Paracetamol vs ibuprofen: Is there a difference?
What’s the difference and how do you know which one to take?
Most of us have paracetamol and ibuprofen in our medicine cabinets. But what’s the difference between these common painkillers and how do you know which one to take?
We spoke with nib Group Medical Advisor Dr Hamish Black to find out. By understanding how each painkiller works, you’ll be able to make an informed decision next time you or your child experience pain or fever.
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.
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 be effective in all cases.
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. Perhaps the most surprising finding was that it was ineffective for lower back pain despite its popularity for treating this condition. As for abdominal pain, pain during dental procedures and middle ear infections, paracetamol’s effectiveness was unclear.
Because most of the studies in the review only examined a single dose of paracetamol, more research is needed on the effectiveness of repeated doses. But the researchers concluded that paracetamol was unlikely to be the pain cure-all we’ve long believed it to be, and they suggest a holistic approach to pain relief that also includes exercise, physiotherapy or other lifestyle changes.
If paracetamol isn’t easing your pain, you may wish to try ibuprofen instead or talk to your doctor about other options, says Hamish.
What is ibuprofen?
Ibuprofen is a non-steroidal anti-inflammatory drug (NSAID) used to relieve pain caused by inflammation and bring down fever. It works by blocking an enzyme that produces inflammation, which in turn reduces pain signals sent to the brain. It can be used to treat fever and ease pain, swelling and redness associated with the following symptoms:
Headaches (including migraines)
Back pain
Muscle pain
Period pain
Joint pain (including arthritis)
Dental pain
Pain related to colds and flu.
While medical professionals generally recommend taking NSAIDs with food to prevent stomach upset (gastritis), in recent years numerous studies have failed to find a link between stomach issues and taking ibuprofen without food. 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.
Talk to your doctor before taking ibuprofen if you have any of these conditions. As with any medication, take ibuprofen at the recommended dose and for short periods of time, advises Hamish. If ibuprofen isn’t easing your pain or fever, or you believe it’s giving you an upset stomach, seek medical advice.
What is the difference between paracetamol and ibuprofen?
The main difference between the two medications is that ibuprofen reduces inflammation, whereas paracetamol doesn’t. Because they’re different medicines, they can be used together. This is a particularly good option when there is inflammation e.g sinus pain.
According to Hamish, there’s no advantage in using brand names such as Nurofen or Panadol over the cheaper generic versions available from the chemist or supermarket.
Related article: What's the difference between branded and generic medications
The main takeaway is that paracetamol is safer because of those groups that are more at risk, but if there’s an inflammatory component, then you’re better off taking ibuprofen
But taking either medicine consistently over a long period isn’t wise for two reasons Hamish advises. “Firstly, the pain may be from a new condition that has not been diagnosed and so seeing your GP early makes sense. Secondly, taking daily paracetamol or ibuprofen on a daily basis for pain can lead to a rebound headache when stopped – the so-called analgesic headache.”
Is paracetamol or ibuprofen better for children?
Both paracetamol and ibuprofen are safe for children and have few side effects when administered correctly for a short period. Paracetamol shouldn’t be given to babies under one month and ibuprofen isn’t recommended in babies under three months.
While it used to be believed that ibuprofen shouldn’t be given to young children, a 2020 review of 19 studies found that ibuprofen was more effective than paracetamol at controlling fever and pain in children under two, and it 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 swelling in children, such as with teething, ibuprofen may be more effective. Always read the label and give your child the correct dose for their weight.
The bottom line
Whether you choose to use paracetamol or 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.
Have a health concern and not sure where to turn? We answer some of your most common health questions.
Please note: The tips throughout this article serve as broad information and should not replace any advice you have been given by your medical practitioner.
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Dr Hamish Black
In collaboration with nib Group Medical Advisor
Dr Hamish Black
Dr Hamish Black has been a medical practitioner for more than 25 years. In addition to his role as nib group medical advisor, he still spends two days a week practising as a GP. He has spent many years working in emergency departments and in rural Australia, including a stint with the Royal Flying Doctor Service. Hamish also loves karaoke and dancing (though not that well at either, he says!), with Play that Funky Music by Wild Cherry being his karaoke favourite.