Dr. Thomas Dwan - Is It Bad For You? Approved by Dr. Thomas Dwan

Is Advil PM Bad For You?

Also Known As: Ibuprofen PM



Short answer

Advil PM may be effective for short-term pain relief and sleep assistance, but it does come with potential risks. Common side effects include drowsiness, dizziness, dry mouth, and GI distress, while serious ones include heart problems, gastrointestinal bleeding, and kidney damage. Dependency and increased fall risk, especially for the elderly, are concerns with long-term use. Always adhere to labeled guidelines and use responsibly to minimize health risks.



Long answer

Active Ingredients in Advil PM and Their Functions

Advil PM is a popular over-the-counter medication intended to alleviate pain and assist with sleep. It comprises two main active ingredients, each serving distinct therapeutic purposes. Let's dissect these components to understand their individual roles and combined effects on the body.


  • Classification: Nonsteroidal anti-inflammatory drug (NSAID)
  • Function: Reduces inflammation, relieves pain, and lowers fever.
  • Operational Mechanism: Ibuprofen operates by inhibiting the activity of cyclooxygenase (COX) enzymes, particularly COX-1 and COX-2. These enzymes play a role in the synthesis of prostaglandins, which contribute to inflammation and pain perception.
  • Dosage in Advil PM: Each tablet usually contains 200 milligrams of ibuprofen.
  • Considerations: Despite its effectiveness, long-term use of NSAIDs, including ibuprofen, can increase the risk of gastrointestinal bleeding, kidney damage, and other adverse effects, particularly in higher doses or in vulnerable populations.

Diphenhydramine Citrate:

  • Classification: Antihistamine with sedative properties
  • Function: Used to treat allergy symptoms and as a sleep aid due to its sedating effects.
  • Operational Mechanism: Diphenhydramine is an H1 receptor antagonist; it inhibits the action of histamine in the brain, which can decrease wakefulness and facilitate sleep.
  • Dosage in Advil PM: Each Advil PM tablet typically includes 38 milligrams of diphenhydramine citrate.
  • Considerations: Though considered safe for short-term use, diphenhydramine can cause side effects such as drowsiness, dry mouth, dizziness, and cognitive impairment. Caution is advised when using it, especially for the elderly or individuals operating heavy machinery.

Combined, ibuprofen alleviates the physical discomfort that may prevent restful sleep, while diphenhydramine induces drowsiness, facilitating the onset of sleep. It's critical to use Advil PM strictly according to the labeled instructions and to be mindful of the potential risks associated with each active ingredient, particularly if considering regular or long-term use.

Research supports the efficacy of both active ingredients for their intended purposes. A study published in the journal Pain demonstrated the analgesic effects of NSAIDs, including ibuprofen [source], while the Journal of Clinical Sleep Medicine noted diphenhydramine's sedative properties to be beneficial for sleep initiation [source]. However, healthcare professionals advocate for the cautious use of such medication and suggest it should be used for short-term purposes rather than as a long-term solution to sleep issues.

In summary, the active ingredients in Advil PM are intended to provide relief from occasional sleeplessness due to minor aches and pains. It's essential for users to understand the functions and potential risks associated with these ingredients to use the medication safely and effectively.

Potential Side Effects of Using Advil PM

Advil PM combines ibuprofen, a nonsteroidal anti-inflammatory drug (NSAID), with diphenhydramine, an antihistamine that can induce sleep. While it is effective in managing minor pains and assisting with sleep, it is not without potential side effects. These side effects can vary from mild to severe and may affect individuals differently based on their health status, age, and dosage. Below we detail the common and serious side effects to be aware of when taking Advil PM.

Common Side Effects:

  • Drowsiness: As a sleep aid, drowsiness is an expected and therapeutic effect, but it may also impair daytime activities and alertness.
  • Dizziness: Some users may experience dizziness, which could increase the risk of falls, especially in the elderly.
  • Dry Mouth: Antihistamines like diphenhydramine can reduce saliva production, leading to dry mouth.
  • Blurred Vision: Diphenhydramine can also cause temporary blurring of vision or other visual disturbances.
  • Constipation: Reduced gut motility is another common antihistamine side effect.
  • Gastrointestinal Distress: NSAIDs can irritate the GI tract, causing nausea, vomiting, heartburn, or stomach pain.

