Ibuprofen vs Paracetamol - Which Is Better?

Ibuprofen vs ParacetamolIbuprofen and paracetamol are both common painkillers and over-the-counter medications used to relieve pain and reduce fever. Both are considered safe and effective, but they work differently in the body.

 

Ibuprofen is a non-steroidal anti-inflammatory drug (NSAID) that works by blocking the production of certain chemicals in the body that cause inflammation. It is effective in relieving pain caused by inflammation, such as pain from arthritis, menstrual cramps, or a headache.

 

Paracetamol, on the other hand, works by blocking the production of certain chemicals in the brain that transmit pain signals. It treats pain effectively caused by minor injuries, headaches, or fever.

 

We will discuss how ibuprofen and paracetamol work, and which you should be taking for specific conditions.

Ibuprofen

ibuprofen_dosageIbuprofen is a commonly available over-the-counter medication, and is available under a number of brand names, such as Brufen, Nurofen, Advil and Motrin. It comes in both syrup (for children and infants) and in tablet form. It is used mainly to treat fever (including COVID-related fever), mild to moderate pain,  menstrual pain, pain from arthritis, dental pain, headaches, and pain from kidney stones.

 

NSAIDs such as ibuprofen work by inhibiting the cyclooxygenase (COX) enzymes, which convert a chemical substance in the body called arachidonic acid to prostaglandins. Prostaglandins are hormone-like substances that affect several bodily functions, including inflammation, pain and uterine contractions. There are two COX enzymes, namely COX-1 and COX-2. Ibuprofen is a nonselective COX inhibitor, meaning that it inhibits both COX-1 and COX-2. Cox-Inhibition

 

Ibuprofen works by blocking COX-2, decreasing the synthesis of prostaglandins involved in mediating inflammation, pain, fever, and swelling. It also reduces fever by acting on a part of the brain called the hypothalamus, which in turn increases blood flow to the peripheral parts of the body and help dissipate heat. However, as ibuprofen is a nonselective COX inhibitor, the inhibition of COX-1 results in unwanted effects on the stomach, intestines and kidneys. There are newer medications on the market which are COX-2 specific inhibitors, reducing the risk of affecting the stomach, intestines and kidneys.

 

Side Effects Of Ibuprofen

Some side effects of ibuprofen include: nausea, stomach upset, diarrhea, constipation, stomach ulceration/bleeding, headache, dizziness, rash, fluid retention, and high blood pressure. In rare cases, ulcers of the food pipe, heart failure,  and kidney impairment may occur. Ibuprofen can potentially exacerbate asthma, sometimes fatally. Drinking alcohol when taking ibuprofen may increase the risk of stomach bleeding.

Paracetamol

panadol_dosageParacetamol is an over-the-counter medication used for pain relief and to reduce fever. It is also known as acetaminophen and is available under a number of brand names, such as Panadol and Tylenol. It is one of the most widely used pain relievers in the world.

 

It works by blocking the production of certain chemicals in the body that cause pain and inflammation. It is available in both syrup form (for children and adults) and tablet form. It is typically used to reduce fever and also used to treat mild to moderate pain, such as headaches, toothaches, menstrual cramps, and muscle aches. 

 

How paracetamol works is fairly similar to classical NSAIDs such as ibuprofen, that act by inhibiting COX-1 and COX-2 enzymes; and especially similar to selective COX-2 inhibitors. Paracetamol inhibits prostaglandin synthesis by reducing the active form of COX-1 and COX-2 enzymes, reducing pain and inflammation. However, it is important to note that paracetamol does not have anti-inflammatory effects like ibuprofen; it only reduces pain and fever. The anti-inflammatory action of paracetamol (via COX inhibition) has also been found to primarily target the brain and not other areas of the body, explaining the lack of side effects associated with conventional NSAIDs such as gastric bleeding.

