Pamprin vs Midol vs Tylenol for Period Cramps: What's Inside

Pamprin and Midol use the same painkiller for period cramps: acetaminophen, the same medicine that is in Tylenol. Midol Complete and Pamprin Multi-Symptom each have 500 mg of acetaminophen per caplet, the same as a Tylenol Extra Strength caplet. The difference is the extras they add for bloating and water weight.

One Pamprin formula is different. Pamprin Max also has aspirin, which is a nonsteroidal anti-inflammatory drug (NSAID). This guide shows what is in each box, which ingredient does the work on cramps, and how to take them safely. It is general information and not medical advice. The doses here come from the Drug Facts labels, and formulas can change, so always read the label on your own box.

Quick answer: what is in Midol, Pamprin and Tylenol

These are the active ingredients in each caplet, from the current labels. "Max a day" is the most caplets the label allows in 24 hours.

For all four, the label dose for adults and children 12 and older is 2 caplets at a time. You can take the next dose after 6 hours for Midol Complete, Pamprin Multi-Symptom, Pamprin Max and Tylenol Extra Strength.

What each ingredient does

• Acetaminophen is the pain reliever in all four products. It is called paracetamol outside the US.
• Aspirin, in Pamprin Max, is a second pain reliever. The label lists it as an NSAID, the same family as ibuprofen and naproxen.
• Caffeine, in Midol Complete and Pamprin Max, is listed as a diuretic. It helps your body lose extra water. A full dose has about as much caffeine as a cup of coffee.
• Pamabrom, in Pamprin Multi-Symptom, is a diuretic without caffeine.
• Pyrilamine, in Midol Complete and Pamprin Multi-Symptom, is an antihistamine. It can make you drowsy, so be careful when you drive or use machines.

The diuretic and the antihistamine are there for bloating, water-weight gain and other period symptoms. On cramps, the pain reliever does the work.

Pamprin vs Midol: the real difference

Midol Complete and Pamprin Multi-Symptom have the same painkiller dose and the same antihistamine. The main difference is the diuretic. Midol Complete uses caffeine, and Pamprin Multi-Symptom uses pamabrom and has no caffeine. If caffeine makes you jittery or keeps you awake, that can matter more than the brand. Too much caffeine can cause nervousness, irritability, sleeplessness and sometimes a fast heartbeat, so count your coffee, tea and energy drinks too.

The label limits are different. You can take up to 8 Pamprin Multi-Symptom caplets in 24 hours, but only 6 Midol Complete caplets.

Pamprin Max is the one that is different from both. Each caplet has half the acetaminophen of the others plus 250 mg of aspirin. Because it has an NSAID, it also carries the NSAID warnings below.

Midol vs Tylenol: is Midol just Tylenol?

Midol Complete is not plain Tylenol, but its painkiller is the same. A Midol Complete caplet and a Tylenol Extra Strength caplet each have 500 mg of acetaminophen, and both labels allow 6 caplets in 24 hours. Midol adds caffeine and pyrilamine. If you only want pain relief and no caffeine or drowsiness, plain acetaminophen does the same job on the pain. Tylenol's label lists premenstrual and menstrual cramps among its uses.

Is there ibuprofen in Midol?

No. Midol Complete has acetaminophen, not ibuprofen. One brand name can cover more than one formula, so look at the "Active ingredients" line in the Drug Facts box, not the name on the front. If that line says ibuprofen or naproxen, the product is an NSAID, and our guide to ibuprofen and naproxen for period cramps applies.

NSAIDs vs acetaminophen for period cramps

For most people, an NSAID such as ibuprofen or naproxen is the better first choice for period cramps. Cramps come from prostaglandins, chemicals that make the womb squeeze. NSAIDs reduce the prostaglandins your body makes, and they are usually the first step in treatment. Acetaminophen works in a different way.

In trials, NSAIDs gave more pain relief for period pain than paracetamol (acetaminophen). That result comes from only three trials, so it is not strong evidence, but it fits how the two medicines work. NSAIDs also work best when you take them at the first sign of your period or pain, and you usually need them for only 1 or 2 days.

Acetaminophen is still a good choice when you cannot take an NSAID. People with bleeding disorders, asthma, an aspirin allergy, liver damage, stomach disorders or ulcers should not take NSAIDs unless a doctor says it is safe. If that is you, ask a doctor or pharmacist which painkiller suits you.

For more ways to ease cramps, such as heat and exercise, see what helps period cramps.

How to take them safely

Do not double up on acetaminophen

This is the most important rule. All four products contain acetaminophen, and other medicines can contain it too. Every label says: do not use it with any other drug that contains acetaminophen, prescription or not. If you are not sure whether a medicine contains acetaminophen, ask a pharmacist. If you take Midol in the morning and Tylenol in the afternoon, both doses count toward the same daily limit.