Serious Side Effects:

  • Heart Problems: Long-term use of NSAIDs may increase the risk of heart attack or stroke, especially in individuals with preexisting cardiovascular conditions.
  • Gastrointestinal Bleeding: NSAIDs can cause bleeding in the stomach or intestines, which can be life-threatening.
  • Kidney Damage: Regular use of NSAIDs can lead to kidney problems, including kidney failure.
  • Respiratory Depression: Although rare, high doses of diphenhydramine can depress respiration, which is particularly risky for those with existing respiratory conditions.
  • Allergic Reactions: Some individuals may experience severe allergic reactions, such as anaphylaxis, which require immediate medical attention.
  • Cognitive Impairment: The use of diphenhydramine, especially among the elderly, has been linked to a decline in cognitive functioning and an increased risk of dementia.

It should be noted that the occurrence of side effects is often dose-dependent, and following the recommended guidelines can reduce the risk of adverse effects. A study published in the Journal of Sleep Research highlighted that diphenhydramine's sedative effects could potentially increase falls and confusion in the elderly.

Moreover, the American Heart Association has raised concerns about the potential for NSAIDs to contribute to heart issues. Responsible use includes consulting with a healthcare provider, particularly for those with pre-existing conditions, and adhering to the recommended dosages on the product labeling.

The Risk of Dependency and Overuse

One of the concerns with the use of Advil PM, which contains ibuprofen and diphenhydramine, is the risk of developing a dependency or engaging in overuse. Although Advil PM is generally safe when used as directed for short-term management of pain and sleep difficulties, there are potential risks associated with its misuse or prolonged use.

Understanding the Active Ingredients

To properly assess the risk of dependency and overuse, it is crucial to understand the active ingredients in Advil PM:

  • Ibuprofen: A nonsteroidal anti-inflammatory drug (NSAID) used to relieve pain and reduce inflammation.
  • Diphenhydramine: An antihistamine commonly used to treat allergy symptoms, which also has sedative properties to help induce sleep.

Potential Risks of Ibuprofen Overuse

  • Gastrointestinal Issues: Chronic use of NSAIDs like ibuprofen can lead to gastrointestinal bleeding, ulcers, and other stomach problems.
  • Kidney Damage: Long-term use of ibuprofen can affect renal function and potentially lead to kidney damage or failure.
  • Cardiovascular Concerns: Some studies have linked prolonged use of NSAIDs to an increased risk of heart attack and stroke. It's essential to use these medications cautiously, especially in individuals with pre-existing heart conditions.

Potential Risks of Diphenhydramine Dependency

  • Tolerance: The body can build a tolerance to the sedative effects of diphenhydramine, leading to the need for higher doses to achieve the same sleep-inducing effect.
  • Withdrawal Symptoms: Stopping diphenhydramine suddenly after prolonged use can cause withdrawal symptoms such as nausea, dizziness, and trouble sleeping.
  • Cognitive Impairment: Elderly patients are particularly at risk of cognitive decline and confusion with long-term use of antihistamines with sedative properties.

Recommendations for Safe Use

Here are guidelines to minimize the risk of dependency and overuse of Advil PM:

  • Use the lowest effective dose for the shortest duration possible to manage symptoms.
  • Always follow the dosing instructions provided on the packaging or by a healthcare provider.
  • Avoid using Advil PM for more than 10 consecutive days for pain or 2 consecutive weeks for sleep issues, unless directed by a doctor.
  • Consult with a healthcare professional if you find yourself relying on Advil PM regularly to manage chronic pain or insomnia symptoms.

Key Points for Consideration

Individuals with a history of substance abuse or addictive behaviors should be particularly cautious when using any medication with potential sedative effects, including Advil PM. If symptoms persist or worsen, it's vital to seek medical attention rather than increasing the dosage of over-the-counter medications.

Recognizing the signs of dependency and overuse is important. If you or someone you know is experiencing an inability to sleep without the drug, using higher doses than recommended, or suffering from adverse side effects due to long-term use of Advil PM, it's time to consult a healthcare provider. Moderation and following medical guidance can help prevent dependency and overuse, ensuring the safe use of Advil PM.

Considering these factors, users of Advil PM should be vigilant and proactive about their health to avoid the potential risks of dependency and overuse. Those with chronic conditions or pain should seek professional medical advice for appropriate and safe long-term treatment options.

Interaction With Other Medications and Alcohol

Advil PM, a combination of ibuprofen, an NSAID (nonsteroidal anti-inflammatory drug), and diphenhydramine, an antihistamine, is used for managing pain and promoting sleep. While it can be effective for short-term use, it’s crucial to be aware of its potential interactions with other medications and alcohol, which can increase the risk of side effects or reduce the effectiveness of treatments.

