When patients with, or at risk for, CV disease need pain relief, TYLENOL® is a good fit.

The American Heart Association recommends acetaminophen
as a first-line analgesic for patients with, or at risk for, cardiovascular disease2*


Cardiovascular disease

Many adults ages 40 to 59 have cardiovascular disease5

percentage of male and female patients with cardiovascular disease

Ibuprofen and naproxen labels warn that the risk of heart attack or stroke may increase if patients use more than directed or for longer than directed

Acetaminophen labels do not


Hypertension

Nearly 1 in 3 American adults have hypertension

About half (54%) have it under control5

OTC NSAID labels warn that patients should ask a doctor before use if they have high blood pressure


Aspirin heart therapy

50 million adults are on aspirin heart therapy6

TYLENOL® does not interfere with aspirin's cardioprotective mechanism, like ibuprofen can.1 Plus, adding an NSAID to aspirin can increase the risk of stomach bleeding7


Proven analgesic efficacy +-


TYLENOL®: Analgesic efficacy in osteoarthritis—even with inflammation present8

Acetaminophen 4000 mg/day is as effective as Rx doses of ibuprofen (2400 mg/day) and the maximum OTC dose of ibuprofen (1200 mg/day) for OA of the knee9

Results as measured by patient-assessed pain scores at 4 weeks


TYLENOL®: Analgesic efficacy in sprains and strains

Acetaminophen extended-release 3900 mg/day is comparable to ibuprofen 1200 mg/day for grade I or II lateral ankle sprains10

Results as measured by visual analog pain scale at days 4 and 9

Excellent safety profile when used as directed +-


Acetaminophen long-term use clinical study

No clinical evidence of liver dysfunction—even when dosed at 4000 mg/day for up to 1 year11

Per FDA, 3X ULN* for ALT, accompanied by total serum bilirubin >2X ULN, is the most specific indicator of a medicine’s potential to cause liver injury. No subject in the study had ALT ≥3X ULN

Aspirin long term use study scatter plot

Adapted from Temple AR, et al. Clin Ther. 2006;28(2):227-235.
*ULN: upper limit of normal range (Laboratory Reference Range)

Ibuprofen Can Compromise Aspirin Heart Therapy1

Ibuprofen can compete with aspirin to occupy a platelet COX-1 receptor

GI Considerations

NSAIDs and GI Side Effects

Acetaminophen Metabolism in the Liver

3 main hepatic pathways are involved in acetaminophen metabolism12

Renal Considerations

NSAIDs and Renal Function

*When symptoms are not controlled by nonpharmacological approaches

REFERENCES: 1. Catella-Lawson F, Reilly MP, Kapoor SC, et al. Cyclooxygenase inhibitors and the antiplatelet effects of aspirin. N Engl J Med. 2001;345(25):1809-1817. 2. Antman EM, Bennett JS, Daugherty A, Furberg C, Roberts H, Taubert KA. Use of nonsteroidal anti-inflammatory drugs: an update for clinicians: a scientific statement from the American Heart Association. Circulation. 2007;115(12):1634-1642. 3. Elliott WJ. Drug interactions and drugs that affect blood pressure. J Clin Hypertens. 2006;8(10):731-737. 4. Horn JR, Hansten PD. NSAIDs and antihypertensive agents. Pharm Times. 2006. http://www.pharmacytimes.com/publications/issue/2006/2006-04/2006-04-5484. Accessed November 23, 2014. 5. Mozaffarian D, Benjamin E, Go A, et al. Heart disease and stroke statistics—a report from the American Heart Association. Circulation. 2015;131:e29-e322. 6. Campbell CL, Smyth S, Montalescot G, Steinhubl SR. Aspirin dose for the prevention of cardiovascular disease. JAMA. 2007;297(18):2018-2024. 7. American College of Cardiology. ACCF/ACG/AHA 2008 expert consensus document on reducing the gastrointestinal risks of antiplatelet therapy and NSAID use. Circulation. 2008;1894-1909. 8. Bradley JD, Brandt KD, Katz BP, Kalasinski LA, Ryan SI. Treatment of knee osteoarthritis: relationship of clinical features of joint inflammation to the response to a nonsteroidal antiinflammatory drug or pure analgesic. J Rheumatol. 1992;19(12):1950-1954. 9. Bradley JD, Brandt KD, Katz BP, Kalasinski LA, Ryan SI. Comparison of an anti-inflammatory dose of ibuprofen, an analgesic dose of ibuprofen, and acetaminophen in the treatment of patients with osteoarthritis of the knee. N Engl J Med. 1991;325(2):87-91. 10. Dalton JD, Schweinle JE. Randomized controlled noninferiority trial to compare extended release acetaminophen and ibuprofen for the treatment of ankle sprains. Ann Emerg Med. 2006;48(5):615-623. 11. Temple AR, Benson GD, Zinsenheim JR, Schweinle JE. Multicenter, randomized, double-blind, active-controlled, parallel-group trial of the long-term (6-12 months) safety of acetaminophen in adult patients with osteoarthritis. Clin Ther. 2006;28(2):222-235. 12. McNeil Consumer Healthcare. TYLENOL® Professional Product Information. 2015.