Acetaminophen vs. aspirin: Differences, similarities, and which is better for you

In this article:

• Main differences
• Conditions treated
• Efficacy
• Coverage and cost
• Side effects
• Interactions
• Warnings
• FAQs

In this article

• Main differences
• Conditions treated
• Efficacy
• Coverage and cost
• Side effects
• Interactions
• Warnings
• FAQs

Acetaminophen and aspirin are two of the most commonly used over-the-counter (OTC) medications for relieving aches, pains, and fever. Both have been around for years and are considered safe and effective when used as directed. In addition, acetaminophen and aspirin are generic medications that may be found on shelves in various brand-name forms. They are sometimes combined with other medications to relieve symptoms of different ailments.

But what are the differences between these two medications, and which one is better for you? This article will explore the similarities and differences between the two and help you decide which medication is best for your specific needs.

Main differences between acetaminophen and aspirin
	Acetaminophen	Aspirin
Drug class	Non-opioid analgesic	NSAID
Brand/generic status	Brand and generic versions available	Brand and generic versions available
What are the brand names?	Tylenol	Bayer, Ecotrin, Ecpirin, Halfprin, Bufferin, Durlaza, etc.
What form(s) does the drug come in?	Oral tablet Chewable tablet Oral capsule Oral liquid Rectal suppository	Oral tablet Chewable tablet Enteric-coated tablets Oral capsule Rectal suppository
What is the standard dosage?	Mild to moderate pain relief and fever reduction: 650 mg every 4 to 6 hours or 1,000 mg every 6 hours Dosage varies by indication	Mild to moderate pain relief and fever reduction: 325 to 650 mg every 4 to 6 hours as needed Dosage varies by indication
How long is the typical treatment?	Short-term, usually up to 10 days; however, treatment duration can vary by indication	Short-term, usually up to 10 days; however, treatment duration can vary by indication
Who typically uses the medication?	Adults, children, and infants 12 weeks and older	Adults

What are the main differences between acetaminophen and aspirin?

There are some important differences to know between acetaminophen and aspirin. They are part of different drug classes, have different brand names, and work in different ways. 

Acetaminophen, commonly known by the brand name Tylenol, is a non-opioid analgesic (pain reliever) and antipyretic (fever reducer). It is not an NSAID. It is believed to work by stopping pain signals from reaching the brain and reducing the levels of prostaglandins or certain chemicals in the body that cause pain and swelling. For reducing fever, acetaminophen may affect the part of the brain that controls body temperature.

Aspirin is part of a group of medications called nonsteroidal anti-inflammatory drugs (NSAIDs). It helps relieve pain, reduce swelling, and lower fever by blocking the production of prostaglandins. Aspirin is also known as acetylsalicylic acid (ASA) and can be found under brand names like Bayer and Ecotrin.

Conditions treated by acetaminophen and aspirin

Acetaminophen and aspirin are commonly used as pain relievers. They can treat mild pain and minor aches caused by menstrual cramps, migraine headaches, toothaches, and muscle aches. 

As an NSAID, aspirin may be better for inflammatory pain, such as pain caused by arthritis or tendonitis. However, using higher doses of aspirin is often necessary for these conditions, which may increase the risk of experiencing side effects.

Aspirin is a common medication that acts as a blood thinner, helping to prevent blood clots. At low doses, it is often used to reduce the risk of heart attacks in people who have had a heart attack before or those who have heart disease. It can also be useful in reducing the chances of death for someone having a heart attack. In addition, aspirin may help prevent certain types of strokes in people who are at high risk.

Condition	Acetaminophen	Aspirin
Pain	Yes	Yes
Fever	Yes	Yes
Prevention of stroke	No	Yes
Prevention of heart attack	No	Yes

Is acetaminophen or aspirin more effective?

Acetaminophen and aspirin are both effective OTC medications for pain and fever. The more effective medication may depend on the overall condition being treated. Aspirin may be more effective for targeting inflammation but is more likely to cause gastrointestinal side effects, like an upset stomach and ulcers. 