Interactions with Prescription Medications

Advil PM can interact with various prescription medications, including:

  • Anticoagulants (blood thinners): Ibuprofen in Advil PM may enhance the effects of drugs like warfarin, increasing the risk of bleeding.
  • Antihypertensive medications: NSAIDs can reduce the effectiveness of certain blood pressure medications such as ACE inhibitors, beta-blockers, and diuretics.
  • Selective serotonin reuptake inhibitors (SSRIs): Concurrent use of SSRIs and NSAIDs might increase the risk of gastrointestinal bleeding.
  • Other NSAIDs: Using multiple NSAIDs together can lead to an increased risk of ulcers and bleeding.
  • Corticosteroids: Combination with NSAIDs may increase the risk of gastrointestinal side effects.
  • Lithium: Ibuprofen can raise lithium levels, potentially leading to toxicity.
  • Methotrexate: NSAIDs like ibuprofen can decrease the excretion of methotrexate, increasing toxicity risks.

Always consult with a healthcare provider before combining Advil PM with prescription medications to avoid harmful interactions.

Interactions with Over-The-Counter Medications and Supplements

Over-the-counter medications and dietary supplements should also be used with caution while taking Advil PM:

  • Aspirin: When taken with Advil PM, may increase the risk of gastrointestinal bleeding.
  • Acetaminophen: Concurrent use with ibuprofen may increase the risk of kidney damage.
  • Alcohol: It’s strongly advised not to mix alcohol with Advil PM. Alcohol can enhance the sedative effects of diphenhydramine and increase the risk of gastrointestinal bleeding associated with ibuprofen.

Alcohol Considerations

Mixing alcohol with Advil PM requires particular attention:

  • Alcohol can intensify the drowsiness and sedative effects of diphenhydramine, increasing the risk of accidents and impairing one’s ability to operate machinery or drive.
  • The use of Advil PM with alcohol can irritate the lining of the stomach, leading to increased risk of ulcers, bleeding, and other gastrointestinal problems.

Due to these risks, it is generally recommended to avoid alcohol altogether when taking Advil PM. If you have consumed alcohol, it is best to wait at least 24 hours before taking Advil PM or seek advice from a healthcare professional.

Understanding these interactions is essential for safe medication use. Always disclose all medications and supplements you are taking to your healthcare provider to prevent potential adverse reactions.

Impact of Long-Term Use on Liver and Kidney Health

The long-term use of Advil PM may raise concerns about its impacts on liver and kidney health. Advil PM combines ibuprofen, a nonsteroidal anti-inflammatory drug (NSAID), with diphenhydramine, an antihistamine. While this combination can be effective for pain relief and sleep assistance, the continuous use of such medications can pose risks to the liver and kidneys, which play critical roles in drug metabolism and excretion.

Liver Health Concerns:

Ibuprofen, the active pain reliever in Advil PM, has been associated with rare but serious liver injury. The liver is instrumental in metabolizing many substances, including medications. Over time, the metabolic byproducts of ibuprofen can lead to liver stress or damage. Symptoms of drug-induced liver injury (DILI) may include jaundice, fatigue, and abdominal pain. A study published in the Journal of Hepatology emphasized that while DILI is uncommon, NSAIDs are among the drugs that can cause it.

Long-term users of Advil PM must be aware of the potential for elevated liver enzymes, indicating liver stress. Regular monitoring through blood tests can be critical in detecting early signs of liver damage.

Kidney Health Concerns:

As for kidney health, NSAIDs like ibuprofen can reduce blood flow to the kidneys over prolonged periods. This action can lead to a decrease in kidney function and increase the risk of chronic kidney disease (CKD). The antihistamine component of Advil PM, while less directly harmful to the kidneys, can still contribute to risks when used chronically, especially in individuals with pre-existing kidney conditions.

An article in the New England Journal of Medicine discussed how NSAIDs can impair kidney function by altering the balance of blood flow regulation. Over time, consistent use can lead to conditions such as interstitial nephritis or nephrotic syndrome in susceptible individuals. Recognizing the possibility of renal impairment, it is advisable for long-term Advil PM users to undergo regular kidney function assessments.

Risk Factors Affecting Liver and Kidney Health:

  • Pre-existing liver or kidney disease
  • High doses or frequent use of NSAIDs
  • Concurrent use of other medications that also have potential liver or kidney toxicity
  • Age - the elderly have a decreased ability to metabolize and excrete drugs
  • Alcohol consumption, which can exacerbate liver damage when combined with NSAIDs

Patients particularly at risk may need to explore alternative pain relief and sleep aid methods or limit their use of Advil PM. It is imperative to consult with a healthcare provider before initiating any long-term medication regimen, to assess individual risk factors and existing health conditions.

In summary, while short-term use of Advil PM is generally considered safe for most individuals, careful consideration and medical oversight are recommended for anyone considering its long-term use due to potential risks to liver and kidney health. Monitoring organ function and practicing responsible medication use can help to minimize these risks.

