'I'm a pharmacist - is paracetamol or ibuprofen best for headaches'

A pharmacist has explained whether ibuprofen or paracetamol is best for headaches - and when people should take it. In the UK millions of both pills are taken every day around the country and both promise pain relief.

Both ibuprofen and paracetamol have analgesic (pain-reducing) and antipyretic (fever-reducing) effects. However, paracetamol is not an anti-inflammatory, whereas ibuprofen is.

But people are given warnings about when to take both. The NHS says the maximum dose of Paracetamol that a person can take in 24 hours is 4g. It advises that people take 2 x 500mg tablets of paracetamol every 4 hours to help maintain a good level of pain relief.

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With ibuprofen there are also potentially serious side effects, and medics suggest people eat just before as Ibuprofen can cause ulcers in your stomach or gut, especially if you take it by mouth for a long time or in big doses. If you need to take it for a long time your doctor may also prescribe a medicine to help protect your stomach.

Pharmacist Álvaro Fernández, known on social media as @farmaceuticofernandez, spoke on ‘Herrera en COPE’, and explained that it all depends on the type of headache. “Headache is a catch-all term for everything that happens when we feel pain from the neck up. There are many types of headaches; a tension headache is not the same as a migraine or a headache caused by a muscle strain.”

Therefore, sometimes it is more appropriate to take one medication over the other, depending on the type of pain. For example, ibuprofen is recommended for cases involving “muscle pains that cause headaches,” where it could be “useful.”

However, “there are cases where you have a fever and both paracetamol and ibuprofen are prescribed alternately,” because both have an “antipyretic” effect that reduces fever. In this case, paracetamol’s effect is greater.

“The main difference between ibuprofen and paracetamol is that ibuprofen has analgesic and anti-inflammatory effects, while paracetamol doesn’t,” he noted. For this reason, “when there are injuries, ibuprofen is usually better. In cases of fever, paracetamol is generally more indicated, but some people cannot take paracetamol, so ibuprofen is a good alternative,” he concluded.

Another issue Álvaro Fernández addressed was why we self-medicate so much and what happens if we do not respect medication dosing intervals. “Paracetamol can cause liver problems and liver damage. The same happens with ibuprofen and the kidneys.” Nonetheless, he reminds us of the safety profile of all medications sold in our country. “They are safe. Otherwise, they would no longer be authorized for sale,” he noted.

Regarding what to do if a medication has expired, he concludes by indicating that “you should take it to your pharmacy for proper disposal.” If you take an expired medication, he explains, “it’s very rare for it to become dangerous, but its efficacy is reduced.”