Experts on when to take paracetamol and ibuprofen and whether you can take both

Paracetamol can have serious side effects if taken too often
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Paracetamol and ibuprofen can help to ease aches and pains when taken correctly - however many people are unsure about which would work better and when and whether you should double up and take both.

Both of these common over-the-counter medications are painkillers, taking away symptoms of pain. But they have different mechanisms of action, different drug interractions to be aware of, and are broken down differently, experts explain.

Doctors at the London Clinic have looked at the way both of the common over-the-counter medications work and given their advice on which is better to help with everything from arthritis and join pain through to headaches and high temperatures, WalesOnline reports. This is what they say:


Paracetamol - otherwise known as acetaminophen - is a mild painkiller but it also reduces fevers. It should be used to reduce pain caused by toothache, headaches, joint and muscle pain - such as mild arthritis pain.

Paracetamol does not need to be taken after food and can usually be safely taken with other medications. It is possible to take paracetamol and ibuprofen at the same time, as they work in the body in different ways.

It is available in a variety of forms but is most commonly taken as a 500mg capsule or 500mg tablet. However it can be taken as a liquid for children and can even be given intravenously in hospitals. It is safe for children to take paracetamol at the appropriate dose for children.

Can it be taken in pregnancy?

It can also be taken for pain relief in pregnancy as there is no evidence to suggest that paracetamol is harmful to take during pregnancy. It's also safe for breastfeeding mothers to take paracetamol.

When not to take paracetamol

However if you suffer from liver or kidney problems it is important to consult your doctor before taking paracetamol, since paracetamol is predominantly broken down by the liver.

There are also a number of drugs that if you are taking then you should avoid taking paracetamol as well:

  • Carbamazepine

    • Treatment for epilepsy and nerve pain

  • Warfarin

    • Blood thinner

  • Phenytoin

    • Anti-epileptic medication


  • Common treatment for heartburn, nausea and vomiting

Paracetamol side-effects

Side effects a result of taking paracetamol are rare but the most common are:

  • Allergic reactions, these can cause swelling and a rash

  • Blood disorders

  • Heart irregularities – low blood pressure (this happens most commonly when paracetamol is given intravenously)

Paracetamol overdose

Overdose of paracetamol is potentially very harmful, and anyone who thinks they may have taken too much paracetamol should seek urgent medical attention. Since paracetamol is mainly broken down by the liver, overdose can lead to acute liver damage.

When taking cold remedies, it's important to be aware that these commonly contain paracetamol too. Taking both cold treatments and extra paracetamol tablets for example should be avoided, to prevent the risk of accidental overdose.


Ibuprofen is used in a very similar way to paracetamol as it treats pain but can also be used to treat fever. However the chief difference is that is reduces inflammation.

Ibuprofen is a non-steroidal anti-inflammatory drug. In the body. Inflammation happens for a variety of reasons such as a sign of infection or the body's response to damage.

Although the pain-reducing effect will happen quickly, the anti-inflammatory effect can take weeks to work optimally. It is available in a number of different forms: capsules, tablets, sprays, gels and creams.

Ibuprofen gel is a popular remedy to back pain and muscle pains, as it gives effective, local pain relief.

Who can take ibuprofen?

Unlike paracetamol not everyone can take ibuprofen. Avoid taking it completely if you are:

  • Allergic (hypersensitive) to other non-steroidal anti-inflammatory drugs (NSAIDs)

  • Have a stomach ulcer

  • Suffer from heart failure

  • Are a liver disease patient

People with the following conditions may take ibuprofen, but must to be cautious:

  • Kidney problems or liver problems

  • Systemic Lupus Erythematosus (SLE) patients

  • Ulcerative colitis

  • Asthma

  • High blood pressure (hypertension)

  • If you have suffered a stroke previously

Ibuprofen can interact unpredictably with drugs therefore it is very important that before taking ibuprofen you check that the other medications that you may be taking do not have any interaction.

Can it be taken in pregnancy?

Pregnant women should always take advice from a doctor before taking any medications. During pregnancy, paracetamol is generally a more appropriate painkiller.

Ibuprofen should be completely avoided in the third trimester of pregnancy, as it can affect the foetal heart.

Ibuprofen side effects

Ibuprofen has a larger number of side effects than paracetamol. These include:

  • Nausea

  • Bowel habit alterations

  • Abdominal pain

  • Headache

  • Raised blood pressure

  • Gastritis