Head-to-head clinical analysis & difference comparison: details on mechanism of action, dosing, half-life, interactions, and maternal-fetal safety.
ADVIL ALLERGY AND CONGESTION RELIEF vs ACTRON
Clinician-reviewed, head-to-head comparison of mechanism, dosing, pharmacokinetics, and safety profiles.
Last clinically reviewed: July 2026 · OpiCalc Medical Review Team
Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that inhibits cyclooxygenase (COX-1 and COX-2), reducing prostaglandin synthesis, which mediates inflammation, pain, and fever. Pseudoephedrine is a sympathomimetic amine that acts as a decongestant by stimulating alpha-adrenergic receptors in the nasal mucosa, causing vasoconstriction.
Acetaminophen (paracetamol) is a non-opioid analgesic and antipyretic. Its mechanism is not fully understood but involves inhibition of cyclooxygenase (COX) enzymes in the central nervous system, reducing prostaglandin synthesis. It also modulates the endocannabinoid system and serotonergic pathways.
Temporary relief of symptoms due to hay fever or other upper respiratory allergies: nasal congestion, sinus pressure, sneezing, runny nose, itching of nose or throat, and itchy, watery eyes due to allergies.,Temporary reduction of fever.,Relief of minor aches and pains associated with the common cold, headache, toothache, muscular aches, backache, menstrual cramps, and arthritis pain.
Mild to moderate pain,Fever
Ibuprofen 200 mg and pseudoephedrine HCl 30 mg per tablet. Usual adult dose: 1-2 tablets orally every 4-6 hours as needed, not to exceed 6 tablets in 24 hours.
Oral: 400 mg every 4-6 hours as needed for pain; maximum 1200 mg/day.
Ibuprofen: 2-4 hours; pseudoephedrine: 5-8 hours. Shorter half-life requires frequent dosing for sustained relief.
Terminal elimination half-life 2-4 hours; prolonged to 6-12 hours in elderly or renal impairment (Cr Cl <30 m L/min).
Ibuprofen is primarily metabolized by cytochrome P450 (CYP) enzymes, mainly CYP2C9, to inactive metabolites (hydroxyibuprofen and carboxyibuprofen). Pseudoephedrine is partially metabolized in the liver by N-demethylation to an inactive metabolite.
Primarily metabolized in the liver via glucuronidation (UGT1A1, UGT1A6, UGT1A9), sulfation (SULT1A1, SULT1A3), and oxidation (CYP2E1, CYP3A4) to form the toxic metabolite N-acetyl-p-benzoquinone imine (NAPQI), which is detoxified by glutathione.
Renal excretion of unchanged drug and metabolites; approximately 1% excreted unchanged (pseudoephedrine) and 15% (ibuprofen). Biliary/fecal elimination accounts for <5%.
Renal: 90% as unchanged drug; biliary/fecal: 10% as metabolites.
Ibuprofen: 99% bound to albumin; pseudoephedrine: negligible protein binding.
>99% bound to albumin.
Ibuprofen: 0.1-0.2 L/kg; pseudoephedrine: 2.5-3 L/kg.
0.1-0.2 L/kg; indicates limited extravascular distribution.
Oral: ibuprofen 80-100%; pseudoephedrine 100%.
Oral: 70-90% (first-pass metabolism minimal); IV: 100%.
For pseudoephedrine: Cr Cl <30 m L/min, reduce dose by 50% or administer every 12 hours. For ibuprofen: avoid use if Cr Cl <30 m L/min; if Cr Cl 30-59 m L/min, use lowest effective dose and monitor renal function.
GFR <30 m L/min: Avoid use. GFR 30-50 m L/min: Reduce dose to 50% of normal, maximum 600 mg/day.
For ibuprofen: Child-Pugh class A and B: no adjustment necessary; Child-Pugh class C: avoid use. For pseudoephedrine: use with caution in severe hepatic impairment; no specific dose adjustment recommended, but monitor for adverse effects.
Child-Pugh Class B: Reduce dose by 50%; maximum 600 mg/day. Child-Pugh Class C: Contraindicated.
Not indicated for children under 12 years of age. For children 12 years and older: same as adult dose (1-2 tablets every 4-6 hours, max 6 tablets per day). Weight-based: not routinely used; safety and efficacy not established for <25 kg.
Children ≥12 years: 400 mg orally every 6-8 hours as needed; maximum 1200 mg/day. Children <12 years: Not recommended.