Too much acetaminophen can cause severe liver damage. The Tylenol label warns about more than 4,000 mg of acetaminophen in 24 hours from all products. The risk is also higher if you have 3 or more alcoholic drinks every day. Ask a doctor first if you have liver disease or take the blood thinner warfarin.

If you think you took too much, get medical help or call Poison Control right away (1-800-222-1222 in the US), even if you feel fine.

Acetaminophen can also cause severe skin reactions. If you get reddening, blisters or a rash, stop and get medical help right away.

The NSAID warnings in Pamprin Max

Aspirin is an NSAID, so Pamprin Max has a stomach bleeding warning. The chance of bleeding is higher if you are 60 or older, have had stomach ulcers or bleeding, take a blood thinner or a steroid, take another NSAID such as ibuprofen or naproxen, or have 3 or more alcoholic drinks every day.

Ask a doctor before you use it if you have high blood pressure, heart disease, liver cirrhosis or kidney disease, or take a diuretic. Do not use it if you are allergic to aspirin or to any other pain reliever. Do not take Pamprin Max together with ibuprofen or naproxen.

If you are pregnant or breastfeeding, ask a health professional before you take any of these products. Aspirin is especially important to avoid in the last 3 months of pregnancy unless a doctor tells you to take it.

Caffeine and drowsiness

Midol Complete and Pamprin Max each have about a cup of coffee's worth of caffeine per dose. Pamprin Multi-Symptom and Midol Complete contain pyrilamine, which can make you drowsy. Alcohol, sedatives and tranquilizers make the drowsiness worse.

What to track

A short record over two or three periods shows which product helps you, and it gives a doctor clear facts. Note:

• Which product you took, how many caplets, and the time of each dose
• Your pain from 0 to 10 before the dose and 1 to 2 hours after it (our period pain scale can help)
• How many days you needed a painkiller, and the days you missed work or plans
• Side effects, such as stomach pain, a fast heartbeat or drowsiness
• Other symptoms, such as heavy bleeding, bloating, headaches or pain during sex

Endolog lets you log your pain severity and where it hurts, bleeding, bloating and other symptoms next to your cycle, and add notes. You can then share a PDF report with your doctor. Our pain diary for your doctor shows what to bring to an appointment.

When to see a doctor

Period cramps that these medicines do not help need a doctor's check. Most cramps come from prostaglandins alone. Sometimes a condition such as endometriosis, adenomyosis or fibroids causes the pain. This pain tends to get worse over time and often lasts longer than normal cramps.

See a doctor if:

• Over-the-counter painkillers at the label dose do not ease your cramps over two or three periods
• The pain keeps you from work, school or your usual activities
• Your periods get more painful over the years, or the pain goes on after your period ends
• Your pain gets worse or lasts more than 10 days while you take a painkiller
• You need a painkiller on many days each month

If medicines do not relieve your pain, treatment should focus on finding the cause. Read how endometriosis pain differs from normal period cramps. Severe period pain is a medical problem, and you deserve treatment for it.

Get urgent help

Stop the medicine and get medical help right away if you have signs of stomach bleeding: you feel faint, vomit blood, have bloody or black stools, or have stomach pain that does not get better. Also get help right away for signs of an allergic reaction such as hives, facial swelling, wheezing or shock, or if you may have taken too much acetaminophen. Go to the emergency department if you have sudden, severe pain in your belly or pelvis, and more so if you could be pregnant.

FAQ: Midol, Pamprin and Tylenol for period cramps

Is Pamprin or Midol better for period cramps?

Neither is better on the pain itself. Midol Complete and Pamprin Multi-Symptom both have 500 mg of acetaminophen per caplet. Midol Complete has caffeine and Pamprin Multi-Symptom does not. Pamprin Max is different because it adds aspirin, an NSAID.

Is Midol the same as Tylenol?

The painkiller is the same. Midol Complete and Tylenol Extra Strength both have 500 mg of acetaminophen per caplet. Midol adds caffeine and pyrilamine for bloating. Do not take them together, because both doses count toward one acetaminophen limit.

Is Midol just ibuprofen?

No. Midol Complete has acetaminophen, caffeine and pyrilamine, and no ibuprofen. Always check the active ingredients on the box, because one brand can sell more than one formula.

Can I take Midol and ibuprofen together?

Ask a doctor or pharmacist before you mix painkillers. Midol Complete has no NSAID. Pamprin Max has aspirin, so do not take it with ibuprofen or naproxen, because two NSAIDs raise the chance of stomach bleeding.

Which is best for cramps: ibuprofen or acetaminophen?

For most people, an NSAID such as ibuprofen works better. NSAIDs gave more relief for period pain than acetaminophen in trials. Acetaminophen is the choice when an NSAID is not safe for you.