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Should I Take Tylenol Or Ibuprofen Or Aspirin? Which Painkiller Is Safest For Pregnancy and Breastfeeding?

in Breastfeeding, Conventional Medication, Pregnancy

Sometimes life gets painful and we need to find relief. If you’re like me, you prefer using natural remedies when possible, but sometimes a natural option isn’t going to work or isn’t available and you need to make-do with what you can find in a pharmacy. 

In this article I cover the pros and cons of the top over-the-counter painkillers (acetaminophen, ibuprofen, and Aspirin) plus all the extra things you need to keep in mind if you’re pregnant, breastfeeding, or treating little ones at home. Let’s talk about which painkiller is safest for pregnancy and breastfeeding.

*Always discuss painkiller use during pregnancy and lactation with your doctor. This is general information and may not be applicable to you. 

**All of the following medications have drug interactions and medical conditions in which they should be avoided. These contraindications are not thoroughly covered in this article. Speak with a doctor for advice.

Ibuprofen (Advil, Motrin) & Naproxen (Aleve)

Pros of Ibuprofen & Naproxen

Ibuprofen and naproxen both belong to a class of drugs called NSAIDs. They reduce fever, pain, and inflammation. Ibuprofen is dosed every 4-6 hours and naproxen is dosed every 8-12 hours.

Cons of Ibuprofen & Naproxen

Ibuprofen and naproxen are hard on the stomach and aren’t a good choice for people who have heartburn, stomach pain, or ulcers. There are enteric coated preparations available, but they don’t necessarily reduce the risks of gastrointestinal injury. Ibuprofen and naproxen may increase the risk of cardiovascular events like heart attack and stroke. Ibuprofen and naproxen may increase the risk of serious bleeding events. People who are allergic to Aspirin should also avoid ibuprofen and naproxen. People with kidney problems should avoid ibuprofen and naproxen.

Considerations for pregnancyShould I Take Tylenol Or Ibuprofen Or Aspirin? - Dr. Green Mom

Ibuprofen and naproxen are usually not recommended during pregnancy. Acetaminophen is the preferred painkiller during pregnancy. 

Considerations for lactation

Ibuprofen is the preferred painkiller for use while breastfeeding because very low levels are transferred to breast milk. Additionally, ibuprofen is safe for infants in doses higher than they would receive through breast milk.

There is less information available about naproxen use during breastfeeding and it is generally not recommended. 

Considerations for kids

Ibuprofen is considered safe for children when dosing directions are followed. Naproxen is not recommended for children under 12. 

Acetaminophen (Tylenol, Panadol)

Pros of Acetaminophen

Acetaminophen reduces fever and pain, but doesn’t reduce inflammation. It doesn’t have any adverse effects on the stomach or bleeding so is considered safe for people on blood thinners and/or people with stomach concerns. It is also considered a good alternative for people who can’t take NSAIDs because of cardiovascular or kidney concerns. 

Cons of Acetaminophen

Acetaminophen doesn’t reduce inflammation and so isn’t as helpful for injuries, PMS pain, and other cases when an anti-inflammatory is needed.

Acetaminophen use can be hard on the liver and can cause liver damage if taken in higher doses than recommended and/or if combined with alcohol. Acetaminophen overuse decreases glutathione. 

Acetaminophen may cause allergic reactions.

Considerations for pregnancy

Acetaminophen is the preferred painkiller for use during pregnancy, and is considered safe for short term use. However, daily use over a long period is associated with adverse effects for the fetus, so risks should be weighed against benefits and a holistic pain management strategy should be discussed with your doctor.

Considerations for lactation

Acetaminophen is an acceptable choice while breastfeeding. Amounts of the drug present in breastmilk are much less than the safe dose for infants. 

Considerations for kids

Acetaminophen is considered safe for kids if taken at the recommended doses. 

Salicylic Acid (Aspirin)

Pros of Aspirin

Aspirin reduces inflammation, pain, and fever. It also helps reduce the risk of blood clotting and many people take it in a low dose as prevention. 

Cons of Aspirin

Aspirin may cause allergic reactions. In the case of an Aspirin allergy, all NSAIDs and salicylic acid containing herbs (like willow bark) should be avoided. 

Aspirin is hard on the stomach for many people and should be avoided if heartburn, ulcers, or stomach pain are present. 

Aspirin’s ability to reduce blood clotting can be a pro, but it can also be a con. Aspirin usually shouldn’t be used by people with bleeding disorders or people taking blood thinning medication. 

Considerations for pregnancy

Salicylic acid preparations are not recommended during pregnancy.

Considerations for lactation

Aspirin is not recommended as a painkiller during breastfeeding because at doses required for pain relief, potentially unsafe amounts of the drug are present in breastmilk. 

At the low doses (75- 325 mg per day) used for blood thinning effects, aspirin doesn’t enter breast milk and some doctors may recommend it. If it is being used in this way, the infant should be monitored for signs of blood thinning like bruising and bleeding. 

Considerations for kids

Aspirin generally isn’t recommended for children under 18 because it is associated with Reye’s syndrome when taken during viral illness. Some doctors may prescribe Aspirin in special cases if the benefits outweigh the risks. 

Natural Alternatives for Pain and Fever

Painkillers like Aspirin, Ibuprofen, Acetaminophen, and Naproxen are convenient and effective options for managing pain and fever. However, these options aren’t without side effects. Luckily there are natural alternatives for pain and fever management which are safer and have fewer side effects. 

