Should you take acetaminophen, ibuprofen or aspirin?

If you’ve ever had a headache, muscle pain or a common cold, you’ve likely found yourself staring at three bottles in the medicine cabinet: ibuprofen, acetaminophen and aspirin. All three say “pain reliever” and “fever reducer,” so which one do you choose?

“When it comes to over-the-counter pain relief, choosing the right medication isn’t one-size-fits-all,” says Ali Zanial, Sharp Grossmont Hospital’s director of pharmacy. “Understanding how these medications work, and how they interact with your body, is key to safely and effectively managing everyday aches and pains.”

Acetaminophen

Acetaminophen, commonly known as Tylenol, is effective for relieving headaches and reducing fevers. It works by blocking pain signals in the nervous system. It’s important to note that acetaminophen does not reduce inflammation.

“Ultimately, acetaminophen is a safe, gentle choice, especially if anti-inflammatory effects are not needed,” says Denia Pondexter, lead advanced practice provider at Sharp Grossmont Hospital Express Care. “It’s gentle on the stomach, but proper dosing is essential.”

If you experience any of these side effects, please stop taking acetaminophen immediately or get emergency medical attention:

• Red, peeling or blistering skin

• Rashes

• Hives

• Itching

• Swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles or lower legs

• Hoarseness, or difficulty breathing or swallowing

Acetaminophen is processed by the liver, so do not use it if you have liver problems or if you drink multiple alcoholic beverages a day. Be cautious before taking acetaminophen or any over-the-counter pain relievers if you are taking cold medicines or other prescription pain medicines.

“Acetaminophen is in more than 600 over-the-counter and prescription medications, so it can be easy to take too much if you take multiple medications,” says Rachael Doebel, Sharp Grossmont Hospital’s medication safety pharmacist. “Check ingredients on any medication you take and note that acetaminophen could be listed as APAP, acetaminoph, acetaminop, acetamin or acetam.”

Ibuprofen

Ibuprofen, commonly known by the brand names Advil or Motrin, helps reduce fever and relieve pain or inflammation caused by headaches, muscle aches, toothaches, back pain, arthritis, menstrual cramps, joint pain and the common cold.

As a nonsteroidal anti-inflammatory drug (NSAID), ibuprofen works by blocking enzymes that produce substances that cause inflammation, pain and fever. This can also make the lining of the gut vulnerable to stomach acid, so it is recommended that it be taken with food.

NSAIDs, like ibuprofen, can increase the risk of stomach bleeding, especially for people over 60, with a history of ulcers or bleeding problems, taking blood thinners or steroids, or who consume three or more alcoholic drinks a day. It is also not recommended for people with kidney disease or who have had weight loss surgeries.

Overall, ibuprofen offers reliable pain and inflammation relief, but stop taking ibuprofen and seek medical help immediately if you experience:

• Hives

• Facial swelling

• Asthma (wheezing)

• Shock

• Skin reddening

• Rashes or blisters

Aspirin

Aspirin, commonly found in products with the brand names Bayer, Bufferin and Excedrin, is a pain reliever for everyday aches and pains. It can also help reduce fevers and relieve symptoms of colds and flu.

Aspirin is most effective for reducing inflammation, such as swelling and redness, and for relieving mild to moderate pain, including muscle aches, joint pain, toothaches and headaches. Taken in low doses, it can also help prevent blood clots, reducing the risk of heart attacks and certain types of strokes.

Those under 18 should not take aspirin. And like ibuprofen, aspirin is an NSAID, so individuals taking blood thinners; with heart or stomach issues; or with a history of stomach ulcers, gastroesophageal reflux disease (GERD) or bleeding disorders should avoid using it.

Stop taking aspirin and seek medical attention immediately if you experience:

• Coughing up blood or blood in your urine, stool or vomit

• Yellowing of the whites of your eyes

• Dark urine

• Swelling in your hands or feet

What’s best for you

Choosing between acetaminophen, ibuprofen and aspirin comes down to your specific needs and health considerations.

Both aspirin and ibuprofen reduce inflammation and pain, but aspirin is often used for heart health or occasional use due to stomach irritation. Ibuprofen is better for general aches and swelling, while acetaminophen is gentler on the stomach and ideal for pain or fever when inflammation is not the main issue.

No matter which one you take, it’s important to follow the correct dosing guidelines and always consult your doctor before starting any new medication.

Get the latest health and wellness news, trends and patient stories from Sharp Health News and subscribe to our weekly newsletter by clicking the "Sign up" link below.