Medically Approved

Which is best — acetaminophen or ibuprofen?

4 minute read
Person having neck pain

Both of these OTC pain relievers are great for treating mild aches and pains. But sometimes one might be better than the other.

Jessica Sebor

By Jessica Sebor

It’s never fun to deal with a throbbing headache, an achy joint or a mild fever. These health issues might be minor. But they can definitely take the joy out of your day. Thankfully, you can use an over-the-counter (OTC) pain medication to get relief.

But should you choose acetaminophen or ibuprofen? These are the generic names for 2 popular pain medications you can buy in your local pharmacy or grocery store. You probably have a couple of bottles in your medicine cabinet.

Both are effective. But depending on your symptoms, one might be better than the other.

Our guide will help you figure it out. You’ll learn how each pain reliever works and what’s best for your symptoms.

What is acetaminophen?

Acetaminophen is an ingredient used to lower high body temperatures and relieve pain. It’s sold as Tylenol® and other brand names. It’s also combined with other ingredients in multi-symptom cold medications, sleep aids and prescription pain relievers.

“Acetaminophen works in the brain,” explains Marie N. Hanna, MD. She’s the medical director of the peri-operative pain program at Johns Hopkins University in Baltimore, Maryland. Experts think it blocks chemicals that create the sensation of pain and fever.

Adults typically take acetaminophen as a pill or capsule. It takes about 30 to 45 minutes to kick in and can last 4 to 6 hours, says Dr. Hanna.

What is ibuprofen?

Ibuprofen is part of a class of medications called nonsteroidal anti-inflammatory drugs (NSAIDs). Popular brands include Advil® and Motrin®. Ibuprofen is also used to lower fevers and relieve pain. Bonus: It also reduces inflammation.

Ibuprofen works both in the brain and the body. It also blocks pain chemicals. These OTC medications last about 4 to 6 hours. And you can take them 3 to 4 times a day if needed.

You can buy over-the-counter pain relievers or schedule a virtual visit at the Optum Store — all from the comfort of home. Start exploring.

How do I know which one to choose?

In most cases, the decision comes down to your personal preference. That said, there are certain times one may be better than the other.

Treating inflammation. Ibuprofen is better than acetaminophen for treating inflammation. So ibuprofen is the better choice if you have:

  • Joint and muscle pain
  • A toothache
  • Menstrual cramps

When you’re taking another medication. Mixing medications can be dangerous. That’s true for ibuprofen and acetaminophen, too. Both may interact with other medications you take.

“For example, many patients on blood thinners can’t take ibuprofen since it can cause heavy bleeding,” says Yomna Nassef, MD. She’s a spokesperson for the American College of Emergency Physicians. It’s important to check with your doctor if you regularly take other medications.

If acetaminophen is your pain reliever of choice, you shouldn’t take more than 1 medication with that ingredient at a time, says the U.S. Food and Drug Administration. For example, many multi-symptom cold medications contain acetaminophen. So if you have a cold, do not also take acetaminophen on its own. Taking too much can cause liver problems.

Before and after surgery. Preparing for root canal surgery? Recovering from a knee operation? Save the pain reliever until your doctor gives the okay. This is because ibuprofen thins your blood. And it can cause bleeding and bruising.

You should always tell your doctor if you’re having surgery and take this medication, according to the Mayo Clinic. They will likely tell you to stop any OTC pain relievers until after the operation.

Young children. Ibuprofen isn’t recommended for children under 6 months old, according to the American Academy of Pediatrics. And any baby under age 2 should have ibuprofen use approved by a pediatrician. Acetaminophen may be safe for children as young as 12 weeks old.

Both medications come in a children’s version. And the dosage amount will be based on your baby’s weight. Check with your pediatrician before giving your child either medication.

Persistent pain. Have pain that just won’t go away? Both medications working together might do the trick. “Alternating pain relievers every 3 hours is a great strategy for patients with pain conditions,” says Dr. Nassef. Talk to your doctor to ensure you make a safe medication plan.

Understanding side effects

Both ibuprofen and acetaminophen are generally safe if you take them correctly. But as with all OTC medications, they may have side effects. “Some of them can even be dangerous if you’re not careful,” says Dr. Nassef.

Possible side effects of acetaminophen include:

  • Nausea
  • Vomiting
  • Constipation
  • Abdominal pain
  • Itchy skin
  • Allergic reactions
  • Liver problems (if taken in large doses, over long periods of time or with alcohol)

Possible side effects of ibuprofen include:

  • Constipation, diarrhea, gas and bloating
  • Dizziness
  • Ringing in the ears
  • Nervousness
  • Ulcers and stomach issues (if taken in large doses, over long periods of time or with alcohol)

To avoid side effects, follow the dosing directions on the bottle. If you have questions or experience side effects, talk to your doctor.

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Additional sources
Mixing medications: U.S. Food and Drug Administration (2018). “Don’t Double Up on Acetaminophen”
Before surgery: Mayo Clinic (2022). “Ibuprofen (oral route)”
Age limit: American Academy of Pediatrics (2021). “Ibuprofen Dosing Table for Fever and Pain”