What's the difference between ibuprofen and acetaminophen?

Dr. Darria Gillespie, MD
Emergency Medicine Specialist

These are two totally different families of medicines that work in different ways. They each have their pros and cons.

Ibuprofen (Advil/Motrin) is part of a class of medications called Non-Steroidal Anti-Inflammatory medications. Not surprisingly, they reduce inflammation.

  • Benefit: NSAIDs are great for any pain or swelling, especially due to trauma (such as a fracture or tear), a sprain, or arthritis.
  • Negative: It can irritate the lining of your gut, could damage your kidneys and may increase your risk of bleeding. Also, the FDA recently strengthened an existing warning on prescription and over-the-counter NSAIDs for a small but significant increased risk of heart attack or stroke.  Of course, women who are pregnant should speak with their doctor before taking NSAIDs.

Acetaminophen (Tylenol)

  • Benefit: Acetaminophen is helpful for relieving all kinds of pain and fever, although it doesn’t reduce swelling and inflammation the same targeted way that ibuprofen does.
  • Negative: As is the case with all medications, Acetaminophen has its own side effects, most notably that taking too much can damage your liver.

Unfortunately, no medication is without side effects, but when taken as prescribed, both of these will be safe for the majority of people.

For me, if I have an injury or strain to a muscle or bone, I take ibuprofen. If I have a headache, sinus pressure or fever from an illness such as the flu, I usually stick to acetaminophen. No matter what you take, try to always take the lowest effective dose, and never take more than the amount advised on the box.

Stacy Wiegman, PharmD
Pharmacy Specialist

Ibuprofen and acetaminophen differ in how they work to treat fever, inflammation and pain. Ibuprofen is an NSAID (non-steroidal anti-inflammatory drug) that prevents the body and the brain from producing a hormone-like chemical called prostaglandin. Prostaglandin in the brain is involved in producing fever and prostaglandin in the body is involved in tissue inflammation and the pain that it triggers. Therefore, ibuprofen can reduce fever, pain and inflammation. Acetaminophen is an analgesic (painkiller) and antipyretic (fever reducer) that works in the brain by a mechanism that is not certain. It appears to increase the pain threshold which is the amount of pain it takes for the brain to perceive the pain. It inhibits prostaglandin in the brain only where it is involved in producing fever. Therefore, acetaminophen can reduce fever and pain, but not inflammation.


The difference between ibuprofen and acetaminophen is the former can be used as an anti-inflammatory, in addition to pain relief.

To know the differences between acetaminophen (Tylenol) and ibuprofen (Advil), it's helpful to understand their pros and cons.


  • Pros: Acetaminophen is easier on the stomach than ibuprofen. It's better for minor headaches and has fewer side effects. Also, taking it for a long time doesn’t put you at risk for heart attacks. Using nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen does.
  • Cons: Too much acetaminophen can lead to liver problems. Also, a big worry is the hidden risk of getting more of this medication than you think you are taking.


  • Pros: It works to reduce pain and lower a fever. Unlike acetaminophen, it is an NSAID, so it helps ease inflammation. Ibuprofen is good for treating headaches, toothaches, back pain, arthritis, menstrual cramps or minor injuries. It is not a narcotic, so you won't get addicted to it.
  • Cons: Taking a lot of ibuprofen at once or using it regularly for a long time increases your risk of heart disease, ulcers or gastrointestinal bleeding. NSAIDs also can hurt your kidneys or cause blood pressure problems. The good news is occasional use doesn’t cause these problems. If you’re a regular user, don’t stop cold turkey. Talk to your healthcare provider if you’re concerned or have questions. If you’re having side effects, your doctor may prescribe medicines called proton pump inhibitor (like Nexium or Prilosec) to help.

This content originally appeared on

Continue Learning about Nonsteroidal Anti-inflammatory Drugs

An Alarming Side Effect of NSAIDs: Ovulation Stops
An Alarming Side Effect of NSAIDs: Ovulation Stops
According to research revealed at the 2015 European League Against Rheumatism Annual Congress meeting, many women stop ovulating after taking standard...
Read More
How can I prevent side effects from NSAIDs?
Here are some ways you can lower your risk of developing side effects from nonsteroidal anti-inflamm...
More Answers
Can NSAIDs cause erectile dysfunction?
Dr. Mehmet Oz, MDDr. Mehmet Oz, MD
Men who use NSAIDs, which includes the common over-the-counter painkiller ibuprofen, on a regula...
More Answers
Are Steroid Injections for Back Pain Safe?
Are Steroid Injections for Back Pain Safe?

Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.