Better Sleep Hygiene vs. Sleep Aids

Sleep is a crucial component of overall health, and achieving quality sleep is often a priority for many individuals. When dealing with occasional sleeplessness, one may consider over-the-counter sleep aids such as Advil PM. However, it's important to weigh the benefits and risks associated with such medications against the practice of good sleep hygiene. Here we delve into the comparison to help better understand their roles in sleep health.

Understanding Sleep Hygiene

Sleep hygiene refers to the collection of habits and practices that are conducive to sleeping well on a regular basis. Experts agree that establishing a routine that promotes restful sleep is critical for long-term health. Components of good sleep hygiene include:

  • Consistency with sleep and wake times, even on weekends
  • A bedroom environment that is dark, cool, and quiet
  • Limiting exposure to screens and blue light before bedtime
  • Engaging in relaxing activities before sleep such as reading or taking a bath
  • Avoiding large meals, caffeine, and alcohol before bedtime
  • Getting regular physical activity during the day, but not too close to bedtime

When to Consider Sleep Aids

Sleep aids, including Advil PM, are often used as a short-term solution for occasional sleeplessness. They may contain antihistamines, which have a sedative effect, and in the case of Advil PM, an analgesic for pain relief. The decision to use a sleep aid should be based on:

  • The frequency and severity of sleep issues
  • Underlying causes of insomnia, such as pain or stress
  • Other medical conditions and current medications being taken
  • Tolerance and dependency concerns tied to long-term use of sleep aids
  • Discussions with a healthcare professional regarding appropriate use

Risks and Limitations of Sleep Aids

While sleep aids can be effective for short-term situations, they come with risks and limitations that necessitate cautious use:

  • Potential for tolerance, dependence, and withdrawal symptoms
  • Next-day drowsiness or cognitive impairment
  • Interactions with other medications or pre-existing conditions
  • Risk of overuse or misuse, especially without medical supervision
  • Limited effectiveness in addressing the underlying causes of poor sleep

The Research on Sleep Hygiene and Sleep Aids

Studies suggest that improving sleep hygiene can have a substantial impact on sleep quality and overall health. For example, research published in the journal Sleep Medicine Reviews highlights the effectiveness of behavioral interventions for insomnia, suggesting that habit changes can provide sustainable improvements in sleep (source). On the other hand, while sleep aids like Advil PM may offer temporary relief, they do not address long-term sleep habits and should not replace good sleep hygiene practices.

Ultimately, improving sleep hygiene is a foundational approach to better sleep health. It's a sustainable, risk-free method that supports long-term wellbeing. Sleep aids, while helpful in certain circumstances, should be used judiciously and as part of an overall sleep strategy that prioritizes natural and lifestyle-based interventions.

Frequently asked questions

Yes, elderly individuals should use Advil PM with caution due to an increased susceptibility to side effects like dizziness, cognitive impairment, gastrointestinal bleeding, and kidney or liver problems. The same caution also extends to potential risks of falls as a result of drowsiness and sedation. It's best for older adults to consult healthcare professionals before using Advil PM.

While Advil PM is generally safe for short-term use, its sedative component, diphenhydramine, can lead to the development of tolerance, meaning that over time, larger doses might be required to achieve the same sedative effect. This can potentially lead to dependence. It is important to use sleep aids like Advil PM only as directed and to consult with a healthcare provider if you find yourself needing it regularly for sleep.

No, it's not recommended to take Advil PM in conjunction with other NSAIDs. Doing so can significantly increase the risk of gastrointestinal bleeding and other adverse effects. It's essential to follow dosing guidelines and consult a healthcare provider if you feel your pain is not being adequately managed.

Individuals with pre-existing health conditions, especially those affecting the heart, liver, kidneys, and gastrointestinal tract, should consult a healthcare provider before using Advil PM. Both ibuprofen and diphenhydramine can exacerbate certain conditions, and a healthcare provider can help assess potential risks and suggest safer alternatives if needed.

Ask a question about Advil PM and our team will publish the answer as soon as possible.

Possible short-term side effects

  • drowsiness
  • dizziness
  • dry mouth
  • blurred vision
  • constipation
  • gastrointestinal distress

Possible long-term side effects

  • heart problems
  • gastrointestinal bleeding
  • kidney damage
  • respiratory depression
  • allergic reactions
  • cognitive impairment

Possible withdrawal symptoms

  • nausea
  • dizziness
  • trouble sleeping

Ingredients to be aware of


  • pain relief
  • sleep induction

Healthier alternatives

  • good sleep hygiene
  • behavioral interventions for insomnia

Thank you for your feedback!

Written by Dr. Becky Maes
Published on: 02-27-2024

Thank you for your feedback!

Written by Dr. Becky Maes
Published on: 02-27-2024

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