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Acetaminophen vs. Ibuprofen/Naproxen: Which pill is right for your ills?

The first line of defense for your aches, pains and general unrest is the medicine cabinet. Once you start feeling under the weather, you pop a couple pills of acetaminophen or ibuprofen/naproxen. And before you know it — relief!


Bottom of Ibuprofen and Acetaminophen sitting on a shelf

It’s such a habitual reaction, that you probably don’t even think about your choice. You take whatever’s on hand and wait for it to kick in. Tylenol, Advil, Aleve and other store brand generics — it’s all the same, right?

Not at all, actually. While these over-the-counter drugs provide similar results, they are not the same. As you’ve surely seen plastered on every package of Tylenol (acetaminophen) is a pain reliever and fever reducer. Ibuprofen/Naproxen can do both those things, but it’s an anti-inflammatory drug designed to reduce inflammation and swelling.

Which little tablet should I take?

The lines are blurred. Acetaminophen and ibuprofen/naproxen have a different chemical makeup, but the choice between them is not always clear. Depending on your condition, one is typically better suited than the other. When in doubt, use this guide to help you figure out which medicine to take.

When you have... You should take...
Headache Acetaminophen. It provides quick pain relief and is safer to take more for longer periods if your symptoms last.
Inflammation Ibuprofen/Naproxen. The most common of the non-steroidal anti-inflammatory drugs (NSAIDS), ibuprofen/naproxen inhibits the chemicals that cause inflammation in the body. It’s the pick for things like sinus infections, arthritis, earaches and toothaches.
Fever Either. Some people find relief from acetaminophen, others from ibuprofen. If your fever is accompanied by an upset stomach, take acetaminophen. Ibuprofen may make your stomach feel worse.
Muscle aches or strains Ibuprofen/Naproxen. Its anti-inflammatory properties are better for muscle soreness and body aches that typically stem from inflammation.
Cold or sore throat Acetaminophen. A study published in the British Medical Journal shows that acetaminophen relieves the symptoms better than ibuprofen.
Pain Either. Acetaminophen is a pain reliever. Ibuprofen/Naproxen acts on inflammation, which can be the root of your pain. Take the one that provides you comfort and try the other pill if your pain persists.
Menstrual cramps Ibuprofen/Naproxen. It inhibits the production of prostaglandins, hormone-like lipids that cause your cramps. Acetaminophen only relieves the pain and doesn’t reduce your levels of prostaglandins.

In addition, although these are over-the-counter medications, they are not entirely risk-free. For instance, people who are on prescription blood thinners should not take NSAIDs such as ibuprofen. And people who have severe liver disease, in general, should not take Tylenol/acetaminophen. These are just two examples, so it’s important to talk with your physician to make sure that these medications, even though they are over-the-counter, are safe for you.

Should I worry about side effects?

Every medication has side effects. For acetaminophen, they’re minimal. Ibuprofen/Naproxen can do a number on your digestive system, causing stomach ulcers, heartburn, constipation and upset GI tract. Also, Cardiologists feel that ibuprofen/naproxen can be harmful to heart health. Check the labels for a list of potential side effects.

You may not find signs of allergic reactions on the warning labels. But those symptoms are just as important as the ones you’re trying to resolve. If you experience any of these signs after taking acetaminophen or ibuprofen, it’s cause for concern and you should get medical help right away:

  • Itching or hives
  • Wheezing or trouble breathing
  • Tightness in your chest
  • Swelling of your face, hands, lips, mouth or throat

Acetaminophen is the safer of the two drugs for adults, but in rare cases, especially in people who drink alcohol routinely, too much acetaminophen can lead to liver damage. It’s important to keep the total daily dose of acetaminophen under 2000 mg daily (unless advised by a physician) so check the labels of all products you’re taking to make sure you’re staying within the recommended dosage.

Can I give it to my kids?

As an adult, it’s easy to understand the proper dosage of acetaminophen and ibuprofen. It’s right on the side of the bottle. For children, there is no such blanket recommendation. The correct amount of medicine depends on the age and weight of your child. This information is not provided on adult bottles. Sometimes it isn’t even included with infant formula medications.

In the correct doses, acetaminophen and ibuprofen are safe for kids. Follow these dosage charts recommended by The Iowa Clinic to give your child a safe amount.

Acetaminophen Dosage Chart for Infants and Children

Do not give acetaminophen to infants under 12 weeks of age.

If your baby has a fever, you should make an appointment with your pediatrician to see what’s wrong. Once your baby is 12 weeks old, consult this chart to find the right dosage. Children can have a dose of acetaminophen every four to six hours, up to five times a day, but again, do NOT give acetaminophen to infants under 12 weeks of age. View the following chart as a PDF.

Acetaminophen Dosage Chart for Infants and Children

Ibuprofen Dosage Chart for Infants and Children

You can’t give your child ibuprofen until they’re six months old, unless it’s recommended by your pediatrician. Use acetaminophen for babies ages 12 weeks to six months. After six months, use this table to give your kid the right dosage. Children can have ibuprofen every six to eight hours as needed. View the following chart as a PDF.

Ibuprofen Dosage Chart for Infants and Children

These charts are good guides, but you should always discuss dosage and medications with your pediatrician first. A quick call to the clinic can answer all your questions, and alert your pediatrician to health issues that may require a visit.

What if acetaminophen and ibuprofen/naproxen don’t work?

Acetaminophen and ibuprofen/naproxen are short-term solutions. If you can’t shake your symptoms — or they get worse — stop taking the pills and head to the doctor. This is especially important if you’re taking these medications to manage pain. Acetaminophen and ibuprofen/naproxen do not cure the root of your pain; they merely mask it temporarily. Long-term use of both drugs can be dangerous. Taking acetaminophen regularly, in higher doses (over 2000mg daily), can cause permanent liver damage if you also drink daily. Prolonged use of ibuprofen can lead to stomach ulcers, kidney disease, heart attack and stroke.

For a quick fix, acetaminophen and ibuprofen/naproxen are go-to drugs for a reason. They are safe and effective. They are so commonplace and often interchangeable that most people aren’t sure which one to take for their health issues. When neither of the two medications cut it, visit your doctor to get to the root of the problem and find the cure for what ails you.

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