About Acetaminophen vs. Ibuprofen

Pain medications are not equal, nor are medicines that reduce fever. In particular, the two commonly used medicines, acetaminophen and ibuprofen, help with pain and are commonly used to treat fever. However, they belong to two separate classes of drug and have entirely different mechanisms of action and side effects. Which is safer, acetaminophen or ibuprofen?

The Facts: Acetaminophen vs. Ibuprofen

• Acetaminophen and ibuprofen are both analgesics, or pain relievers. They also reduce fever, making them antipyretics. Scientists don't know exactly how acetaminophen works to relieve pain, but it's thought to increase pain threshold. The ability of acetaminophen to reduce fever comes from its direct action on the hypothalamus in the brain. Unlike ibuprofen, acetaminophen, or paracetemol has no anti-inflammatory properties.

Risk Factors of Pain Relievers

• Ibuprofen belongs to a class of drugs called NSAIDs, or non-steroidal anti-inflammatory, also described as a COX 1 and 2 (cyclo-oxygenase) inhibitor. It has a stronger action than acetaminophen, but many people are limited because it can promote bleeding. Ibuprofen stops pain by inhibiting the release of prostaglandins (hormones) that cause inflammation and pain in the body. Endorphins, natural stress and pain relievers, are then allowed to circulate freely, assisting with pain relief.

  Concomitant use of carbamazepine, phenytoin and barbiturates have also been reported as risk factors for hepatotoxicity, or liver damage

  Risk factors to consider when taking ibuprofen include history of bleeding, use of blood thinning medications, heart disease, heart failure and ulcer disease. Kidney damage can occur from long-term use of high dose ibuprofen, and patients with kidney impairment may be at risk at much lower doses. Caution in elders is especially important. Those at risk for heart attack or stroke should also take caution when using ibuprofen. Short-term use is the best approach to minimize risk factors associated with the drug.

History of Acetaminophen and Ibuprofen

• Acetaminophen first became available in 1955 as an elixir for children, introduced by McNeil laboratories, later acquired by Johnson and Johnson in 1959, and has been a huge seller ever since.

  Charles Gerhardt discovered Tylenol in 1852. The first description is found in chemical literature as early as 1878. The drug received little attention until 1951 when researchers presented findings that acetaminophen was as effective as aspirin for reducing pain and fever, described at a New York symposium sponsored by the Institute for the Study of Analgesic and Sedative Drugs.

  Ibuprofen was discovered by Dr. Stewart Adams, John Nicholson and Colin Burrows, both colleagues of Dr. Adams, in an attempt to find a safer drug than aspirin. Work began in the 1950s, and ibuprofen was first synthesized in 1961, further developing it n 1964. Ibuprofen was introduced in the UK as a treatment for rheumatoid arthritis at lower than the presently recommended dose. In 1974, ibuprofen was delivered to patients in the United States at a dose of 1200 to 3200 mg/day.

  Ibuprofen, unlike acetaminophen, is available at a higher dose with a prescription.

Misconceptions

• Medications sold over the counter are not necessarily safe. If you're looking for pain relief or treatment of fever, you should first speak with your doctor to find out if acetaminophen or ibuprofen is right for you.

  Medications should always be taken in the recommended dose -- more is not better. Recognizing the difference in action and side effects of ibuprofen and acetaminophen can help you make better decisions regarding your health care needs.

Side Effects

• Neither medication will cause drowsiness or dependence, and in people with no health problems, they can be used in conjunction with one another to provide maximum benefit. Again, speak with your doctor about dosing, use and your personal benefits of using acetaminophen versus ibuprofen.