy and need assistance, talk to your pharmacist. They can help you choose the right OTC pain reliever for your symptoms. They can also check for potential medication interactions.

What are the common side effects of aspirin and Advil?

Aspirin is generally well-tolerated. The most common side effect is stomach upset or stomach pain. Taking aspirin with food can help relieve this. But if these side effects don’t go away, they could be a sign of more serious problems, like stomach ulcers or bleeding. Be sure to contact your healthcare provider if you experience severe stomach pain that doesn’t go away.

Aspirin shouldn’t be taken by people under the age of 19 unless a healthcare provider says to do so. Using aspirin in those younger than 19 is linked to a condition called Reye’s syndrome. Although rare, it can cause life-threatening brain swelling and liver damage.

Advil is well-tolerated as well. Common Advil side effects include:

  •     Dizziness
  •     Stomach discomfort
  •     Heartburn
  •     Nausea

Advil also carries a risk of stomach bleeding and ulcers. It’s recommended to only take OTC Advil for 10 days in a row when using it for pain or 3 days in a row for fever. After that, you should speak with your healthcare provider. This helps lower your risk of serious side effects.

Advil can be safely used for adults and children over 6 months. In children, the dose is based on their weight. If your child is under 2 years old, you should contact their healthcare provider to ask for the appropriate dose. For children ages 2 and up, doses are provided on the OTC product’s packaging.

Summary:

Both aspirin and Advil are used for relieving fever, mild pain, and swelling. Your healthcare provider can prescribe higher doses of Advil for moderate pain. Aspirin can be useful for preventing certain types of blood clots.

Aspirin and Advil have different common side effects. But overall they’re both tolerated very well. When choosing which medication to use, check with your pharmacist or healthcare provider to make sure it’s the best option for you.

References

American Society of Hematology. (n.d.). Blood clots.

Arif, H., et al. (2021). Salicylic acid (aspirin). StatPearls.

Driver, B., et al. (2019). Not all (N)SAID and done: Effects of nonsteroidal anti-inflammatory drugs and paracetamol intake on platelets. Research and Practice in Thrombosis and Haemostasis.

Florida Pharmaceutical Products, LLC. (2021). Ibuprofen [package insert].

Food and Drug Administration. (2015). OTC drugs facts label.

Food and Drug Administration. (2016). Ibuprofen drug facts label.

Food and Drug Administration. (2016). Medication guide for nonsteroidal anti-inflammatory drugs (NSAIDs).

Ghlichloo, I., et al. (2021). Nonsteroidal anti-inflammatory drugs (NSAIDs). StatPearls.

Ittaman, S. V., et al. (2014). The role of aspirin in the prevention of cardiovascular disease. Clinical Medicine & Research.

MedlinePlus. (2021). Aspirin.

MedlinePlus. (2022). Blood clots.

Nemours KidsHealth. (2018). How to safely give ibuprofen.

Ngo, V. T. H., et al. (2021). Ibuprofen. StatPearls.

Ong, C. K. S., et al. (2007). An evidence-based update on nonsteroidal anti-inflammatory drugs. Clinical Medicine & Research.

Written by John Maneno, PharmD | Reviewed by Joshua Murdock, PharmD | Photo by ANIRUDH on Unsplash


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