- Acetaminophen is an analgesic and an antipyretic, which means that it is good for pain relief reducing fevers; whereas ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID), which works by reducing the amount of a hormone called prostaglandin and therefore reducing inflammation.
- Because of its anti-inflammatory properties, ibuprofen is better for people with arthritis.
- Both medications are effective at minor aches and pains, but ibuprofen works faster and has slightly better results in reducing fever.
Acetaminophen and Ibuprofen are two of the most common over-the-counter drugs used for treating minor ailments like pain and fevers. Even though they serve the same functions, they belong to separate classes of drugs and work in different ways.
Here are the major differences between the two and which might be better for you.
The difference between acetaminophen and ibuprofen
Acetaminophen belongs to a class of drugs called analgesics. Analgesics are drugs used specifically for pain relief.
It is also an antipyretic, which is a class of drugs that are used to reduce fevers. You might recognize acetaminophen at your pharmacy by its most popular brand name: Tylenol. It is also called paracetamol in some countries.
It's not completely clear how acetaminophen works, but research suggests that it helps to reduce pain and fevers by inhibiting the COX enzyme. The COX enzymes form prostanoids, which are responsible for our body's inflammatory reactions to 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, fevers, and mild to moderate pain. Popular brand names of ibuprofen include Advil and Motrin.
Ibuprofen works by reducing the amount of a hormone called prostaglandin in the body, which is released when we are injured or ill and can cause pain and swelling. It does this by inhibiting cyclooxygenase (COX) enzymes, which are responsible for producing this hormone.
One of the key differences is that ibuprofen is better at reducing inflammation and swelling. That's why it is typically recommended as a pain reliever for people who have arthritis.
"While both can be used for fever and pain relief, ibuprofen should be chosen instead of acetaminophen for its anti-inflammatory properties when treating conditions such as osteoarthritis or rheumatoid," says Mike Martinez II, DO, a board-certified anesthesiologist and Assistant Professor at TCU and UNTHSC School of Medicine.
Who can use acetaminophen and ibuprofen?
While acetaminophen and ibuprofen are considered safe to use for most people, there are a few exceptions. For children who are under 6 months, ibuprofen is typically not recommended.
People with certain medical conditions are also advised against taking both drugs. If you have a history of blood clots, kidney disease, or liver disease, talk to your doctor before taking either medication. Also, both medications should be avoided if you are a heavy drinker.
According to Santosh Sanagapalli, MD, a gastroenterologist and physician in internal medicine at St Vincent's Hospital in Sydney, Australia, you should avoid acetaminophen if you:
- Drink heavily
- Have liver cirrhosis
- Are malnourished
Sanagapalli says you should avoid ibuprofen if you:
- Have liver cirrhosis
- Have an inflammatory bowel disorder, like Chron's disease
- Have a stomach ulcer
- Have kidney disease
- Have a history of severe heart failure or heart attack
- Have coronary artery disease
The side effects of aspirin and ibuprofen
Like with many medications, you might experience some side effects when using either ibuprofen or acetaminophen. Both drugs have minor side effects like nausea and vomiting. But they each have some side effects that are unique to them.
Acetaminophen is relatively safe and most people experience no side effects when using the medication. However, you might experience:
- Headaches
- Itching
- Hives or rash
- Some swelling in your face, throat, tongue or other body parts
If you experience any of the above side effects, you should stop taking acetaminophen and see your doctor. In rare cases, some people might also experience liver or kidney damage from using acetaminophen. This typically occurs when the drug has been used excessively.
On the other hand, some common side effects you might experience with ibuprofen, but not with acetaminophen include:
- Heartburn
- Stomach ache
- Indigestion
- Diarrhea
In rare cases, ibuprofen might also cause more serious side effects like strokes, edema, and stomach bleeding. Overall, Martinez says that acetaminophen is typically considered to be safer than ibuprofen.
Which one should you take?
Deciding which of these medications to take depends on several factors. Your age, illness, other conditions you might have, or medications you might be taking, play a big factor in determining which of the two pain relief medications will be better for you.
For illness: Both acetaminophen and ibuprofen work great for illnesses that cause minor pains and fevers, like the cold or flu. "While both are useful for the treatment of mild to moderate pain and fever, some patients find that ibuprofen has a more powerful effect in reducing the intensity of these symptoms," says Sanagapalli.
For injuries: Ibuprofen is good for injuries that might result in both pain and inflammation. For example, if you strain a muscle, ibuprofen will be better for you, as it will help with the swelling and inflammation around the strained muscle.
For pain relief: Both drugs are effective for treating pain and fevers. But while ibuprofen can help with inflammation and swelling, acetaminophen can't. A 2015 review found that when participants were given a standard dose of ibuprofen in different painful conditions, it was more effective at relieving acute pain, migraines, back pain, and osteoarthritis.
When taken orally, ibuprofen takes about 20 to 30 minutes to work, while acetaminophen can take up to an hour. Both pain-relieving effects typically last for about 4 hours.
For fever: Research suggests that ibuprofen might be better for treating fevers. In a 2004 meta-analysis comparing the effectiveness of acetaminophen to ibuprofen for treating children's fevers, scientists found that ibuprofen was more effective than acetaminophen for fevers at 2, 4, and 6 hours after it has been given.
Insider's takeaway
Acetaminophen and ibuprofen are both effective medications used for pain relief and treating fevers. They both have side effects and deciding which is better for you comes down to what you are taking the medication for, what other medications you might be taking, and if you have any other conditions that might be aggravated by the drug. If you are unsure of what to take when in pain, acetaminophen is generally considered to be the safer option.
"Because of its safety, acetaminophen should be the first-line painkiller of choice for most people with mild to moderate pain," says Sanagapalli. "Ibuprofen should be reserved for symptoms not responding adequately to acetaminophen. If ibuprofen is used, it should be ideally limited to short periods. If prolonged use of ibuprofen is required, consult your doctor to discuss whether it is appropriate or if alternatives are available."
If you have any worries about being adversely affected by either medication, it's advisable to talk to your doctor before taking it.
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