Which one is right for your pain? Choosing between ibuprofen and acetaminophen

Photo: Vitaly Gariev/Unsplash

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by Paul Arco
OSF Healthcare

ROCKFORD - Whenever you feel a headache coming on or you tweak your back, it’s common to reach into the medicine cabinet for a couple of acetaminophens (Tylenol) or ibuprofen (Advil). But does it matter which one you take? And is there anything wrong with taking both to fight off what ails you?

Acetaminophen is an analgesic, which is a type of drug that reduces pain signals within your nervous system. It’s used to treat discomfort like headaches and joint pain, and to reduce fever.

Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that is typically used to tackle issues such as back pain, menstrual cramps and toothaches. It also works to decrease fever.

Photo provided

Sarah Sheley

Sarah Sheley is a pharmacist with OSF HealthCare. She says it’s important to know that ibuprofen helps with inflammation and acetaminophen can’t do that.

"The difference between the two is the fact that the ibuprofen, that anti-inflammatory component, reduces pain by affecting the production of certain hormones in your body that cause inflammation," she says.

But each pain reliever comes with its own risks.

Acetaminophen is typically safer to use for most people. Some side effects include nausea, vomiting and headache. But it’s a drug that's absorbed by your liver so it’s not the best option for people with liver problems.

The side effects of ibuprofen include heartburn, nausea and stomach pain (it’s important to take it with food). Taking ibuprofen for a long time or at high doses can increase the risk of blood clots, kidney damage and ulcers.

Check with your pediatrician before giving your child any pain relievers.

"With ibuprofen there is more concern with patients using it if they had renal insufficiency, heart failure, GI (gastrointestinal) issues like Crohn's or IBS; they could cause a lot of irritation in the GI tract or stomach," Sheley says.

If you are taking a blood thinner ibuprofen can increase your risk of bleeding so opt for acetaminophen instead.

Sheley says that acetaminophen and ibuprofen are appropriate choices for children with fevers. However, stick with acetaminophen for infants 3 months or younger. The correct dose for your child is based on their weight, not their age. Do not guess their weight — acetaminophen and ibuprofen can be dangerous when given in the wrong dose. Check with your pediatrician before giving your child any pain relievers.

Be aware that ibuprofen and acetaminophen can have a negative interaction with some prescription and over-the-counter drugs.

Since the two pain relievers work differently, Sheley says it’s fine for most adults to use them interchangeably.

"As long as you don't have any kidney or liver issues, you can alternate between the two. It is safe," she says. "You want to keep the doses four to six hours apart to help maintain and it probably is a good thing to alternate those, if you want to hit the pain from two different mechanisms."

Sheley says the most important tip is to know why you’re taking a particular pain reliever and don’t overdo it. The recommended maximum dosage for adults is 3,000 milligrams a day for acetaminophen and 2,400 milligrams a day if you’re taking ibuprofen.

Additionally, other factors such as your medical history and underlying cause of pain also help determine which pain reliever is best for you.

"Making sure that you know the source of your pain is important, and make sure that you are aware of a total daily dose that you should be taking of either medication prior to starting it," Sheley says.

Be aware that ibuprofen and acetaminophen can have a negative interaction with some prescription and over-the-counter drugs. If you have any concerns or questions, consult with your primary care provider or your pharmacist.

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