Differences between Acetaminophen and Aspirin

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Acetaminophen vs. Aspirin

Acetaminophen and aspirin are common over-the-counter medications used to treat pain and fever.[1][2] While they have similar applications, they belong to different drug classes and have distinct mechanisms of action, side effects, and risks.[1][2] Aspirin, a nonsteroidal anti-inflammatory drug (NSAID), reduces pain, fever, and inflammation.[3] Acetaminophen reduces pain and fever but does not have anti-inflammatory effects.[4][5]

Comparison Table

Category Acetaminophen Aspirin
Drug Class Analgesic (pain reliever) and antipyretic (fever reducer)[2] Nonsteroidal anti-inflammatory drug (NSAID)[2]
Primary Functions Relieves pain and reduces fever[4] Relieves pain, reduces fever, and reduces inflammation[3]
Anti-inflammatory Effect No Yes
Blood-thinning Effect No Yes
Stomach Irritation Less likely to cause stomach irritation Can cause stomach upset and bleeding
Risk of Reye's Syndrome in Children Not associated with Reye's syndrome Linked to Reye's syndrome in children, especially with viral illnesses[3]
Primary Organ Affected by Overdose Liver[4] Stomach, with potential for gastrointestinal bleeding
Venn diagram for Differences between Acetaminophen and Aspirin
Venn diagram comparing Differences between Acetaminophen and Aspirin


Mechanism of Action

Aspirin works by inhibiting the production of prostaglandins, which are chemicals involved in pain, fever, and inflammation. Acetaminophen's exact mechanism is not fully understood, but it is believed to work primarily in the central nervous system to block pain signals and reduce fever by acting on the part of the brain that controls body temperature.[4]

Key Differences in Use

Due to its anti-inflammatory properties, aspirin can be particularly effective for conditions like arthritis and muscle injuries where inflammation is a key factor.[4] In low doses, aspirin is also used to help prevent heart attacks and strokes because of its blood-thinning properties.[3]

Acetaminophen does not reduce inflammation, making it less effective for inflammatory conditions.[5] However, it is often preferred for general pain relief, such as for headaches, and for individuals who have a history of stomach problems or are taking blood-thinning medications, as it is gentler on the stomach and does not affect blood clotting.[1]

Risks and Side Effects

A significant risk associated with aspirin use in children and teenagers, particularly during viral illnesses like the flu or chickenpox, is Reye's syndrome, a rare but serious condition that can cause swelling in the brain and liver. For this reason, aspirin should not be given to children under 16 unless specifically prescribed by a doctor. Common side effects of aspirin can include stomach upset, heartburn, and gastrointestinal bleeding.

The primary concern with acetaminophen is the risk of liver damage, particularly with overdose.[4] Acetaminophen overdose is a leading cause of acute liver failure in the United States. The risk of liver damage is increased when acetaminophen is taken with alcohol.[3]

References

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