Acetaminophen vs Ibuprofen: Which One Should You Choose?

When it comes to over-the-counter pain relief, two of the most commonly used options are acetaminophen and ibuprofen. While both can effectively reduce pain and fever, they work in different ways and have their own pros and cons. Acetaminophen vs ibuprofen: here is a breakdown of each option to help you determine which is the best choice for you.

Acetaminophen

Acetaminophen, also known as paracetamol, is a pain reliever and fever reducer that is found in many common medications, such as Tylenol. It works by blocking pain signals in the brain and can be used to treat mild to moderate pain, as well as reduction of fever.

Pros

Does not irritate the stomach lining
Safe for most people to take, including children, pregnant women, and the elderly
It can be taken with food or on an empty stomach

Cons

It can cause liver damage if taken in large doses or mixed with alcohol
Does not reduce inflammation
It can be less effective for certain types of pain, such as menstrual cramps or migraines

Ibuprofen

Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that is used to relieve pain, reduce fever, and decrease inflammation. It is commonly found in medications such as Advil and Motrin.

Pros

Reduces pain, inflammation, and fever
It can be more effective for certain types of pain, such as menstrual cramps or migraines
Available in both pill and topical form

Cons

It can irritate the stomach lining and cause gastrointestinal issues such as ulcers if taken in large doses or on an empty stomach
It may not be safe for some people to take, including those with asthma, bleeding disorders, or kidney problems
Should not be taken with certain medications such as blood thinners or aspirin

How They Work

The exact mechanism by which acetaminophen and ibuprofen relieve pain and reduce fever is not fully understood. However, we do have a good theory. Chemicals in the body called prostaglandins play a role in transmitting pain, generating fever, and promoting inflammation. Acetaminophen and ibuprofen block enzymes the body needs to make prostaglandins. These are known as COX enzymes. While acetaminophen only works in the brain, ibuprofen works in the brain and the rest of the body. This means acetaminophen only helps reduce pain and fever, while ibuprofen has the added benefit of reducing inflammation and swelling at the site of an injury.

Risks and Benefits

The benefits of acetaminophen and ibuprofen are clear: less pain, lower fever, and (in the case of ibuprofen) reduced inflammation. However, we must also consider the risks. Prolonged use of ibuprofen can result in decreased stomach protection from normal stomach acid. This may result in ulcers and bleeding. Ibuprofen can also damage the kidneys and cause high blood pressure, especially when large doses are taken over a prolonged period.

The biggest risk with acetaminophen is liver damage when very high doses are taken. This can lead to liver failure and death if prompt medical attention is not sought after an overdose. If you are concerned about taking too much acetaminophen, you should always call your local poison center.

When acetaminophen or ibuprofen are used to treat headaches over a long period, they may result in a rebound headache. This headache is caused by decreasing levels of acetaminophen or ibuprofen in the blood, which means you must keep taking these medicines to avoid the headache (not a good thing!).

Acetaminophen and ibuprofen are very safe when used at the correct dose for brief periods. If you are unsure of the proper dose, refer to the bottle label or call your doctor. If you need to use acetaminophen or ibuprofen for more than a few days, you should also contact your medical provider.

Alternating the Two

Alternating acetaminophen and ibuprofen is an easy way to keep the fever away. Acetaminophen is dosed every 4 to 6 hours (no more than five doses in 24 hours), while ibuprofen is dosed every 6 hours (no more than four doses in a 24-hour period). However, if you alternate the two in an equally staggered fashion (with 6 hours between doses of the same medicine), you can receive one or the other every 3 hours.

Two Are Stronger Than One

Acetaminophen and ibuprofen block the COX enzymes at different locations. This means they can be taken at the same time. Acetaminophen and ibuprofen also potentiate each other. This means acetaminophen helps ibuprofen work better, and ibuprofen helps acetaminophen work better. Dosing the two together can relieve more severe and persistent pain, such as pain with broken bones and tooth decay. When used together, acetaminophen and ibuprofen should be dosed every 6 hours (with no more than four doses in a 24-hour period). This strategy may help avoid using an opioid painkiller, which can lead to addiction. However, if the pain is severe and/or prolonged enough to use acetaminophen and ibuprofen together, be sure to let your home doctor know!

Ibuprofen Addiction: Can you get addicted to ibuprofen

Most people think of addiction as either abusing prescription medications, excessive alcohol use, or substances one may obtain in a dark alley, not an over-the-counter medication that is considered safe and effective for people as young as three months old. However, ibuprofen addiction is real, and there can be serious side effects.

Symptoms of an Ibuprofen Addiction

A case study recorded the symptoms of a person who met the DSM-5 criteria for moderate substance use disorder, as she took more than the amount of ibuprofen prescribed. The criteria she met included the following:

Developing a tolerance to ibuprofen
Using more ibuprofen than was prescribed or intended
Failure to stop using ibuprofen
Craving ibuprofen

Signs of an Ibuprofen Overdose

Taking too much ibuprofen could result in an overdose. The symptoms of an ibuprofen overdose include:

Agitation
Blurred eye vision concerns
Chills
Confusion
Convulsions
Diarrhea
Dizziness
Drowsiness
Heartburn
Low blood pressure
Nausea
Rash
Ringing ears
Severe headache
Slow or difficult breathing
Stomach pain
Sweating
Unsteadiness
Vomiting
Weakness
Wheezing

Acetaminophen Addiction: Can I get addicted to acetaminophen?

Acetaminophen is used to relieve pain and reduce fever in patients. It does not become habit-forming when taken for a long time. But acetaminophen may cause other unwanted effects, including serious liver damage when taken in large doses. Although rare, the use of acetaminophen has been reported to lead to liver transplantation and death, usually at high doses and when multiple acetaminophen-containing products have been used.

While Tylenol and generic acetaminophen do not require a prescription, Tylenol 3 does. This is because Tylenol 3 is a stronger version of regular Tylenol. Tylenol 3 contains a high amount of codeine as well as acetaminophen.

It is the codeine in prescription Tylenol 3 that can create dependency when used improperly or without a prescription. Dosages should be monitored, and prescriptions should be taken exactly as prescribed to avoid Tylenol 3 addiction. When abused, painkillers have the ability to create a calm, relaxed feeling that can increase with high doses. This makes Tylenol 3 and acetaminophen abuse extremely dangerous and can lead to dependency.

Which One Should You Choose?

Ultimately, the choice between acetaminophen and ibuprofen depends on your needs and health history. It is important to speak with a healthcare provider before taking any medication, especially if you have any underlying health conditions or are taking other medications.

If you are looking for a pain reliever that is safe for most people to take, acetaminophen may be the better option. However, ibuprofen may be more effective if you are dealing with inflammation and pain. It is important to follow the recommended dosage and not exceed the maximum daily limit for either medication.

In summary, acetaminophen and ibuprofen can effectively reduce pain and fever, but they work in different ways and have their own pros and cons. Always speak with a healthcare provider before taking any medication and follow recommended dosages to ensure safety and effectiveness.