Magnesium is a favorite natural treatment for pain with very few side effects. It has been found effective for nerve pain, muscle pain, fibromyalgia, headaches, migraines, and more

Pain is one of the most important ways that your body alerts you when something is wrong. It is always important to look into the root cause of pain and try to address it before taking a painkiller to mask it. 

Fever is also an important and natural part of the body’s defense mechanism. It isn’t always necessary to treat unless it becomes too high, too uncomfortable, or it interferes with sleep. I recently wrote about herbal teas for fever management which also have the added benefits of improving the immune response and soothing other symptoms.

Summary

Aspirin, Acetaminophen, Ibuprofen, and Naproxen are all safe and effective pain killers when taken in the appropriate doses for the short term. They each have different negative effects to take into account. 

  • The most commonly recommended painkiller for women in pregnancy is acetaminophen (Tylenol).
  • The most commonly recommended painkiller for women who are nursing is ibuprofen (Motrin, Advil).
  • Children under 18 should avoid Aspirin because it is associated with Reye’s Syndrome.
  • People with gastrointestinal tract issues, bleeding issues, cardiovascular issues, or kidney issues should choose acetaminophen (Tylenol) instead of an NSAID like ibuprofen or naproxen. 
  • People with liver concerns should avoid acetaminophen (Tylenol).
  • If inflammation is playing a role in the pain (eg. sprain, strain, menstrual cramps), an NSAID like ibuprofen (Motrin, Advil) or naproxen (Aleve) is a better choice than acetaminophen (Tylenol).
  • If an allergy to Aspirin is present, NSAIDs and salicylic acid containing herbs like willow bark should be avoided.

Keeping these factors in mind can help in choosing the right painkiller to address pain while minimizing adverse effects.   

 

References

Ibuprofen. (2021). In Drugs and Lactation Database (LactMed). National Library of Medicine (US).

Naproxen. (2019). In Drugs and Lactation Database (LactMed). National Library of Medicine (US).

Acetaminophen. (2021). In Drugs and Lactation Database (LactMed). National Library of Medicine (US).

Aspirin. (2021). In Drugs and Lactation Database (LactMed). National Library of Medicine (US).

Ibuprofen: Generic, Uses, Side Effects, Dosage, Interactions & Warnings

Ishitsuka, Y., Kondo, Y., & Kadowaki, D. (2020). Toxicological Property of Acetaminophen: The Dark Side of a Safe Antipyretic/Analgesic Drug?. Biological & pharmaceutical bulletin, 43(2), 195–206. https://doi.org/10.1248/bpb.b19-00722

Brookhuis, S., Allegaert, K., Hanff, L. M., Lub-de Hooge, M. N., Dallmann, A., & Mian, P. (2021). Modelling Tools to Characterize Acetaminophen Pharmacokinetics in the Pregnant Population. Pharmaceutics, 13(8), 1302. https://doi.org/10.3390/pharmaceutics13081302

Jóźwiak-Bebenista, M., & Nowak, J. Z. (2014). Paracetamol: mechanism of action, applications and safety concern. Acta poloniae pharmaceutica, 71(1), 11–23.

Black, E., Khor, K. E., Kennedy, D., Chutatape, A., Sharma, S., Vancaillie, T., & Demirkol, A. (2019). Medication Use and Pain Management in Pregnancy: A Critical Review. Pain practice : the official journal of World Institute of Pain, 19(8), 875–899. https://doi.org/10.1111/papr.12814

Davies N. M. (1999). Sustained release and enteric coated NSAIDs: are they really GI safe?. Journal of pharmacy & pharmaceutical sciences : a publication of the Canadian Society for Pharmaceutical Sciences, Societe canadienne des sciences pharmaceutiques, 2(1), 5–14.

AlHajri L. (2017). Enteric-Coated, Extended-Release and Sustained-Release Formulations of NSAIDs. The Annals of pharmacotherapy, 51(4), 354–356. https://doi.org/10.1177/1060028016678007

Aspirin vs. Acetaminophen (Tylenol) OTC Treatment for Pain: Differences & Side Effects

Shin, H. J., Na, H. S., & Do, S. H. (2020). Magnesium and Pain. Nutrients, 12(8), 2184. https://doi.org/10.3390/nu12082184

Aspirin: Generic, Uses, Side Effects, Dosages, Interactions & Warnings

Side Effects of Tylenol (Acetaminophen), Warnings, Uses

https://www.rxlist.com/naprelan-drug.htm

Ha, M. W., & Paek, S. M. (2021). Recent Advances in the Synthesis of Ibuprofen and Naproxen. Molecules (Basel, Switzerland), 26(16), 4792. https://doi.org/10.3390/molecules26164792

White, W. B., Kloner, R. A., Angiolillo, D. J., & Davidson, M. H. (2018). Cardiorenal Safety of OTC Analgesics. Journal of cardiovascular pharmacology and therapeutics, 23(2), 103–118. https://doi.org/10.1177/1074248417751070

Wilcox, C. M., Cryer, B., & Triadafilopoulos, G. (2005). Patterns of use and public perception of over-the-counter pain relievers: focus on nonsteroidal antiinflammatory drugs. The Journal of rheumatology, 32(11), 2218–2224.

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