Acetaminophen vs. Ibuprofen: What’s the Difference?

Over-the-counter (OTC) painkillers have earned their spot in your medicine cabinet. You reach for them to lower a fever, banish a headache or ease those monthly cramps.

Both acetaminophen (such as Tylenol®) and ibuprofen (like Advil® or Motrin®) are used to treat fevers and pain. But they’re not exactly interchangeable.

So, when it comes to ibuprofen vs. acetaminophen, which should you choose?

Family medicine specialist Matthew Goldman, MD, discusses what you should know about ibuprofen vs. acetaminophen, and which one makes the most sense for your aches and pains.

Understanding ibuprofen and acetaminophen

So, how does ibuprofen work? Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID). Ibuprofen blocks the production of prostaglandins, the chemicals that cause inflammation.

And as the name suggests, it tends to be most helpful for discomfort that goes hand-in-hand with inflammation, which can include redness, swelling, heat, pain and/or loss of function at the site or source.

Common side effects of ibuprofen include:

• Constipation
• Heartburn
• Nausea
• Stomach pain (so it’s important to take with food)

Taking ibuprofen for a long time or at high doses can also increase the risk of more serious side effects, such as:

• Blood clots
• Heart attack
• Kidney damage
• Stomach bleeding (ulcers)
• Stroke

Ibuprofen is metabolized by your kidneys and, therefore, isn’t a great option for those with kidney issues.

Acetaminophen is a type of drug called an analgesic. Translation: It reduces pain signals within the nervous system and not at the site itself.

Side effects of acetaminophen (which may be called paracetamol in countries outside the U.S.) are minimal, but some people experience problems, including:

• Nausea
• Vomiting
• Headache

Acetaminophen is metabolized by your liver and isn’t a great option for those with liver issues.

How to choose between ibuprofen and acetaminophen

Dr. Goldman says there isn’t necessarily one right answer for everyone. Factors such as your underlying cause and medical history (like kidney or liver issues) may determine if one option is safer than the other. It’s best to check with a healthcare provider on which option to use.

But in general, here are some examples of when you may want to use each.

As an anti-inflammatory drug, ibuprofen may be a smart pick for pain such as:

• Back and neck pain
• Earache
• Menstrual cramps
• Muscle sprains and strains
• Sinus infections
• Toothache

Acetaminophen, which reduces pain signals, may be a good choice for pain like:

• Headaches
• Joint pain/arthritis
• Sore throat

Additionally, most research suggests acetaminophen and ibuprofen have similar results in controlling fevers in adults, so pick what works for you. But ibuprofen tends to work better as a fever reducer in children. Be sure to follow the dosage guidelines on the label for your little one’s age and weight.

Dosage information

How often can you take Advil and other types of ibuprofen? What about acetaminophen?

The recommended max dosage for adults is:

• Acetaminophen: 3,000 milligrams per day
• Ibuprofen: 2,400 milligrams per day

Acetaminophen can also be hidden in several over-the-counter medicines, including cough and cold medications. If you’re taking more than one medication, read drug labels carefully so you don’t go over the recommended dosage. For example, it may not be safe to take cold medicine and Tylenol at the same time.

But can you take ibuprofen and acetaminophen together?

“For those who have neither kidney nor liver issues, sometimes, we alternate acetaminophen and ibuprofen to avoid overdosing as well as attacking pain and inflammation from two different approaches,” says Dr. Goldman.

Another important note? Both ibuprofen and acetaminophen can interact negatively with some prescription and over-the-counter drugs. If you’re taking medication, talk to your provider doctor or pharmacist before reaching for the painkillers.

Bottom line?

It can be confusing to know which pain medication to use for your aches and pains. But educating yourself on how ibuprofen and acetaminophen each work can help you make an informed decision.

When used responsibly, ibuprofen and acetaminophen are safe choices for turning down the dial on fever and pain. And isn’t it good to have options?