Acetaminophen and ibuprofen can both relieve pain and reduce fever, but they are not interchangeable for every person or every situation. Ibuprofen also reduces inflammation and swelling; acetaminophen generally does not. The better choice depends on the type of pain, medical history, other medications, age, pregnancy status, and how long the product will be used.
What Is Acetaminophen?
Acetaminophen, also known by the brand name Tylenol, is used to temporarily relieve pain and reduce fever.
It may be found in products for:
- Headaches
- Muscle aches
- Arthritis pain
- Toothaches
- Menstrual discomfort
- Colds and flu
- Sleep
- Prescription pain treatment
Acetaminophen does not provide the same anti-inflammatory effect as ibuprofen.
What Is Ibuprofen?
Ibuprofen, available under brand names including Advil and Motrin, is a nonsteroidal anti-inflammatory drug, or NSAID.
It can:
- Reduce pain
- Reduce fever
- Reduce inflammation
- Reduce swelling
Because it treats inflammation, ibuprofen may be useful for certain sprains, menstrual cramps, dental pain, and inflammatory muscle or joint discomfort.
Which Is Better for Inflammation?
Ibuprofen has anti-inflammatory activity. Acetaminophen generally does not.
However, that does not automatically make ibuprofen the safer or more appropriate choice.
People with certain kidney, stomach, cardiovascular, bleeding, or pregnancy-related concerns may need to avoid or limit NSAIDs.
What Are the Main Acetaminophen Risks?
Taking too much acetaminophen can cause severe liver damage.
Accidental overdoses can occur when someone uses several products that contain acetaminophen, such as a pain reliever plus a cold-and-flu product.
FDA advises consumers to:1
- Read every medication label
- Check for acetaminophen or the abbreviation APAP
- Avoid using more than one acetaminophen-containing product at the same time
- Follow the product's dosing directions
- Consider alcohol-related warnings
Ask a healthcare professional before using acetaminophen when you have liver disease, drink alcohol regularly, or take other medications containing it.
What Are the Main Ibuprofen Risks?
Ibuprofen and other NSAIDs can increase the risk of:
- Stomach irritation
- Ulcers
- Gastrointestinal bleeding
- Kidney problems
- Fluid retention
- Increased blood pressure
- Cardiovascular events
- Medication interactions
The risk may be greater in older adults, people using blood thinners, individuals with kidney disease, and those with a history of ulcers or gastrointestinal bleeding.
What About Pregnancy?
FDA recommends avoiding NSAIDs at approximately 20 weeks of pregnancy or later unless specifically advised by a healthcare professional because they may cause rare but serious kidney problems in the developing baby and reduce amniotic fluid.2
Pregnant patients should consult their healthcare professional before using any medication, including acetaminophen or ibuprofen.
Can You Take Acetaminophen and Ibuprofen Together?
Some patients may be instructed to use both products because they work differently.
However, combining or alternating medicines can create dosing errors, particularly when combination cold, flu, or prescription pain products are involved.
Ask a pharmacist or prescriber to help create a schedule rather than improvising one.
What About Children?
Children's doses may depend on age, weight, product concentration, and the active ingredient.
Never use an adult dose for a child. Use the measuring device supplied with a liquid medication and read the Drug Facts label carefully.3
Ask a pediatrician or pharmacist when the dose is unclear.
Contact a Healthcare Professional When
Seek advice when:
- Pain follows a serious injury
- Fever is persistent
- Symptoms are worsening
- Pain repeatedly returns
- You have kidney or liver disease
- You take a blood thinner
- You have a history of ulcers
- You are pregnant
- The patient is an infant
- You need the medication longer than the label recommends
The Bottom Line
Acetaminophen may be appropriate for pain or fever when inflammation is not the primary issue. Ibuprofen can address inflammation but carries additional stomach, kidney, bleeding, cardiovascular, and pregnancy considerations. Neither medication is automatically the safer choice — the right one depends on your symptoms, your medical history, and what else you're taking.
Frequently Asked Questions
Is ibuprofen stronger than acetaminophen?
Neither is universally "stronger." Ibuprofen additionally reduces inflammation and swelling, which can make it more effective for certain sprains or dental pain, while acetaminophen may be preferred when inflammation isn't the primary issue or when NSAIDs aren't appropriate.
Can I take acetaminophen and ibuprofen on the same day?
Some patients are instructed to alternate or combine them since they work differently, but this increases the risk of dosing errors, especially with combination products. Ask a pharmacist to help set up a schedule.
Is ibuprofen safe during pregnancy?
FDA recommends avoiding NSAIDs like ibuprofen at approximately 20 weeks of pregnancy or later unless specifically advised by a healthcare professional, due to rare but serious kidney risks to the developing baby.
Which is safer for someone with kidney disease?
NSAIDs like ibuprofen generally carry more kidney-related risk and are often avoided or limited in people with kidney disease. Acetaminophen may be preferred, but anyone with kidney or liver disease should check with a healthcare professional before using either.
The best bottle is not always the one closest to the checkout scanner. Match the medication to the symptom and your medical history, not just the brand name on the box.
References
- U.S. Food & Drug Administration. Acetaminophen: Safe Use of Over-the-Counter Pain Relievers and Fever Reducers. fda.gov/drugs/safe-use-over-counter-pain-relievers-and-fever-reducers/acetaminophen
- U.S. Food & Drug Administration. FDA Recommends Avoiding Use of NSAIDs in Pregnancy at 20 Weeks or Later. fda.gov/drugs/drug-safety-and-availability
- U.S. Food & Drug Administration. The Over-the-Counter Drug Facts Label. fda.gov/drugs/understanding-over-counter-medicines/over-counter-drug-facts-label