Ibuprofen vs Paracetamol
Short answer: Both ease mild to moderate pain and fever. Ibuprofen, an anti-inflammatory, often works better for period pain, sprains and dental pain, but can upset the stomach, kidneys and heart. Paracetamol is gentler on the body and preferred in pregnancy, but overdose can damage the liver. For many people either is fine.
Ibuprofen (Nurofen and generics)
- Non-steroidal anti-inflammatory drug (NSAID)
- Reduces pain, fever and inflammation
- Take with food; short courses where possible
- Not for everyone: see who should avoid it below
Paracetamol (Panadol and generics)
- Pain and fever reliever; not anti-inflammatory
- Few side effects at the right dose
- Preferred in pregnancy
- Overdose can cause serious liver damage
Which works better?
- Period pain: NSAIDs such as ibuprofen work well (in trials about half of women got good relief, versus 18% on placebo) and did better than paracetamol in the few trials that compared them.
- Acute low back pain: a large Australian trial found paracetamol no better than placebo for recovery time. Keeping active is the main treatment; NSAIDs give a small benefit for some.
- Knee and hip osteoarthritis: paracetamol gives only a very small benefit. Exercise, weight management and anti-inflammatory gels or tablets are usually more useful.
- Headache, toothache, sore throat and colds: both help. Ibuprofen often has an edge where there’s inflammation, such as dental pain or sprains.
- Fever in children: both lower temperature. Ibuprofen kept children fever-free a little longer in a UK trial, but treating fever is about comfort, not the number on the thermometer.
Who should check before taking ibuprofen
- A stomach ulcer or bleeding now or in the past, or reflux
- Kidney, liver or heart disease, heart failure, or a past stroke
- Asthma that gets worse with aspirin or NSAIDs
- Taking blood thinners, or blood pressure tablets (ACE inhibitors or ARBs) together with a diuretic: adding an NSAID to this pair (the “triple whammy”) can cause kidney injury
- Older age, dehydration, or vomiting and diarrhoea
- Pregnancy: avoid unless a doctor advises it, especially from 20 weeks, when NSAIDs can affect the baby’s kidneys and the fluid around it
- Babies under 3 months, and children who are dehydrated
Who should check before taking paracetamol
- Liver disease, heavy drinking, or very low body weight (a lower dose may be needed)
- Taking warfarin long term
- Babies under 1 month
- Many cold, flu and combination painkillers already contain paracetamol, so check labels to avoid doubling up
Pregnancy and breastfeeding
- Paracetamol is the preferred pain and fever reliever in pregnancy. In September 2025 the TGA said robust evidence shows no causal link between paracetamol in pregnancy and autism or ADHD. Use the lowest effective dose for the shortest time and check with your doctor or pharmacist.
- Avoid ibuprofen in pregnancy unless a doctor advises it.
- Both are commonly used while breastfeeding; ask your pharmacist.
Can you take them together?
- Yes. They work differently, so they can be taken together or alternated, and the combination can give better relief than either alone for some pain.
- Keep within the label dose for each, and write down times if you’re alternating, especially for children.
- See a doctor if you need either for more than a few days, or a child needs them for more than 48 hours.
In Australia
- Since 1 February 2025, paracetamol packs sold outside pharmacies are limited to 16 tablets, and pharmacy packs on open shelves to 50. Larger packs need a pharmacist.
- Low-dose ibuprofen is available without a prescription; stronger or long-term use should be discussed with your GP.
- Possible overdose of either? Call the Poisons Information Centre on 13 11 26 any time, or 000 if someone is unwell, even if they seem fine.
Common questions
Is ibuprofen or paracetamol better for pain?
It depends on the pain. Ibuprofen often works better for period pain, sprains and dental pain because it reduces inflammation. Paracetamol has fewer side effects and suits people who can’t take anti-inflammatories. For many headaches and colds, either is fine.
Can I take ibuprofen and paracetamol together?
Yes. They work in different ways, so most adults can take them together or alternate them, keeping within the label dose for each. Check with a pharmacist if you have other health conditions or take other medicines.
Which is better for a child’s fever?
Both work. Ibuprofen may keep a fever down a little longer, but the aim is comfort, not a normal temperature. Don’t give ibuprofen to babies under 3 months or a child who is dehydrated, and see a doctor for any fever in a baby under 3 months.
Can I take ibuprofen while pregnant?
Avoid it unless a doctor advises it, especially from 20 weeks. Paracetamol is the preferred painkiller in pregnancy.
Is paracetamol bad for your liver?
At the recommended dose, paracetamol is safe for most people. Taking too much, even over a few days, can seriously damage the liver. If you might have taken too much, call 13 11 26 (Poisons Information Centre, Australia) straight away.
Sources
- Marjoribanks J et al. NSAIDs for dysmenorrhoea. Cochrane 2015
- Williams CM et al. Efficacy of paracetamol for acute low-back pain (PACE). Lancet 2014
- Leopoldino AO et al. Paracetamol versus placebo for knee and hip osteoarthritis. Cochrane 2019
- Hay AD et al. Paracetamol plus ibuprofen for fever in children (PITCH). BMJ 2008
- Royal Children’s Hospital Melbourne: Pain relief for children
- Royal Children’s Hospital Melbourne: Fever in children
- NHS: Who can and cannot take ibuprofen
- healthdirect: Paracetamol
- FDA: Avoid NSAIDs in pregnancy at 20 weeks or later
- ANMJ: TGA confirms paracetamol safe for use in pregnancy (September 2025)
- TGA: Final decision to reduce paracetamol pack sizes
- bpacnz: The triple whammy