Most of us have paracetamol and ibuprofen in our medicine cabinets but how are they different? Do we really need both? And how do we know which one to take?
The simple answer is that they do work in different ways and have different effects. Understanding these differences will help you to make an informed decision next time you or your child is suffering from pain or has a fever. We spoke with nib Group Medical Advisor Dr Hamish Black to get the information you need.
What is paracetamol?
Paracetamol has been used to relieve pain and fever in Australia since the 1950s. Scientists believe paracetamol reduces pain signals in the brain, but they still don’t fully understand how it works.
Hamish says paracetamol is safe and well-tolerated by people of all ages when used in recommended doses. It’s available in tablet, capsule, oral powder or oral liquid form.
What is the best way to take paracetamol?
You should leave at least four hours between doses of paracetamol. Check the package to find the right dose, and don’t take more than the recommended dose over a 24-hour period.
What are the side effects?
Feeling tired, drowsy or itchy or breaking out in a rash are the most common side effects of paracetamol – though not the only ones. Let your doctor know if you experience any other changes.
What is ibuprofen?
Ibuprofen is a non-steroidal anti-inflammatory drug (NSAID) used to relieve pain caused by inflammation and bring down fever. It can be used to treat fever and ease pain, swelling and redness.
What is the best way to take ibuprofen?
For some time, medical professionals have generally recommended taking NSAIDs with food to prevent stomach upset (gastritis). However, some studies carried out in recent years have failed to find a link between taking ibuprofen without food and stomach issues. Ibuprofen is not generally recommended if you have a history of stomach ulcers, gastrointestinal bleeding, asthma, heart problems, high blood pressure, diabetes or kidney disease.
If you have any of these conditions talk to your doctor before taking ibuprofen. Hamish advises that, as with any other medication, you take ibuprofen at the recommended dose and for short periods of time. If ibuprofen isn’t easing your pain or fever, or you believe it’s causing an upset stomach, seek medical advice.
Are there any side effects?
Not everyone has side effects but, if they do, the most common include an upset stomach, headache, dizziness, high blood pressure and fluid retention. More serious side effects such as shortness of breath, swelling of the face, lips or tongue, dark vomit or black stools need immediate medical attention.
What is the difference between paracetamol and ibuprofen?
The main difference between the two medications is that ibuprofen reduces inflammation and paracetamol doesn’t.
Hamish sees no advantage in using brand names such as Nurofen or Panadol over the cheaper generic versions available from the chemist or supermarket. There’s also no point in paying more for pain relief medication that claims to target specific areas of the body as they all have the same ingredients.
Related article: What's the difference between branded and generic medications
Is paracetamol or ibuprofen better?
While paracetamol has long been recommended to relieve pain caused by a wide range of conditions, a 2021 review by the University of Sydney discovered that it may not always be effective. For example, paracetamol was found to relieve pain associated with general headaches, but not migraines. It worked for knee and hip osteoarthritis, but not for other forms of osteoarthritis – and it had no effect on lower back pain.
If paracetamol isn’t easing your pain, ibuprofen may help.
Taking paracetamol and ibuprofen together
Because they work in different ways, they can be used together and can be more effective for certain conditions such as sinus pain. It can be a good idea to stagger the doses so you can keep track of the effects. Each one will take between 30 minutes and an hour to work so you can wait for an hour after the first medication to see whether you still have symptoms. If so, take the second medication.
Administering to children
Both paracetamol and ibuprofen are safe for children and have few side effects when administered correctly for a short period of time. The Royal Children’s Hospital Melbourne advises against giving paracetamol or ibuprofen to your child for more than 48 hours without seeing a doctor.
Paracetamol isn’t recommended for babies under one month, ibuprofen for babies under three months. Doctors used to believe that ibuprofen wasn’t appropriate for young children, but a 2020 review of 19 studies found it was more effective than paracetamol at controlling fever and pain in children under two. It also had very low rates of adverse reactions.
As with adults, the medication you choose may depend on the condition you’re treating. If you need to reduce pain caused by swelling in children, such as when they’re teething, ibuprofen may be more effective. Always read the label and give your child the correct dose for their weight.
Taking them safely
There are two reasons why taking either medicine consistently over a long period isn’t a good idea. “Firstly, the pain may be from a new condition that has not been diagnosed and so seeing your GP early makes sense,” says Hamish. “Secondly, taking paracetamol or ibuprofen on a daily basis for pain can lead to a rebound headache when stopped – the so-called analgesic headache.”
The bottom line
Whether you choose to use paracetamol, ibuprofen or both for yourself or your child, the most important thing is to follow the recommended dosage. If these common painkillers aren’t doing the trick, see a doctor without delay.
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