The difference between acetaminophen and ibuprofen and which one to take based on your ailment

Both paracetamol and ibuprofen are great for treating illnesses like colds and flu. Antonio_Diaz / Getty Images
Paracetamol is an analgesic and an antipyretic which means that it is good for reducing pain relief in fever. While ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that works by reducing the amount of a hormone called prostaglandin, thereby reducing inflammation.
Because of its anti-inflammatory properties, ibuprofen is better for people with arthritis.
Both drugs are effective for mild pain, but ibuprofen works faster and has slightly better results at lowering fever.
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Acetaminophen and ibuprofen are two of the most common over-the-counter drugs used to treat minor illnesses such as pain and fever. Although they perform the same functions, they belong to different classes of drugs and work in different ways.
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Here are the main differences between the two, and which ones might be better for you.
The difference between paracetamol and ibuprofen
Paracetamol belongs to a class of drugs called analgesics. Analgesics are drugs that are specifically used to relieve pain.
It's also an antipyretic, a class of drugs used to lower fever. You may recognize paracetamol in your pharmacy by its most popular brand name: Tylenol. In some countries it is also called paracetamol.
It's not entirely clear how acetaminophen works, but research suggests that it helps relieve pain and fever by blocking the COX enzyme. The COX enzymes form prostanoids, which are responsible for the inflammatory reactions in our body under certain conditions.
On the other hand, ibuprofen belongs to a class of drugs called nonsteroidal anti-inflammatory drugs (NSAID). NSAIDs are drugs used to treat inflammation, fever, and mild to moderate pain. Popular brand names of ibuprofen are Advil and Motrin.
Ibuprofen reduces the amount of a hormone called prostaglandin in the body that is released when we are injured or sick and can cause pain and swelling. It does this by inhibiting cyclooxygenase (COX) enzymes, which are responsible for producing this hormone.
One of the main differences is that ibuprofen is better at reducing inflammation and swelling. This is why it is usually recommended as a pain reliever for people with arthritis.
"While both can be used for fever and pain relief, because of its anti-inflammatory properties, ibuprofen should be chosen instead of paracetamol in the treatment of conditions like osteoarthritis or rheumatoid," says Mike Martinez II, DO, certified anesthetist and assistant professor at TCU and the UNTHSC School of Medicine.
Who Can Use Paracetamol and Ibuprofen?
While acetaminophen and ibuprofen are considered safe for most people, there are a few exceptions. Ibuprofen is usually not recommended for children under 6 months of age.
People with certain medical conditions are also advised not to take both drugs. If you have a history of blood clots, kidney or liver disease, talk to your doctor before taking any medication. Also, both drugs should be avoided if you are a heavy drinker.
According to Dr. Santosh Sanagapalli, gastroenterologist and internal medicine doctor at St. Vincent's Hospital in Sydney, Australia, should avoid acetaminophen if you:
Do you drink much
Have cirrhosis of the liver
Are malnourished
Sanagapalli says you should avoid ibuprofen if you:
Have cirrhosis of the liver
Have an inflammatory bowel disease such as Chron disease
Do you have a stomach ulcer?
Have kidney disease
Have a history of severe heart failure or heart attack
Have a coronary artery disease
The side effects of aspirin and ibuprofen
As with many medications, some side effects can occur when using ibuprofen or paracetamol. Both drugs have minor side effects such as nausea and vomiting. But they each have some side effects that are unique to them.
Paracetamol is relatively safe and most people do not experience any side effects when taking the drug. However, you could experience:
a headache
itching
Hives or rash
Some swelling in the face, neck, tongue, or other parts of the body
If you notice any of the above side effects, you should stop taking paracetamol and see your doctor. In rare cases, some people may also experience liver or kidney damage from the use of paracetamol. This typically occurs when the medicine has been used excessively.
The most common side effects that may occur with ibuprofen but not with paracetamol include:
heartburn
stomach pain
Indigestion
diarrhea
In rare cases, ibuprofen can also cause more serious side effects such as stroke, edema, and stomach bleeding. Overall, Martinez says that acetaminophen is typically considered safer than ibuprofen.
Which one should you take?
The decision which of these drugs to take depends on several factors. Your age, illness, other medical conditions, or medications you may be taking play an important role in determining which of the two pain relievers is better for you.
For illnesses: Both paracetamol and ibuprofen are great for illnesses that cause mild pain and fever, such as the common cold or flu. "While both are useful for treating mild to moderate pain and fever, some patients find that ibuprofen has a greater effect on reducing the intensity of these symptoms," says Sanagapalli.
For injuries: Ibuprofen is good for injuries that can cause both pain and inflammation. For example, if you are putting weight on a muscle, ibuprofen is better for you as it will help with swelling and inflammation around the tense muscle.
For pain relief: Both drugs are effective in treating pain and fever. But while ibuprofen can help with inflammation and swelling, acetaminophen cannot. A 2015 review found that participants given a standard dose of ibuprofen in a variety of painful conditions were more effective at relieving acute pain, migraines, back pain, and osteoarthritis.
When taken orally, ibuprofen takes around 20 to 30 minutes to work, while acetaminophen can take up to an hour. Both pain relieving effects typically last about 4 hours.
For fever: Research suggests that ibuprofen is better suited for treating fever. In a 2004 meta-analysis that compared the effectiveness of paracetamol with ibuprofen in treating fever in children, scientists found that ibuprofen was more effective than paracetamol for fever 2, 4 and 6 hours after a fever was given.
Insider to take away
Acetaminophen and ibuprofen are both effective drugs for pain relief and the treatment of fever. Both have side effects and the decision which is better for you will depend on what you are taking the medication for, what other medications you may be taking, and whether you have other medical conditions that the drug could make worse. If you are unsure of what to take for pain, acetaminophen is generally considered a safer option.
"Because of its safety, acetaminophen should be the first pain reliever of choice for most people with mild to moderate pain," says Sanagapalli. "Ibuprofen should be reserved for symptoms that do not respond adequately to acetaminophen. Ideally, when ibuprofen is used, it should be limited to short periods of time. If prolonged use of ibuprofen is required, consult your doctor to discuss whether it is appropriate." is or whether alternatives are available. ""
If you are concerned that you may be affected by either medication, speak to your doctor before taking it.
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