Paracetamol (called acetaminophen in the US and Canada) relieves pain and fever and is gentle on the stomach, but too much can damage the liver. Ibuprofen relieves pain and fever and also reduces inflammation, so it may work better for sprains, period pain and dental pain, but it can irritate the stomach and affect the kidneys and heart. For most healthy adults, either is suitable for short-term use when taken as directed on the label.
Side-by-side comparison
| Paracetamol / acetaminophen | Ibuprofen (an NSAID) | |
|---|---|---|
| Pain | Yes | Yes |
| Fever | Yes | Yes |
| Inflammation | No | Yes |
| Stomach | Gentle | Can cause indigestion, ulcers, bleeding |
| Main risk | Liver damage in overdose or with heavy alcohol use | Stomach bleeding, kidney problems, raised blood pressure, heart risk |
| Pregnancy | Usually preferred (short-term, as advised) | Generally avoided, especially from 20 weeks, unless prescribed |
| Take with food? | Not required | Yes, with or after food |
When paracetamol may be better
- Headache, fever, mild to moderate pain
- People with stomach ulcers, kidney disease, heart failure or asthma triggered by NSAIDs
- Older adults
- Pregnancy (follow your midwife or healthcare provider’s advice)
When ibuprofen may be better
- Sprains, strains and muscle pain
- Period pain
- Dental pain
- Pain with obvious swelling
Who should avoid or ask first before ibuprofen
- History of stomach ulcers or bleeding
- Kidney disease, heart failure, uncontrolled high blood pressure
- Taking blood thinners, steroids, some blood pressure medicines or lithium
- Asthma that worsens with aspirin or NSAIDs
- Dehydration (e.g. vomiting, diarrhoea)
Paracetamol safety
- Never exceed the maximum daily dose on the label
- Check combination products: many cold and flu remedies already contain paracetamol
- Take extra care with heavy alcohol use, low body weight or liver disease
- Paracetamol overdose may cause no early symptoms; seek urgent help even if you feel well
Can you take them together?
Many adults can take both for short periods, because they work differently, either together or alternating, following the label for each. Ask a healthcare provider if unsure, and don’t use this approach routinely for children without professional advice.
Frequently asked questions
Which is stronger?
Neither is simply “stronger”. For inflammatory pain ibuprofen often works better; for many other pains they’re similar.
Can I take ibuprofen on an empty stomach?
It’s better taken with food to reduce stomach irritation.
Related reading: Peptic ulcer and NSAIDs · Migraine vs tension headache
Updated 5 November 2026. Always follow the product label and ask a healthcare provider for advice, especially for children, pregnancy or long-term conditions.
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