What is the difference between tylenol and extra strength tylenol

What is the difference between tylenol and extra strength tylenol
Tylenol (active generic ingredient, acetaminophen) is a drug often recommended by health care providers to treat arthritis pain. Like other anti-inflammatory medicines, it has a role in the non-surgical treatment of hand and arm pain. In fact, some research shows that if you have arthritis pain, you should try acetaminophen first, before trying other medicines, like ibuprofen and naproxen.

You may wonder what makes the Tylenol Arthritis product different than regular Tylenol.

Some patients ask me about Tylenol Arthritis and what ingredients make it different than regular Tylenol. This product is officially named “Tylenol Arthritis Pain”. It contains only acetaminophen, the same drug in regular Tylenol.

Tylenol currently comes in several versions. Most patients taking it for arthritis pain will probably take one of the following:

  • Extra Strength Tylenol Rapid Release Gels (500 mg)
  • Regular Strength Tylenol (325 mg)
  • Tylenol 8 Hour (650 mg)
  • Tylenol Arthritis Pain (650 mg)

The number of milligrams of acetaminophen in each pill is listed in parenthesis above.

I’m not advocating taking one version over the other – you’ll have to spend some time thinking about which version is the right one for you, but the answer to the frequently asked question above is that “Tylenol Arthritis” contains slightly more acetaminophen than Extra Strength Tylenol. It contains no other drugs.

You can check out details of each version of Tylenol on the company website here.

Excedrin vs. Tylenol: Why Excedrin Extra Strength Is More Effective for Headache Relief

These two pain relievers may be similar, but Excedrin has a powerful combination not found in Tylenol®.

When a headache begins, it can disrupt your whole day if you don’t treat it, but Excedrin Extra Strength starts to work in 15 minutes for some.

Clinical studies have demonstrated that Excedrin Extra Strength relieves headaches better than Tylenol® Extra Strength.1 Both Excedrin Extra Strength and Tylenol® Extra Strength include acetaminophen, an analgesic that relieves pain and reduces fever. But Excedrin Extra Strength contains two additional active ingredients, aspirin and caffeine.

Aspirin targets pain by blocking the production of pain signaling chemicals called prostaglandins. Caffeine is referred to as an analgesic adjuvant. This means it helps boost the effects for certain pain relievers. In the case of Excedrin, caffeine boosts the effects of aspirin and acetaminophen – making those medications up to 40% more effective.2,3,4

See the chart below for a breakdown of Excedrin Extra Strength vs. Tylenol® Extra Strength.

2 every 6 hours
(Max. 6 Per Day)

2 every 6 hours
(Max. 6 Per Day)

References: 

  1.  Migliardi JR, Amellino JJ, Friedman M, Gillings DB, Beaver WT. Caffeine as an analgesic adjuvant in tension headache. Clin Pharmacol Ther. 1994;56(5):576-86.
  2. Excedrin. Drug Facts Label. 2020
  3. Laska EM et al. Caffeine as an analgesic adjuvant. JAMA. 1984;251(13):1711-1718.
  4. Lipton RB, Diener H-C, Robbins MS, Gara SY, Patel K. Caffeine in the management of patients with headache. J Headache Pain. 2017;18(1):107.

Tags: headache treatments, caffeine

Many over-the-counter and prescription drugs contain potentially harmful levels of acetaminophen — the active ingredient in Tylenol and other painkillers.

The FDA is now warning people against taking prescription drugs that include more than 325 milligrams of acetaminophen per pill — and it's a good idea to stop taking the over-the-counter drugs that contain this much, too.

Acetaminophen has been widely used for decades, and it surpassed aspirin in popularity sometime during the 1980s. Even though the FDA became aware of the risks posed by the drug as early as 1977,  it delayed taking action until recently. In the meantime, 150 Americans have died annually and tens of thousands have gone to the emergency room each year due to overdoses.

This occurs because when the body breaks down acetaminophen, it produces tiny amounts of a toxic byproduct called NAPQI. Normally, a natural antioxidant produced in the liver neutralizes this NAPQI, but excessive amounts of the toxin — produced by extra-large doses of acetaminophen — can overwhelm the liver, causing permanent damage, and in rare cases, death.

This past January, the FDA put out a safety alert for acetaminophen. Apparently, they felt that many people missed the memo, so they put out a reminder earlier this week.

The FDA safety alert applies specifically to prescription drugs: it tells doctors and pharmacists to avoid prescribing opioid-based painkillers (such as Vicodin and Percocet) that include more than 325 milligrams of acetaminophen per pill, because they're no more effective than low-dose formulations and can be dangerous. Many of these prescription products have already been voluntarily recalled, and in the future, the FDA plans to ban them, but for now, it's relying on health professionals to stop recommending and providing them.

Many over-the-counter drugs have potentially dangerous levels of acetaminophen too

There are dozens of products in any pharmacy that contain more than 325 milligrams of acetaminophen per pill — such as extra strength Tylenol (500 mg per pill), Tylenol cold and sore throat liquid (500 mg per dose), and even some drugs with as much as 625 mg per dose. Over the counter products make up about 80 percent of the $2.6 billion acetaminophen market.

The FDA says it'll address them in a future regulation, but the organization ProPublica — which conducted an extensive investigation into acetaminophen last year — alleges that pharmaceutical companies, such as McNeil (the maker of Tylenol) successfully pressured the FDA to exclude these products from the new 325 mg limit. Extra strength 500 mg pills make up about 92 percent of their acetaminophen sales.

Given the research and the FDA warning for prescription pills, it's smart to stop taking them anyway, and stick to lower-dose products (like regular Tylenol, which has 325 mg per pill) or acetaminophen alternatives, such as ibuprofen, the active ingredient in Advil.

To minimize liver damage and the chance of an overdose, the FDA also recommends against taking multiple acetaminophen-containing products (such as headache relief pills and cough syrup) at the same time, taking more doses than the package recommends in a 24-hour period, or mixing any acetaminophen-based medicine with alcohol.


Update: it's worth noting that for people with reduced kidney function, ibuprofen can also cause problems. If you have kidney problems, you should consult a doctor before taking it.

Is Regular Strength Tylenol better than extra strength?

In a recent study, 1/2 the people reported getting the same relief from regular Acetaminophen as extra strength.

What is Tylenol Extra Strength good for?

Containing 500 mg of acetaminophen, TYLENOL® Extra Strength Caplets help temporarily reduce fever in adults and children 12 years and older, and provide powerful relief of tension headaches, minor back and muscle pain, minor arthritis pain and more.

Which Tylenol is the strongest?

What is the strongest type of Tylenol? The strongest forms of over-the-counter Tylenol are Tylenol 8-Hour Aches and Pain and 8-Hour Arthritis Pain. These products have 650 mg acetaminophen.

Can I take 2 Extra Strength Tylenol at once?

With Extra Strength Tylenol, patients can take 2 pills (each of which contains 500 mg of acetaminophen) every 4 to 6 hours; however, they should not take more than 8 pills in a 24-hour period.