Can You Take Acetaminophen and Ibuprofen Together?

You have back pain, a headache or a fever. Typically, you’d turn to acetaminophen or ibuprofen to help alleviate your discomfort.

Acetaminophen (like Tylenol®) is an analgesic, a type of drug that reduces pain signals within your nervous system. It’s typically used to treat pain like headaches, joint pain and toothaches, and to reduce fever.

Ibuprofen (like Advil® or Motrin®) is a nonsteroidal anti-inflammatory drug (NSAID). This type of drug blocks your body’s production of prostaglandins that cause inflammation. It’s typically used to treat back pain, earaches, menstrual cramps and toothaches, as well as to reduce fevers.

But can you take ibuprofen and acetaminophen together?

“Both ibuprofen and acetaminophen are pain relievers and fever reducers. They both can reduce inflammation, but they work in slightly different ways and are processed by different parts of the body,” says family medicine physician Amy Horwitz, DO. “It can be safe to take them together if taken as directed.”

Dr. Horwitz explains how you can alternate between acetaminophen and ibuprofen.

Can you take acetaminophen and ibuprofen together?

“If you have an injury, back pain or have a fever, you can alternate using both of them,” says Dr. Horwitz. “There are multiple studies that show that we have better pain control with combining ibuprofen and acetaminophen for acute pain management than with some of our less safe pain medications.”

As acetaminophen and ibuprofen work a little differently, the combination of targeting different pathways is beneficial for pain management and fever reduction.

Side effects and risks

There are some other side effects associated with both acetaminophen and ibuprofen.

Acetaminophen, also called paracetamol in some countries, side effects include:

• Headache
• Nausea
• Vomiting
• Loss of appetite

Ibuprofen side effects include:

• Upset stomach
• Nausea
• Diarrhea
• Vomiting
• Leg swelling

“I recommend taking both medications with a little bit of food, like a couple of crackers, yogurt or a banana to help prevent that stomach upset,” advises Dr. Horwitz.

And while both acetaminophen and ibuprofen are typically safe, she adds that if you have kidney, digestive, bleeding or liver problems, you need to be careful with taking these over-the-counter (OTC) medications. Acetaminophen is processed through your liver, while ibuprofen is processed through your kidneys.

You also want to be aware of the recommended max dose for each. For adults and children over the age of 12, you don’t want to go above 4,000 milligrams of acetaminophen or 1,200 milligrams of ibuprofen.

There can be some serious risks if you take more than the recommended dosages. If you take too much acetaminophen or drink alcohol while taking an acetaminophen, you may cause liver damage. And if you take too much ibuprofen, you may cause kidney damage.

Alternating between acetaminophen and ibuprofen

It’s important to clarify that you shouldn’t take both acetaminophen and ibuprofen at the same time.

The idea is to alternate between the two medicines.

So, how close can you take Tylenol and ibuprofen together? Take one first and then four to six hours, later take the other.

For example, if you wake up around 8 a.m., start by taking 400 milligrams of ibuprofen and then around noon, take 500 milligrams of acetaminophen.

“You can alternate like that every three to four hours throughout the day,” instructs Dr. Horwitz.

This routine can also be used for children under 12, but Dr. Horwitz recommends reaching out to your child’s pediatrician to get the right dosage for your child and their body weight.

If you’re taking acetaminophen with ibuprofen consistently for more than three days, she also advises talking with a healthcare provider.

“They can be safe to take together for longer than that,” she clarifies. “But if you’re having fevers or pain that lasts longer than three days, that’s typically when I recommend consulting with your doctor. We don’t want you taking these medications for extended periods of time — even if you’re taking them at the correct doses. Although they’re generally safe, there are real side effects to these medicines.”

A doctor can evaluate you and run any necessary tests to make sure there’s nothing else going on with your health.

Bottom line?

If you want to try a regimen of alternating between acetaminophen and ibuprofen, Dr. Horwitz suggests having a schedule.

“Write out which one you took and what time it was so that way, you can keep track of where you’re at and how much you’re taking.”

And it’s vital to pay attention to the doses you’re taking.

“With acetaminophen, there’s regular strength and extra strength options available,” she adds. “It’s important to make sure that you’re looking at what dose you have in your medicine cabinet. Even though both acetaminophen and ibuprofen are generally considered safe over-the-counter medications, it’s still important that you use them as directed.”