 

Paracetamol also reduces fever by blocking the production of prostaglandins in the hypothalamus, a part of the brain that regulates body temperature. Prostaglandins are chemicals that can cause inflammation, and when produced in the hypothalamus, they can cause an increase in body temperature, resulting in fever. As discussed above, when paracetamol is taken, it blocks the action of an enzyme called cyclooxygenase (COX) in the hypothalamus, which is responsible for producing prostaglandins. By blocking this enzyme, paracetamol reduces the amount of prostaglandins produced, which in turn reduces the fever.

 

It is important to note that paracetamol does not lower the core body temperature directly, it works by reducing the hypothalamus set point temperature, which is the temperature the brain wants the body to be. The body will then work to reduce the temperature by sweating, and moving blood to the extremities to lose heat.

 

It is also worth noting that fever is a natural response of the body to fight off infections and other illnesses, and in most cases, it’s not necessary to lower the fever, but if the fever becomes too high it can cause discomfort, or in some cases can be dangerous, that’s when taking paracetamol can help alleviate the symptoms.

 

Side Effects Of Paracetamol

Paracetamol may rarely cause allergic reactions; and symptoms may include one or more of the following:

  • Swollen face, eyes, lips or tongue
  • Difficulty in breathing
  • Skin rashes

Patients who overdose on Paracetamol may have an increased risk of liver problems. Signs of potential liver damage include:

  • Nausea, sudden weight loss and appetite loss
  • A yellow coloration of the eyes and skin
  • Unexplained bruising of the skin or bleeding from the mouth, gums or nose

Frequently Asked Questions

Ibuprofen is a non-steroidal anti-inflammatory drug (NSAID) that is used to relieve pain, reduce fever, and decrease inflammation. It is used to treat a wide range of conditions, including:

 

  • Mild to moderate pain, such as headaches, menstrual cramps, toothaches, and muscle aches
  • Inflammatory conditions, such as arthritis, and ankylosing spondylitis
  • Pain and inflammation associated with colds and flu
  • Musculoskeletal pain and inflammation caused by strains, sprains and sports injuries
  • Postoperative pain and dental pain

It is available over-the-counter and by prescription. It is generally considered safe when taken as directed, but it can cause side effects such as stomach upset, heartburn, and an increased risk of bleeding. It is not recommended to take ibuprofen with other NSAIDs or with blood thinning medications. It is also important to follow the dosage instructions on the package and not to exceed the recommended maximum daily dose.

Paracetamol is typically used to relieve mild to moderate pain, such as headaches, toothaches, menstrual cramps, muscle aches, and the pain associated with colds and flu. It can also be used to reduce fever. It is available over-the-counter and is generally considered safe when taken as directed. However, it is important to follow the recommended dose and dosage instructions on the package and not to exceed the recommended daily maximum. Additionally, you should avoid taking it with other medications that contain paracetamol, as this can increase your risk of liver or kidney problems.

Ibuprofen may be more useful in the following circumstances vs paracetamol:

  • In reducing fever
  • In inflammatory conditions such as arthritis; as well as muscle strains, sprains and sports injuries 
  • For menstrual pain

Syrup (100mg/5mls)brufen_dosage

 

Please refer to the calculators in the references section for a quicker way to calculate the correct dose.

 

Tablets

For adults, a single 200 mg dose 4-6 hourly, maximum 400 mg per dose, as necessary. Max: 1,200 mg daily. The lowest effective dose for the shortest period of time is recommended. Ibuprofen (syrup/tablet) is recommended to be taken after meals and not on an empty stomach. 

 

Dosing recommendations may vary among individual products and between countries. Always check with your doctor regarding indications and dosages before starting ibuprofen. The medication should always be kept out of reach of children.

Syrup

paracetamol_dosage

 

Please refer to the calculators in the references section for a quicker way to calculate the correct dose.

 

Tablets

For adults, 500mg-1000mg 3-4x / day, not to exceed 4000mg over 24 hours.  

 

The lowest effective dose for the shortest period of time is recommended. Dosing recommendations may vary among individual products and between countries. Always check indications and dosages with your local medical professional before starting paracetamol. The medication should always be kept out of reach of children.

References:

Ibuprofen Dose Calculator | Health Navigator NZ

Paracetamol Dose Calculator | Health Navigator NZ

 

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