For ibuprofen: use lowest effective dose for shortest duration; monitor renal function and GI bleeding risk. For pseudoephedrine: initiate at lower doses (e.g., one tablet every 6 hours) due to increased sensitivity and risk of hypertension, urinary retention, and CNS effects.
Initiate at 200 mg every 6-8 hours; maximum 600 mg/day due to increased risk of gastrointestinal bleeding and renal impairment.
Cardiovascular risk: NSAIDs may increase the risk of serious cardiovascular thrombotic events, myocardial infarction, and stroke, which can be fatal. Risk increases with duration of use and in patients with cardiovascular risk factors. Contraindicated for perioperative pain in coronary artery bypass graft (CABG) surgery. Gastrointestinal risk: NSAIDs increase the risk of serious gastrointestinal adverse events including bleeding, ulceration, and perforation of the stomach or intestines, which can be fatal. Elderly patients and those with prior peptic ulcer disease and/or GI bleeding are at greater risk.
Acetaminophen has been associated with cases of acute liver failure, sometimes resulting in liver transplant and death. Most cases involve use of acetaminophen at doses exceeding 4000 mg per day, often involving more than one acetaminophen-containing product.
Cardiovascular effects: may increase risk of heart attack or stroke; use lowest effective dose for shortest duration. Gastrointestinal effects: may cause GI ulceration, bleeding, perforation. Renal effects: avoid in advanced renal disease; monitor renal function. Hepatic effects: may cause liver enzyme elevation; discontinue if liver disease develops. Anaphylactic reactions: may occur in patients with or without prior NSAID sensitivity. Asthma: may cause bronchospasm. Hypertension: may worsen hypertension. Avoid in late pregnancy due to risk of premature closure of ductus arteriosus. Pseudoephedrine: may cause nervousness, dizziness, insomnia, hypertension, arrhythmias; use with caution in patients with cardiovascular disease, diabetes, glaucoma, prostatic hypertrophy, hyperthyroidism. Avoid in severe hypertension or coronary artery disease.
Hepatotoxicity: risk increased with chronic alcohol use, liver disease, or use of other acetaminophen-containing products. Avoid exceeding 4000 mg/day. Severe skin reactions: Stevens-Johnson syndrome, toxic epidermal necrolysis, acute generalized exanthematous pustulosis. Hypersensitivity reactions: anaphylaxis.
Hypersensitivity to ibuprofen, pseudoephedrine, or any component of the formulation. History of asthma, urticaria, or allergic-type reaction after taking aspirin or other NSAIDs. In the setting of coronary artery bypass graft (CABG) surgery. Severe hypertension. Coronary artery disease. Concurrent use with or within 14 days of monoamine oxidase inhibitors (MAOIs) due to risk of hypertensive crisis. Pregnancy (third trimester).
Severe hepatic impairment or active liver disease. Known hypersensitivity to acetaminophen or any component of the formulation.
Take with food or milk to minimize GI upset. Avoid alcohol as it may increase risk of GI bleeding. No specific food-drug interactions.
Avoid alcohol; may increase risk of GI bleeding. No specific food restrictions, but taking with food can reduce gastrointestinal irritation. Maintain adequate hydration to prevent renal impairment.
First trimester: Possible increased risk of cardiovascular malformations and gastroschisis with NSAID use. Second trimester: No specific malformation risk reported, but avoid prolonged use due to potential oligohydramnios. Third trimester: NSAIDs (including ibuprofen) are contraindicated due to risk of premature ductus arteriosus closure and oligohydramnios. Pseudoephedrine: Limited data; possible association with gastroschisis if used in first trimester; avoid due to vasoconstrictive effects.
First trimester: Based on animal studies and limited human data, possible increased risk of cardiovascular and neural tube defects. Second/third trimester: Risk of premature closure of ductus arteriosus and oligohydramnios with prolonged use. Avoid after 30 weeks gestation.
Ibuprofen: Excreted in low levels (M/P ratio ~0.006); considered compatible with breastfeeding. Pseudoephedrine: Excreted in breast milk (M/P ratio ~2.5-3.5); may reduce milk production and cause irritability in infants; use with caution.
Excreted in breast milk; M/P ratio 0.15. Low oral bioavailability to infant; considered compatible with breastfeeding. Monitor infant for sedation or feeding problems.
Ibuprofen: No specific dose adjustment recommended for pregnancy; however, avoid use in third trimester. Pseudoephedrine: No dose adjustment studied; use lowest effective dose for shortest duration. Neither drug is recommended for regular use during pregnancy.
Dose adjustment not typically required; however, due to increased renal clearance and volume of distribution in pregnancy, higher doses may be needed to achieve therapeutic effect. Use lowest effective dose for shortest duration.
