Woman at the pharmacy

When you have pain, whether chronic or temporary, it can interfere with your daily life. You want to find relief as quickly and safely as you can and get back to feeling great! But which over-the-counter (OTC) pain reliever is right for you and your pain?

Choosing OTC medications can be confusing. If you’ve narrowed it down to acetaminophen or an NSAID like ibuprofen, two of the most common medicines on the shelves, this article can help you determine which one you should take.

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What’s the Difference Between Ibuprofen and Acetaminophen?

Ibuprofen belongs to a class of drugs called NSAIDs, according to the American Academy of Family Physicians (AAFP). (What are NSAID drugs? See below.) Ibuprofen helps reduce pain from arthritis, menstrual cramps, inflammation, headaches, and muscle aches. It’s known by the brand names Advil and Motrin.

Acetaminophen is in a category of its own and is not typically used for inflammation. It’s not an NSAID, but it still helps alleviate pain. Known by one of its brand names, Tylenol, it helps reduce fevers, relieve headaches and other minor pains, and soothe pain from arthritis.

What Are NSAID Drugs and When Should You Take Them?

NSAIDs, as the American College of Rheumatology explains, are non-steroidal anti-inflammatory drugs. They block a hormone-like substance in your body that sends pain messages to your brain. NSAIDs come in many different strengths and can be prescribed by a doctor or purchased over the counter. Prescription-strength NSAIDs, including ibuprofen, are often taken for chronic pain conditions like osteoarthritis, rheumatoid arthritis, and lupus.

OTC ibuprofen and other NSAIDs are taken for:

  • Minor aches and pains (headaches)
  • Menstrual cramps
  • Muscle aches (like after exercise)

These drugs soothe inflammation, so they’re a good choice if you have a muscle or joint sprain, strain, or swelling.

You shouldn’t take NSAID drugs if you:

  • Have more than three alcoholic drinks per day
  • Are allergic to aspirin or other pain medicine
  • Take blood-thinners
  • Have a bleeding disorder or have had stomach bleeding problems/ulcers
  • Have liver, kidney, or heart disease

When Should You Take Acetaminophen?

According to the National Institutes of Health (NIH), acetaminophen has many of the same uses as NSAID pain relievers, but it’s not an anti-inflammatory drug. That means it isn’t as effective as ibuprofen at reducing swelling or inflammation, like from a sprained joint or a muscle ache. However, acetaminophen does help reduce fevers, and, like NSAIDs, it relieves minor aches and pains.

As with NSAIDs, a doctor can prescribe acetaminophen at a higher strength to treat chronic arthritis or other serious pain.

You shouldn’t take acetaminophen if you:

  • Have severe liver or kidney disease
  • Are already taking a medicine containing acetaminophen
  • Have more than three alcoholic drinks per day

What Are the Risks of Taking Ibuprofen and Acetaminophen?

Both types of drugs can have serious side effects if taken incorrectly. Talk to your doctor before starting any new medication, and do not give OTC pain medication to a child without a doctor’s advice. “Taking NSAID medication like ibuprofen every day, long-term can cause worsening acid reflux or even stomach ulcers. Make sure to take NSAID medications with food,” says Shane Eikenberry, MD, Greater Pittsburgh Medical Associates-UPMC.

The NIH warns against taking more than one type of pain medication at the same time without a doctor’s approval; this warning applies to acetaminophen and ibuprofen. Also, do not mix prescription pain medications with OTC pain medicine of any kind. Doing so could cause harmful side effects.

According to the AAFP, the risks of taking ibuprofen include:

  • Upset stomach
  • Stomach bleeding
  • Kidney damage
  • Harmful changes in blood pressure

Taking acetaminophen may put you at risk for liver damage or disease. You should not take more than 4,000 milligrams of acetaminophen per day.

If you have questions about pain medications, contact a UPMC primary care doctor at 1-855-676-8762. The UPMC Pain Management Center can also help you manage chronic pain conditions.

About Primary Care

A bond between doctor and patient can be extremely valuable, and that’s what you get with UPMC Primary Care. When you work with a primary care physician (PCP), you develop a lasting relationship. Your doctor will get to know you and your history and can plan your treatments accordingly. Our PCPs offer a variety of services, including preventive care and treatment for both urgent and chronic conditions. We also operate primary care walk-in centers where you can get treatment without an appointment.