Clinical studies have compared the effectiveness of acetaminophen and aspirin. In a study with 162 patients recovering from dental surgery, researchers compared the pain-relieving effects of acetaminophen (1 gram), aspirin (650 mg), and a placebo. Patients who took acetaminophen reported significantly better pain relief than those who took aspirin or the placebo. The results showed that acetaminophen was especially effective for those experiencing severe pain.

Another study compared the use of acetaminophen and aspirin for fever and other symptoms of upper respiratory tract infection. Equal doses of acetaminophen and aspirin were given to adult patients with fever from a viral infection. Both medications were found to be effective, and there were no significant differences found between the two drugs for relieving fever. 

In many cases, acetaminophen and aspirin can be used together for pain relief. For example, a combination of acetaminophen, aspirin, and caffeine is often used for treating migraine headaches. 

It’s important to consult a healthcare provider for the best option for your symptoms. Other pain relievers, such as ibuprofen and naproxen sodium, are available and may be more effective for your condition. 

Coverage and cost comparison of acetaminophen vs. aspirin

Acetaminophen and aspirin are both generic OTC medications that are easily accessible and have comparable pricing. They are not generally covered by insurance or Medicare plans. Even if a healthcare provider prescribes acetaminophen or aspirin, your insurance plan likely won’t cover it.

Brand names are usually more expensive than generics, so it’s best to opt for the generic if you’re looking to save. You can also check for discounts for these medications at a local pharmacy. In addition, SingleCare offers a coupon or savings card to help save on acetaminophen and aspirin. 

	Acetaminophen	Aspirin
Typically covered by insurance?	No	No
Typically covered by Medicare Part D?	No	No
Quantity	100 tablets (325 mg)	30 tablets (81 mg)
Typical Medicare copay	Varies	Varies
SingleCare cost	$3	$3

Common side effects of acetaminophen vs. aspirin

At normal doses, acetaminophen and aspirin are unlikely to cause serious side effects. The most common side effects of acetaminophen may include headache and nausea. The most common side effects of aspirin include abdominal pain, an upset stomach, and indigestion. 

 Serious side effects of acetaminophen and aspirin may include allergic reactions. In high doses, acetaminophen may cause liver problems. On the other hand, high doses of aspirin may increase the risk of bleeding or stomach ulcers. 

See the table below for other potential side effects of these medications. 

	Acetaminophen	Aspirin
Side Effect	Applicable?	Applicable?
Headache	Yes	Yes
Stomach pain	No	Yes
Nausea/vomiting	Yes	Yes
Insomnia	Yes	No
Indigestion	No	Yes
Constipation	Yes	No
Dizziness	No	Yes

This may not be a complete list. Consult your doctor or pharmacist for possible side effects.

Source: DailyMed (Acetaminophen), DailyMed (Aspirin)

Drug interactions of acetaminophen vs. aspirin

Acetaminophen and aspirin can interact with other medicines, leading to adverse effects or changes in effectiveness. For example, aspirin can interact with blood thinners, such as antiplatelet agents, and other drugs with blood-thinning effects, such as selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs). 

In general, acetaminophen may be a more suitable pain reliever for people taking blood thinners, as it does not typically increase blood thinning effects. However, this isn’t always the case. Studies suggest using acetaminophen and warfarin together may lead to an increased bleeding risk. 

Some antiviral medications can change how acetaminophen is processed in the body, which might affect how well it works or increase the risk of side effects like liver damage. Certain anticonvulsants, such as phenytoin and carbamazepine, as well as the antibiotic isoniazid, can speed up the metabolism of acetaminophen, which may lead to a higher chance of liver problems.

NSAIDs are known to increase blood pressure, which may reduce the effectiveness of antihypertensives or high blood pressure medications, such as diuretics, ACE inhibitors, and angiotensin receptor blockers (ARBs). However, some studies suggest that low doses of aspirin may help improve blood pressure. Therefore, the interaction between aspirin and blood pressure medications may not be as pronounced as with other NSAIDs.

