Acetaminophen and ibuprofen. Both of them are sitting in most of our medicine cabinets at home. Over-the-counter (OTC) shelves are flooded with them – with a variety of brand names (Tylenol, Motrin, Advil, etc.). They both treat pain and fever.
But even though there are similarities, these medicines are not the same. In fact, there are quite a few important differences to be aware of with these products.
How Are They Similar?
Below are some key similarities between acetaminophen and ibuprofen.
- Both are used to treat pain and fever.
- Both are available in OTC and prescription products, including products that contain other medicines.
- Both can be used in infants, children, and adults. Both should be dosed by weight rather than age, if possible, in infants and young children.
- Both may need to be avoided if you have certain medical conditions or take certain medicines.
How Are They Different?
Below are some key differences between acetaminophen and ibuprofen.
How they work
A big difference between acetaminophen and ibuprofen is that they work in different ways.
Acetaminophen does not help reduce inflammation. It may work by blocking pain signals from getting to your brain. Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) and can help reduce inflammation where it's happening in the body. So ibuprofen may be a better choice for certain types of pain linked to inflammation, such as some sprains or strains.
Conversely, some types of pain, such as headaches or general aches and pains, may respond better to acetaminophen than ibuprofen. But people may react differently to one or the other, so it also comes down to your personal preference and what's worked for you in the past. Both medicines work to reduce a fever.
Either medicine usually starts to work within about an hour. But depending on the type of pain you have, it can sometimes be helpful to take acetaminophen and ibuprofen together, to treat different parts of the pain pathway. Depending on the products, you may be able to take the doses at the same time or at different times.
Some health care providers suggest "staggering" or "alternating" the doses of acetaminophen or ibuprofen. This means you take one medicine, wait about two hours, and then take the other. This helps keep a steady stream of medicine in your body so the pain or fever doesn't come back before your next dose. Whether you can do this depends on the directions for your product and how much medicine you'll end up taking throughout the course of the day. But if your health care provider tells you to do this, be sure to write down when you take each dose. It can be hard to remember which medicine you took at what time, which could easily lead to taking too much and an overdose.
There are also some products that contain both acetaminophen and ibuprofen in one pill, to make it easier for you to take both at the same time.
Side effects and safe use
Another key difference between these medicines is their side effects. Acetaminophen is usually well tolerated when taken as directed. Ibuprofen can sometimes cause stomach pain, nausea, or other digestive side effects. Taking it with food or milk may help. Again, people may respond differently.
There are also different warnings and precautions for each of these medicines. For example, taking too much acetaminophen can increase your risk of liver problems, especially if you also drink alcohol. Drinking alcohol can also be risky with ibuprofen, since it may increase your risk of stomach problems, including stomach bleeding or ulcers.
One of these medicines may also be a better choice for you if you have certain medical conditions or take certain medicines. For example, ibuprofen should not be taken right before or right after heart surgery without talking to your health care provider. It may also increase your risk of a heart attack or stroke, especially if you take it at higher doses or for a longer period of time than recommended.
If you have certain health conditions or take certain medicines, you may have to check with your health care provider before taking either acetaminophen or ibuprofen. For example, either may interact with blood thinners. Ibuprofen may also interact with certain blood pressure medicines, water pills (diuretics), and other medicines. Always read the label closely and ask your pharmacist or other health care provider if you are not sure whether a medicine is safe for you. Do not take acetaminophen or ibuprofen long-term without talking to your health care provider.
Dosing and dosage forms
Depending on the product, either acetaminophen or ibuprofen may usually be taken every four to six hours. But check your product label closely, since it can vary based on the product. For example, acetaminophen also comes in an extended-release form that is taken every eight hours. Do not take more than the recommended amount of acetaminophen or ibuprofen.
The strengths of the products can also vary widely. Most OTC ibuprofen products for adults contain 200 milligrams (mg) per tablet or capsule. Acetaminophen products for adults often contain different amounts of the medicine – usually 325 mg or 500 mg per tablet or capsule. The liquids also have different strengths, and dosing instructions differ for adults and children. It is very important to check the label closely to avoid using the wrong dose.
The good news is that both acetaminophen and ibuprofen come in a variety of dosage forms, including tablets, capsules, liquids, and chewable tablets. So in general, you should be able to find a form that you prefer with either medicine. Acetaminophen also comes in a rectal suppository, while ibuprofen does not.
Side-by-Side Comparison
The table below summarizes some of the differences between acetaminophen and ibuprofen.
| Feature | Acetaminophen | Ibuprofen |
| Medicine Effects | Relieves pain and reduces fever | Relieves pain, reduces fever, and reduces inflammation |
| Notable Serious Side Effects | Severe allergic or skin reactions Liver damage | Severe allergic or skin reactions Stomach bleeding Heart attack and stroke Increased blood pressure Heart failure Kidney damage |
| Talk to Your Health Care Provider Before Use if You Have These Conditions | Liver problems Drink alcohol often or in large amounts | Liver or kidney problems Heart problems, such as heart failure or recent heart surgery History of stroke High blood pressure Stomach problems, such as ulcers or heartburn Asthma Allergy to aspirin or any other NSAID |
| Maximum OTC Dose for Adults | 3,000 to 4,000 mg/day | 1,200 mg/day |
Top tips for preventing confusion
Be aware that both acetaminophen and ibuprofen are found in many OTC and prescription products. They are also sometimes included in products that you might not expect, like those for cold and flu symptoms. It's really important not to accidentally double up, because doing so can increase your risk of serious side effects or even an overdose.
Here are some ways to avoid this common problem.
- For all OTC products, check the "Active Ingredients" section (usually on the back of the product) to see what the product contains. Don't rely on brand names. Products with different brand names can have the same ingredients. For example, Advil and Motrin both contain ibuprofen. And although the brand name Tylenol is usually associated with acetaminophen, some Tylenol products do not contain acetaminophen at all. Reading this section of the label helps you quickly find the specific medicine in the product. In fact, because so many OTC products contain acetaminophen, it's usually highlighted in yellow to call attention to this ingredient.
- Many OTC products may contain acetaminophen or ibuprofen with several other ingredients. This is especially common with products for cold and flu symptoms. Check the "Active Ingredients" to be sure you only take the ingredients you need for your symptoms. This strategy also helps limit the chance that you accidentally double up on ingredients.
- For all prescription medicines, check the label closely for the drug name. Sometimes, acetaminophen is abbreviated "APAP." Avoid doubling up on a prescription medicine with "APAP" and an OTC product with acetaminophen.
- Check any medicines you may have from other countries. For example, acetaminophen is called "paracetamol" in many other countries.
Bottom Line
Despite the similarities between acetaminophen and ibuprofen, there are several differences. Which one is right for you depends on a number of things, including the following.
- Your age
- The type of pain you're having
- What's worked for you in the past
- What medical conditions you have
- What medicines you take
- What dosage form you prefer
Sometimes, these medicines can be taken together. Always ask your pharmacist or other health care provider if you're not sure which medicine is right for you, or the best way to take it.