Paracetamol vs. Ibuprofen: Which is Better?

Paracetamol, acetaminophen is generally effective in relieving pain and fever. Besides relieving pain and fever, ibuprofen also has anti-inflammatory and anti-rheumatic properties. In this article we will compare Paracetamol vs. Ibuprofen.

Other key differences:

• As a nonsteroidal anti-inflammatory drug , ibuprofen is most likely to cause gastrointestinal damage , as well as adverse cardiovascular reactions and nephrotoxicity . Therefore, ibuprofen is not suitable for everyone, and people over 65 years old should be especially careful.
• The main side effect of paracetamol is liver damage, especially when taken for a long time or in high doses.
• NSAIDs such as ibuprofen are more effective than paracetamol for pain related to inflammation.
• Both can be used to treat headaches, fevers, etc., but ibuprofen is more effective for strains or sprains.
• Different mechanisms of action: Although paracetamol can reduce prostaglandin levels and have analgesic and fever-reducing effects, it is not classified as a non-steroidal anti-inflammatory drug (NSAID) and has a very weak anti-inflammatory effect; ibuprofen is a non-steroidal anti-inflammatory drug (NSAID) with non-selective anti-inflammatory effects, so it has a strong anti-inflammatory effect and is often used to treat inflammatory diseases, including osteoarthritis, rheumatoid arthritis , etc.

Which one has a longer-lasting effect?

Ibuprofen provides longer-lasting pain relief than paracetamol.

• Both can be used for acute pain and work quickly. Paracetamol provides pain relief for three to four hours, while ibuprofen provides relief for about four hours.
• The maximum dose of paracetamol is 4000 mg/day (US FDA standard, Chinese standard 2000 mg); the maximum dose allowed for ibuprofen over-the-counter (OTC) is 1200 mg/day, and the maximum dose prescribed by a doctor is 3200 mg/day.

Which is more effective?

Paracetamol can control pain and fever, but it cannot control inflammation or reduce swelling. Therefore, ibuprofen is more effective for sprains, muscle spasms, etc. Paracetamol has little benefit in treating osteoarthritis , rheumatoid arthritis , etc.

Comparison of side effect risks

About paracetamol:

• Both have few side effects when taken within the recommended low dose range. However, for the elderly or frail, expert consensus is that paracetamol is a safer choice than nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen.
• Studies have found that high doses of paracetamol (close to 4000 mg/day) have side effects similar to those of NSAIDs such as ibuprofen, including an increased risk of cardiovascular disease, peptic ulcers and bleeding, and kidney toxicity; continuous use for more than 13 weeks can also lead to a decrease in hemoglobin (anemia).
• The higher the dose of paracetamol taken, the greater the damage to the liver.

Learn how to prevent paracetamol side effects: Reducing Paracetamol Side Effects >>

About Ibuprofen:

• All nonsteroidal anti-inflammatory drugs (NSAIDs) are associated with a risk of gastrointestinal, cardiovascular, and renal adverse effects, some more than others. Compared with many other NSAIDs, ibuprofen is less likely to cause gastrointestinal side effects because it is short-acting.
• Low doses of ibuprofen (less than 1200 mg/day) are associated with a lower risk of adverse cardiovascular events ( heart attack or stroke ). However, higher doses of ibuprofen (2400 mg/day) are more likely to cause these side effects. Therefore, people who have already had a heart attack or stroke should consult a doctor before using NSAIDs. One study showed that even one or two doses of ibuprofen or diclofenac (another NSAID) can increase the risk of another cardiovascular event in people who are already at risk for a cardiovascular event.
• Studies have also found a significant increase in the risk of gastrointestinal adverse events when paracetamol and NSAIDs such as ibuprofen are taken together. However, many experts still believe that short-term (e.g., 3 days) co-administration is safe, provided the recommended dose is not exceeded. To reduce the risk of side effects, it is best to alternate the dosing of ibuprofen and paracetamol.

Learn how to prevent side effects of NSAIDs like ibuprofen: Reducing the Toxic Side Effects of Anti-Inflammatory Drugs >>

How to take oral medication safely

About acetaminophen:

• Although the maximum daily dose for healthy adults does not exceed 4000 mg, for adults of small stature, the dose should not exceed 3000 mg/day.
• Pay attention to the content of product ingredients. Usually the paracetamol content ranges from 325mg, 500mg, 1000mg, etc.
• Don’t drink alcohol or limit your alcohol intake.
• If you are taking other medicines, you should talk to your doctor or pharmacist before taking paracetamol.

About Ibuprofen:

• First, the lowest effective dose (less than 1200 mg/day) should be taken for the shortest possible time.
• Do not take other nonsteroidal anti-inflammatory drugs (such as naproxen) at the same time.
• Ibuprofen should be used with caution in people who already have had a heart attack or stroke, and only under a doctor’s supervision.
• Older adults, people with type 2 diabetes , or those with a history of stomach ulcers, kidney problems, or heart disease risk are more likely to experience complications associated with NSAIDs, including gastrointestinal side effects, cardiovascular events, and kidney toxicity. Avoid using ibuprofen without your doctor’s approval.