Which Painkiller: Ibuprofen vs Acetaminophen

 It’s a time-honored moment of head scratching in the pharmacy aisle — what over-the-counter (OTC) painkiller should I get?

Despite the litany of different brand names and packages, there are basically two major types of OTC painkillers: acetaminophen, as found in a bottle of Tylenol or Excedrin; and non-steroidal anti-inflammatory drugs (NSAIDs), a broad class that contains ibuprofen (Advil), naproxen (Aleve), and aspirin.

For the purposes of this article, we’ll be looking at acetaminophen and ibuprofen. Though the two might seem interchangeable, it turns out there’s a lot more difference between them than we’re commonly led to believe.

Painkilling 101

Of the four major painkillers, acetaminophen (paracetamol, if you live overseas) is the second oldest remaining in modern medicine’s toolbox, right after aspirin.

First discovered in the late 19th century, it wasn’t until the 1950s that acetaminophen gained wider acceptance as a safe medication used to relieve pain and reduce fever, after which it was soon marketed as Tylenol. By 1959, it became available OTC in the United States. Despite the late start, acetaminophen is now the widely used painkiller in the world, both via prescription and OTC.