Combination of ibuprofen (NSAID) and pseudoephedrine (decongestant). Ibuprofen may increase blood pressure, counteracting pseudoephedrine's vasoconstriction; monitor in hypertensive patients. Avoid in patients with severe CAD, uncontrolled HTN, or within 2 weeks of MAOI use.
ACTRON (ketorolac tromethamine) is a nonsteroidal anti-inflammatory drug (NSAID) for short-term management of moderate to severe acute pain, typically not exceeding 5 days due to risk of GI bleeding, renal impairment, and cardiovascular events. Avoid in patients with active peptic ulcer disease, bleeding diathesis, or advanced renal disease. Monitor renal function and signs of bleeding. Use lowest effective dose for shortest duration. May cause bronchospasm in aspirin-sensitive asthma.
Do not take with other NSAIDs or cold/flu products to avoid overdose.,Pseudoephedrine may cause insomnia; take last dose at least 4-6 hours before bedtime.,Ibuprofen can cause GI bleeding; take with food or milk to reduce risk.,Stop use and consult doctor if symptoms persist >7 days or if fever lasts >3 days.,Avoid alcohol while taking this medication.
Take with food or milk to reduce stomach upset.,Do not take for more than 5 days as prescribed; longer use increases risk of serious side effects.,Avoid alcohol while taking this medication to lower risk of stomach bleeding.,Report any signs of bleeding (e.g., black stools, vomiting blood), unusual bruising, or decreased urination.,Do not take with other NSAIDs (e.g., ibuprofen, naproxen) or aspirin without consulting your doctor.,Inform your doctor about all medications, especially blood thinners (e.g., warfarin) and diuretics.,If you have asthma, be aware of potential bronchospasm; seek immediate help if you have breathing trouble.,Not recommended during pregnancy, especially in the third trimester.
No interactions on record
No interactions on record
Explore head-to-head clinical comparisons of other medications in the same therapeutic classes.
Common clinical questions about ADVIL ALLERGY AND CONGESTION RELIEF vs ACTRON, answered by our medical review team.
ADVIL ALLERGY AND CONGESTION RELIEF is a NSAID/Decongestant Combination that works by Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that inhibits cyclooxygenase (COX-1 and COX-2), reducing prostaglandin synthesis, which mediates inflammation, pain, and fever. Pseudoephedrine is a sympathomimetic amine that acts as a decongestant by stimulating alpha-adrenergic receptors in the nasal mucosa, causing vasoconstriction.. ACTRON is a NSAID that works by Acetaminophen (paracetamol) is a non-opioid analgesic and antipyretic. Its mechanism is not fully understood but involves inhibition of cyclooxygenase (COX) enzymes in the central nervous system, reducing prostaglandin synthesis. It also modulates the endocannabinoid system and serotonergic pathways.. They differ in pharmacokinetic profiles, FDA-approved indications, and side effect profiles.
Potency comparisons between ADVIL ALLERGY AND CONGESTION RELIEF and ACTRON depend on the specific clinical indication. These are agents from distinct pharmacological classes and are not directly interchangeable by dose. A physician or clinical pharmacist should guide any therapeutic switching decisions.
The standard adult dose of ADVIL ALLERGY AND CONGESTION RELIEF is: Ibuprofen 200 mg and pseudoephedrine HCl 30 mg per tablet. Usual adult dose: 1-2 tablets orally every 4-6 hours as needed, not to exceed 6 tablets in 24 hours.. The standard adult dose of ACTRON is: Oral: 400 mg every 4-6 hours as needed for pain; maximum 1200 mg/day.. Dosing should always be individualized based on indication, renal and hepatic function, age, and other patient factors.
No direct drug-drug interaction has been formally documented between ADVIL ALLERGY AND CONGESTION RELIEF and ACTRON in current clinical databases. However, individual patient risk factors including other medications, organ function, and comorbidities should always be evaluated by a qualified healthcare provider.
The maternal-fetal safety profiles differ. ADVIL ALLERGY AND CONGESTION RELIEF is classified as Category C. First trimester: Possible increased risk of cardiovascular malformations and gastroschisis with NSAID use. Second trimester: No specific malformation risk reported, but avoid prolo. ACTRON is classified as Category C. First trimester: Based on animal studies and limited human data, possible increased risk of cardiovascular and neural tube defects. Second/third trimester: Risk of premature closur. Always consult a maternal-fetal medicine specialist before taking either drug during pregnancy or lactation.