May 15, 2018

Ibuprofen vs. Acetaminophen – Which OTC Pain Reliever Should You Choose?

By Ben Lamm, Pharmacist

We’ve all heard warnings about acetaminophen’s impact on your liver, or how ibuprofen can lead to ulcers. So which one is truly your best option if you need relief from a headache, or joint or muscle pain?

Both are fine, as long as…

Either acetaminophen or ibuprofen are reasonably safe options, as long as you stay within the recommended dosage on the labels. Also, both of these over-the-counter options are equally effective, assuming you’re using them for short-term pain relief.

However, when your pain lasts long enough that you need a second dose, there are small studies suggesting in either direction as to whether alternating one and then the other is more effective.

Cautions and concerns

There are some cautions and dose limitations for both drugs. Concerns about overdosing have caused the FDA to reduce the maximum daily dose of acetaminophen from 4,000 mg/day (equal to 8 extra-strength doses) to 3,000 mg/day (6 extra-strength doses). This is to reduce the risk of acute liver failure.

For ibuprofen, the maximum dose is 6 tablets in 24 hours for a healthy adult that is not taking any blood thinners. Because of possible stomach irritation, ibuprofen should be taken with food or milk and should be avoided altogether if you have an active GI tract ulceration.

When you have a surgery, there is a suggestion in studies that ibuprofen may be more effective than acetaminophen as a premedication for tooth extraction, migraine or earache.

Is one quicker than the other?

The goal of any over-the-counter pain medication is to achieve analgesia – which simply means relief of your pain. For ibuprofen, analgesia typically takes effect within 30 to 60 minutes. With acetaminophen, you can expect to feel the effects in as little as 11 minutes.

The bottom line

When in need of pain relief, either of these over-the-counter choices are safe for short-term use if you are an otherwise healthy adult and you follow the recommendations for usage. However, if you’re ever in doubt, you should contact your pharmacist to discuss your best option based on your specific scenario. I know I always welcome calls from our patients. Whether the question is about prescriptions or over-the-counter products, your pharmacist has answers and will help you decide when it comes to medications.


Ben Lamm, PharmD, practices at the Mission Pharmacy – Lake Toxaway, a service of Transylvania Regional Hospital & Mission Health.

For questions, call the Mission Pharmacy – Lake Toxaway at (828) 883-5473 or visit mission-health.org/pharmacy to learn more.