Drug	Drug Class	Acetaminophen	Aspirin
Coumadin (warfarin)	Anticoagulant	Yes	Yes
Dilantin (phenytoin) Tegretol (carbamazepine)	Anticonvulsant	Yes	No
Sustiva (efavirenz) Epivir (lamivudine) Norvir (ritonavir)	Antiviral	Yes	No
Plavix (clopidogrel) Brilinta (ticagrelor)	Antiplatelet	No	Yes
Nydrazid (isoniazid)	Antibiotic	Yes	No
Lasix (furosemide) Hydrodiuril (hydrochlorothiazide) Demadex (torsemide)	Diuretics	No	Yes
Altace (ramipril) Prinivil (lisinopril) Accupril (quinapril)	ACE inhibitor	No	Yes
Cozaar (losartan) Diovan (valsartan) Benicar (olmesartan)	ARB	No	Yes
Paxil (paroxetine) Lexapro (escitalopram) Prozac (fluoxetine) Zoloft (sertraline)	SSRI	No	Yes
Effexor (venlafaxine) Pristiq (desvenlafaxine)	SNRI	No	Yes

This may not be a complete list of all possible drug interactions. Consult a doctor with all medications you may be taking. 

Warnings of acetaminophen and aspirin

Acetaminophen and aspirin are associated with various precautions and warnings. Long-term use of either medication, particularly at high doses, may increase the risk of serious side effects. Therefore, it is important to follow the recommended dosages and talk to a healthcare provider if you notice any serious problems while taking them.

Hypersensitivity or allergic reactions are possible while taking acetaminophen or aspirin. Seek immediate medical help if you experience severe rash, hives, trouble breathing, or swelling of the face or throat. 

Acetaminophen can cause liver damage when taken in high doses. The maximum dosage of acetaminophen is generally no more than 3,250 mg in 24 hours. People with liver disease should use acetaminophen with caution or avoid the use of too much acetaminophen at one time. Although aspirin should also be used with caution in people with liver disease, it is less likely to cause liver problems than acetaminophen. 

Aspirin may increase the risk of stomach ulcers and bleeding. People with a history of ulcers or bleeding disorders should avoid aspirin or use it with caution. In addition, the use of aspirin may cause an increased risk of kidney problems, such as kidney damage. Acetaminophen may be a safer option for people with kidney disease. 

Aspirin should not be given to children. The use of aspirin in children is associated with an increased risk of Reye’s syndrome, a rare but serious condition that requires immediate medical treatment. Symptoms of Reye’s syndrome may include persistent vomiting, confusion, seizures, and unusual behavior.

Consult a healthcare provider before taking acetaminophen and aspirin. Tell your doctor or healthcare provider about any medical conditions you have and other medications you take before starting treatment. 

Frequently asked questions about acetaminophen vs. aspirin

Are acetaminophen and aspirin the same?

Acetaminophen and aspirin are commonly used OTC pain relievers. They both have similar uses but are part of different drug classes and work differently. Acetaminophen is a non-opioid analgesic, while aspirin is an NSAID. They also have different brand names, side effects, and drug interactions. 

Is acetaminophen or aspirin better?

Acetaminophen and aspirin are both effective pain medications. The better medication will depend on what it is being used for. As an NSAID, aspirin may be a better medication for pain that is accompanied by inflammation. Aspirin also has blood-thinning effects that make it useful for preventing heart attacks and strokes in people at high risk. However, acetaminophen may be a better option for people with kidney disease or people with an increased risk of stomach ulcers. 

Can I use acetaminophen or aspirin while pregnant?

Acetaminophen is generally considered safe to use during pregnancy for mild to moderate pain. Aspirin, along with other NSAIDs, is not usually recommended for women who are pregnant due to the risk of potential complications in an unborn baby. It’s a good idea to consult a healthcare provider for recommendations on the best treatment option while pregnant or breastfeeding. 

Can I use acetaminophen or aspirin with alcohol?

It is not recommended to mix acetaminophen or aspirin with alcohol. Combining acetaminophen with alcohol use may increase the risk of liver damage. On the other hand, mixing aspirin with alcohol may lead to an increased risk of stomach bleeding or other gastrointestinal side effects. 

Can I take acetaminophen and aspirin together?

Yes, acetaminophen and aspirin can be taken together because they help with pain and fever in different ways. Using them together might be helpful for more intense pain than usual, such as migraine headaches. However, there are some risks, such as stomach problems from aspirin and liver issues from taking too much acetaminophen. It’s important to talk to a doctor or pharmacist before using both to make sure it’s safe and to get the right doses.