Acetaminophen and Ibuprofen: Things You Should Know

The medications acetaminophen (Tylenol) and ibuprofen (Motrin, Advil) are available over the counter for many years.

But what are the differences between these two medications?

The majority of people use these drugs interchangeably without knowing about their appropriate indications and possible side effects.

I’ve decided to write this article to help clarify several matters that are important to know before using any of the above medications.

 

First let’s put all the cards on the table.

 

OTC meds have also side effects

Both of these medications are available over the counter. However, it doesn’t mean that they are free of any side effects. Acetaminophen and ibuprofen have several side effects and interactions with other commonly used prescription and over the counter drugs and supplements.

 

Let us talk about the most important distinguishing factors between acetaminophen and ibuprofen.

Acetaminophen helps reduce pain and fever

Acetaminophen can reduce pain and fever and is commonly known as paracetamol in other countries.

This drug is popular because of its friendliness to the stomach. It causes less stomach irritation and bleeding. Many organizations such as the American College of Rheumatology have suggested taking acetaminophen as their first choice for arthritic pain especially in elderly patients.

Ibuprofen helps the pain, fever and inflammation

Ibuprofen belongs to the group of medications called non-steroidal anti-inflammatory drugs (NSAIDs).

These medications can help with reducing pain, fever and most importantly inflammation. One of the most commonly known medications in NSAID group is aspirin that has many additional usage and indications because of its properties. Aspirin and naproxen are longer acting NSAID s and ibuprofen a shorter-acting one.

When should you use ibuprofen rather than acetaminophen?

Clearly, it’s important that you primarily consult your doctor about the right treatment for your specific condition.  As you already know, I sincerely believe in individualized medicine.

In my opinion each person’s needs and tolerance are different than others. However, in general, if the treatment goal is to manage inflammation then ibuprofen will be the first choice (considering that the patient doesn’t have any bleeding, stomach problems, kidney failure and allergies to ibuprofen).

Otherwise, either of the above medications could help in managing fever and mild to moderate pain.  Long-term and frequent consumption of any of these medications may result in serious side-effects, therefore the frequency and duration of treatment should be kept as limited as possible.

 

Not commonly known side effects of acetaminophen and ibuprofen

There are well known side effects of these medications that are widely known and emphasized, such as liver damage through high dosage of acetaminophen and bleeding and stomach discomfort by ibuprofen.

However there are common and serious side effects of acetaminophen and ibuprofen that are not well known to the public as well as by a large number of health care professionals and physicians. Therefore, these common side effects are usually misdiagnosed and ignored.

I list some of serious and common side effects of using these two medications in the following tables.

Less well known but serious side effects of Ibuprofen

Edema (swelling)

Dizziness

Elevated risk of heart attack

Rash and itching

Elevated blood pressure

Tinnitus

Kidney failure

 

Less well known but serious side effects of Acetaminophen

Rash

May increase sugar

May increase uric acid

Kidney damage

Headache

Lowers potassium and magnesium

Constipation and diarrhea

Nausea and vomiting

 

Last but not least, I would like to underline the following often ignored and overlooked side effects of both medications.

Acetaminophen and Ibuprofen can increase blood pressure

A not widely known side effect of acetaminophen and ibuprofen are their ability to increase blood pressure.

The primary management in this population (individuals with border line hypertension) should start with reducing or eliminating the amount of consumed acetaminophen and ibuprofen rather than starting them on a new blood pressure medication.

It is to mention that these side effects of these two medications are dose dependent. It usually means that if you take more of them, the chances of having problems increases.

 

Reference

1. Dedier J, Stampfer MJ, Hankinson SE, Willett WC, Speizer FE, Curhan GC. Nonnarcotic analgesic use and the risk of hypertension in US women.Hypertension. 2002; 40: 604–608; discussion 601–603.
2.  Nonsteroidal antiinflammatory drugs, acetaminophen, and the risk of cardiovascular events. Circulation. 2006 Mar 28;113(12):1578-87. Epub 2006 Mar 13.